Who cares about triglycerides?

Walter's triglycerides were 231 mg. His LDL cholesterol was "favorable" at 111 mg, HDL likewise at 49 mg.

"Everything looks good," his doctor declared.

"Do you think the triglycerides are okay, too?" Walter asked.

"Well, the guidelines do say that triglycerides should be less than 150, but I believe you're close enough. Anyway, triglycerides don't really cause heart disease."


When I met Walter, I made several comments. First of all, in light of his heart scan score of 713, none of his numbers--HDL, LDL, or triglycerides-- were acceptable. But the triglycerides were glaringly and terribly too high.

Why? What exactly are triglycerides?

Triglycerides are a basic fat particle that, though they do not cause heart disease directly, trigger the formation of an array of abnormal lipoprotein particles in the blood that are among the most potent causes of heart disease known.

These abnormal lipoprotein particles include small LDL, VLDL, and IDL (intermediate-density lipoprotein--a really bad pattern). Excess triglycerides also cause HDL to drop. They also cause a distortion of HDL structure, causing the particles to become abnormally small. Small HDL is also useless HDL, unable to provide the protection that HDL is designed to do.

So Walter's elevated triglycerides are, in reality, a substantial red flag for an entire panel of abnormal particles that contribute to the growth of his coronary plaque.

So, if you get this kind of commentary on your triglycerides, ask for another opinion. (Track Your Plaque Members: Also see Triglycerides: Mother of meddlesome particles at http://www.cureality.com/library/fl_dp002triglycerides.asp.)
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Unique vitamin D observations

Unique vitamin D observations

It seems not a single day passes that I don’t learn something new about this unique hormone (mis)named “vitamin D.”

From its humble beginnings recognized only as the factor responsible for bone maturation (with deficiency leading to childhood rickets), vitamin D now commands a recognized role in almost every conceivable aspect of health and disease.

Among the unique observations I’ve made over the past several years, having corrected vitamin D in well over 1000 people:

--Ankylosing spondylitis—This fairly rare genetic disease programs a peculiar solidification of the spinal column that leads to disabling restriction of spinal mobility, accompanied by incapacitating pain. A physician came to my office after reading my Life Extension summary of vitamin D’s cardiovascular benefits, After reading it, he put himself on vitamin D 10,000 units per day and verified “therapeutic” levels with a blood test. He came to my office (he requested a consultation) and proudly showed me his near-normal spine flexibility that, until approximately 2 months earlier, had left him rigid and unable to even tie his shoes. He also reported that the chronic pain that had left him completely dependent on anti-inflammatory agents and narcotics was nearly entirely gone.

--Aortic valve disease—The list of people with either aortic valve stenosis (stiffness) or insufficiency (leakiness) that develops later in life (not congenitally deformed or bicuspid aortic valves) continues to grow. Not everyone responds, but some of the cases I’ve seen have been nothing short of miraculous. One man had severe aortic valve insufficiency (severe leakiness). After one year of vitamin D, 8000 units per day that yielded a blood level of 67 ng/ml, the insufficiency was down to a minimal level. Before vitamin D, I had never witnessed “spontaneous” reversal of aortic valve disease before.

--Chest pain—Not the chest pain of heart disease, but a chronic gnawing, toothache-like pain in the sternum that is relieved within days of initiating vitamin D. I don’t know precisely why this happens, but I speculate that, with vitamin D deficiency, there is disordered calcium metabolism, and perhaps the sternal pain represents cellular (osteoclastic) activity that is eroding sternal calcium for the purpose of maintaining blood calcium, since intestinal absorption of calcium is poor. Replace vitamin D and the abnormal calcium uptake ceases. Just my guess.

--Relief from claustrophobia—This one has me stumped. But one man’s vivid description of his previously terrifying experiences in elevators and other enclosed spaces, now entirely gone raises some fascinating questions. For instance, how much psychological disease is nothing more than the expression of disordered metabolism from vitamin D deficiency?

--Immunity from viral infections--I first learned of this association from Dr. John Cannell of the Vitamin D Council (www.vitamindcouncil.com). Dr. Cannell recounts his experience with the 2006 flu epidemic in the hospital in northern California, where he is a psychiatrist charged with the health of 200 inpatients held in closed wards. While the flu spread like wildfire to the patients in all the other wards, the 200 patients in Dr. Cannell’s ward failed to contract a single episode of flu while taking 2000 units of vitamin D per day.

I was a little skeptical at first, having been disappointed by the failure of several nutritional agents like zinc, vitamin C (perhaps, at best, a minimal effect). Now, three years into my vitamin D experience, I am absolutely convinced that Dr. Cannells’ early observation was correct: Vitamin D enhances immunity enormously. Not only have I personally not had a virus in several years, the majority of my staff and patients have been happily free of viral infections. There have been a few, to be sure. But the usual winters of hacking, coughing, and sneezing in the office have become largely a memory. It is a rare person who comes to the office with viral symptoms.


With new lessons being learned every day, it is inevitable that other fascinating new vitamin D observations have yet to be made.

Comments (47) -

  • Jenny

    2/21/2009 1:33:00 PM |

    Dr. Davis,

    Vitamin D appears to have a very strong antidepressant effect, which may be behind the response in agorophobia. People who have numbed their emotions with SSRIs may not notice it, but for someone who is not taking artificial mood drugs, Vitamin D has an effect on mood very similar to that burst of cheer one feels when going out into strong sunlight.

  • baldsue

    2/21/2009 1:44:00 PM |

    I wish it relieved constant headaches.  I do think the level of pain has dropped a notch or two since I started taking 4000 IUs a day.  And I can definitely tell the difference in my general feeling of wellness, aside from the headache, when I forget to take a dose.  In fact, that's the first question I ask myself when I feel dragged down, "Did I take my vitamin D?"

    Thanks!  I never would have ramped up my dose had I not read your words.

  • Elise P

    2/21/2009 1:51:00 PM |

    I increased my vitamin D supplementation to 3000 IU per day last fall bringing my level of D3 to 53 (I've since increased to 4000 per day).  Every year, about 3 times, I used to get a sore throat that turns to congestion that lasts for a week of misery.  I did catch the bug once this winter but it was two days of congestion and was gone.  I also got pregnant soon after adding the vitamin D, after trying for two years to conceive.  Also, my husband had allergy like symptoms, waking up sneezing and stuffy, which had gone on for 6+ months.  Two months after he upped his D to 6000 IU per day they're gone.  One question I have is for pregnancy - all the books say limit your D to 600 IU and I know they're still using the old information that looks at vitamin D as a dangerous fat soluble vitamin that can be toxic.  I'm planning to keep my supplementation at 4000 IU until the summer when I'll lower it a little, but can anyone speak to the safety of vitamin D during pregnancy?

  • Shreela

    2/21/2009 1:57:00 PM |

    "Relief from claustrophobia"

    I fell asleep in the MRI, but if helps phobias in general, I get fairly freaked when bridges are skinny, steep, or curved (highway connectors).

    I've been taking the tablets since reading about the Vit D newsletter doctor (forget his name, sorry) recommending them, and the were 2 for 1, and I had 2 coupons also.

    I read your post about how taking tablets with oil might help -- I've been taking them with fish oil already, and now I'm using olive oil on my food before taking them.

    I'll get gelcaps when I run out of the tablets, and maybe handle bridges better 8^)

  • Joe E O

    2/21/2009 2:30:00 PM |

    I can personally vouch for the efficacy of Vitamin D in relieving a) chronic chest pain b) generalized anxiety.

    It seems like a bad dream at this point - but I was completely at the end of my rope for much of 2007 vis a vis the chest pain - which also nicely fed into the the anxiety. I was in bad shape....

    Another example of the the law of unintended consequences - i.e.  Avoid the Sun - leading to Vitamin D deficiency


    I wonder if the general "health advice" about avoiding salt is leading to iodine deficiency and the sub-clinical hypothyroidism.

    Peace

    Joe E O

  • steven

    2/21/2009 4:51:00 PM |

    can you explain the difference relationship and difference between D325(OH) and 1.25 measurement of D.  Thanks.

  • Anne

    2/21/2009 5:44:00 PM |

    Dear Dr Davis,

    Please can you tell the significance of the coconut at the top of your blog - is is because of coconut oil being such a good fat ?

    Anne

  • TedHutchinson

    2/21/2009 6:23:00 PM |

    Readers wanting to know more about the
    "Connection with Vitamin D and Cancer"
    will find this new Grassrootshealth 30 minute lecture from Donald Trump worth watching

    http://tinyurl.com/d3xeux

    and while short session of full body nonburning may a reasonable route for some to top up vitamin d in summer,  for many people, particularly those in Australia/NewZealand sun exposure at any time of day may not be worth the risk, but, neither is the use of sunscreen as safe as one might think or hope.
    You may be in for a shock when you listen to Edward Gorham. (and I'm not referring to the quality of his jokes)

    Skin Cancer/Sunscreen - the Dilemma

    http://tinyurl.com/buatue

  • Anonymous

    2/21/2009 7:51:00 PM |

    Another one to add to the unique list, I've noticed that vitamin D helps with improved demeanor.  I first noticed this after my brother-in-law began taking vitamin D along with fish oil.  The brother-in-law had always been a quite person with an unpleasant  demeanor to me.  After he began taking the two supplements he became sociable, and in general I and several others I know found him pleasant to be around.   At the time I didn't know if it was the supplements that helped but joked with other family members that for our sanity we MUST keep him supplied with D and fish oil.      

    After talking with my sister this morning, maybe I shouldn't joke.  My middle nephew is quite.  Talking with him for more than 5 minutes was rare.  He just wasn't a chatty person - much like his father used to be.  Well, my sister told me this morning that the middle nephew began taking vitamin D two weeks ago.  He will not drink milk and so my sister was worried he was not building strong bones - her quote.  

    It dawned on me that my parents had talked about receiving several surprising phone calls this week from the middle nephew - he never called anyone - and how pleasant it was to have long talks with him.  My parents thought their grandson was growing up.  I think it's the vitamin D.

  • Kismet

    2/21/2009 9:17:00 PM |

    Vitamin D supplementation seems almost too good to be true.
    Dr. Davis, although some data on zinc has been negative, zinc *acetate* and *gluconate* lozenges are backed up by some solid research(not for prevention, but to treat the common cold). Only recently there was a positive study published in the J Infect Dis, PMID: 18279051.

  • David Brown

    2/22/2009 12:10:00 AM |

    I've been taking 2,000 IU of vitamin D3 daily for a couple years and it seems to protect me from sunburn. It wasn't enough to protect me from a cold and bout with the flu last winter so I upped intake to 4,000 IU. No sickness so far this winter.

  • Anonymous

    2/22/2009 10:17:00 AM |

    I live in an extreme northern climate state and have been diligently taking 6,000 IU/d of NOW (brand) D3 (soft-gels) for the past seven months.

    I just had my 25(OH)D3 tested for the first time this past week.  It came in at 61 ng/ml.  YES!

    At work, I find my co-workers often coughing and sneezing all day long.  This, in a work place that requires continual contact with hundreds of retail customers.

    This is the first winter that I can remember I haven't had any viral/cold symptoms at all... not even a single runny nose.

    I learned of this hormone here first, and probably still would not have learned of it's importance if not for this blog.  I now continually stress to my family, friends, and co-workers this utmost importance of supplemental D3.

    Thank you Dr. Davis

  • mike V

    2/22/2009 6:14:00 PM |

    EliseP:
    Hope you will find this 2004 review helpful.

    Assessment of dietary vitamin D requirements during pregnancy and lactation.
    Bruce W Hollis and Carol L Wagner

    http://www.direct-ms.org/pdf/VitDGenScience/Hollis%20vit%20D%20pregnacy.pdf

    Note: Do not correct "pregnacy" in the URL. It only works as spelled.

    MikeV

  • hoosierville

    2/22/2009 10:31:00 PM |

    Doc,
    I again want to thank you for this blog. I've directed my siste here. She has 7 stents and had a quadruple about 10 years ago. She's 67 not and doing well but she still hasn't quit smoking. But she's on the D and you'd never know how bad her heart was (is).

    Anyway, I'd like to share this anectdotal little story. A friend at work contracted a bacterial repsiratory infection back in April of 08. I hadn't seen her in several months and then she stopped into my library on January 13, 2009 for a visit (we work for the school system) and she was still very, very sick. Every time she spoke she coughed, and you could tell it was a very dry and painful cough. I started telling her about Vit D and ended up telling her to take 50,000 IUs that day and then take 10,000 IUs for the next week and then do it again the next two weeks. Guess what? She's cured. She's been on every antibiotic under the sun and none of them worked. The vitamin D did it. She's almost norman again. She was sick for almost a year.

    I have had life changing effects from taking vitamin d and I've now joined the grassroots health D action program too.

    I posted sometime back about how it's helped my lungs and how much strength and stamina I've gained just in one short year. It's been an amazing experience.

    Debbie in Indiana

  • Anonymous

    2/23/2009 9:41:00 AM |

    To everyone who has left a comment on this blog, could you say if you were taking vitamin d3 tablets or oil-filled gelcaps?

  • Elise P

    2/23/2009 10:07:00 PM |

    To Mike V. - thank you for the link to that article about Vitamin D and pregnancy - I feel much more confident that I'm benefiting myself and my baby by taking a higher amount of Vitamin D.
    To the comment asking what form I'm taking - the oil gelcaps.

  • TedHutchinson

    2/24/2009 11:16:00 AM |

    I live latitude 52N
    Previously I used BIOTECH 5000iu dry powder filled capsules (not solid tablets) taken with food.

    They raised my status but even with full body sun exposure only to 40ng ~ 120nmol/l.

    I now take 5000iu oil based gel capsules (3 caps over 2 days 7500iu/d)but have also lost weight (stopped eating wheat)
    25(OH)D jumped from
    Sept 08 48ng ~ 120nmol/l
    to Jan 09 110ng/ml ~ 275nmol/l.
    I suspect Dr Davis is correct that oil based caps are more effective although some of that rise will be due to sunbed use and maybe weight loss.
    I have never used solid D3 tablets.

    There is no significant difference in daily cost, both 5000iu powder and 5000iu oil based caps can be bought in the USA and including p&p to UK cost around 5p daily.

  • Anonymous

    2/24/2009 6:39:00 PM |

    I have ank spondy as well - Its a tough disease that I have fixed almost completely with diet BUT the vitamin D has made my back feel more flexible anyway! Three weeks in - I will take a blood test soon to verify levels and see whether I need to modify the dosage.

  • mike V

    2/25/2009 2:38:00 PM |

    Re: Tablets versus Oil based. I started out with tablets (Sam's club) some years ago, and pretty much eliminated colds and infections. Based on Dr Davis's observations I switched about 2 years ago, with similar results. I should mention that I usually take oil soluble vitamins/ supplements together, often with a tablespoon of extra virgin olive oil.
    FWIW I am almost 73, and have no detectable plaque.

    PS To Dr D.
    I challenge all readers of The Heart Scan Blog to send $25 to Dr Cannell at the Vitamin D Council.

    Dr D, if you are posting Cannell's latest newsletter, please edit from this comment.
    Thanks, MikeV



    The Vitamin D Newsletter

    February 24, 2009                                                
                            
    I know some of you want to unsubscribe but the system I used, like the formatting in this newsletter, is beyond my computer skills.  Thus, accept my apologies. If you want to unsubscribe, simply send a blank email
    to unsubscribe@vitamindcouncil.org.
    As readers from 3 years ago remember, this newsletter first published evidence vitamin D would prevent influenza and many varieties of the
    common cold in 2005:

    http://www.vitamindcouncil.org/newsletter/2005-nov.shtml

    I then published the theory in:                                                      
    Cannell JJ, et al. Epidemic influenza and vitamin D. Epidemiology and Infection. 2006 Dec;134(6):1129-40.

    As Science News reported, I realized this after observing an influenza epidemic at Atascadero State Hospital.

    The antibiotic vitamin: deficiency in vitamin D may predispose people to infection.  Science News, November 11, 2006
    Last year, we used vitamin D to explain virtually all of the many unsolved mysteries of influenza.

    Cannell JJ, et al.  On the epidemiology of influenza. Virology Journal. 2008 Feb 25;5:29.

    Our second influenza paper is by far the most accessed paper in the journal this year.

    Top 20 most accessed articles for last year in Virology Journal

    Today, researchers from Harvard and the University of Colorado, writing in the Archives of Internal Medicine, published convincing evidence my observations at Atascadero State Hospital were correct.

    Vitamin D deficiency linked to more colds and flu. Scientific American, Feb 23, 2009

    Adit A, et al.  Association Between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009;169(4):384-390.

    Influenza kill around 35,000 Americans every year and similar viruses cause additional mortality and untold morbidity. As I have said, It appears Linus Pauling was right about everything he said about vitamin C, but he was off by one letter. The Vitamin D Council, the nearly broke non-profit educational organization, now believes most influenza deaths and many other respiratory infections, like the common cold, could be prevented if Americans, and their doctors, understood some simple facts:

    ·         Vitamin D is not a vitamin, but a steroid hormone precursor, which has profound effects on innate immunity.
    ·         The amount of vitamin D in most food and nearly all multivitamins is literally inconsequential.
    ·         The correct daily dose of vitamin D for adults is approximately 5,000 IU/day, not the 200-600 IU recommended by the Institute of Medicine, the National Institutes of Medicine and the FDA.
    ·         The only blood test to determine vitamin D adequacy is a 25-hydroxy-vitamin D, not the 1,25-di-hydroxy-vitamin D test many physicians now order.
    ·         Healthy vitamin D blood levels are between 50-80 ng/ml, levels obtained by fewer than 5% of Americans.
    ·         Medicare’s new proposed rule change, which forbids Medicare carriers for paying for virtually all vitamin D blood tests (Draft LCD for Vitamin D Assay Testing (DL29510), will kill tens of thousands of Americans yearly.
    ·         The mechanism of action of vitamin D in infection, dramatically increasing the body’s production of broad-spectrum natural antibiotics (anti-microbial peptides or AMP) suggests pharmaceutical doses of vitamin D (1,000 IU per pound of body weight per day for several days) will effectively treat not only influenza and the common cold, but help treat a host of other seasonal infections, including meningitis, septicemia, and pneumonia, in both children and adults.
    ·         In 1997, when the Food and Nutrition Board (FNB) set the current guidelines for vitamin D intake, they forgot to correct for the widespread sun avoidance that began in the late 1980’s when the AMA’s Council of Scientific Affairs warned against sun-exposure, and recommended that all Americans should make every effort to never let a photon of sunlight strike their skin.  The failure of the 1997 FNB to compensate for sun-avoidance, has led to millions of deaths around the world.
    ·         Physicians who ignore vitamin D deficiency will eventually suffer medical-legal consequences.
    ·         While many think the influenza virus causes influenza, Cannell notes it was George Bernard Shaw who first understood: “The characteristic microbe of a disease might be a symptom instead of a cause.” George Bernard Shaw, (Preface on Doctors, The Doctor’s Dilemma, 1911).

    If you want professional newsletter services, you will need to help find a foundation that will fund us.

    John Cannell, MD
    http://www.vitamindcouncil.org/

    The Vitamin D Council
    9100 San Gregorio Road
    Atascadero, CA 93422

    (Posted by Mikev)

  • Dr. William Davis

    2/25/2009 10:56:00 PM |

    Thanks, Mike V.

    Dr. John Cannell is truly a visionary when it comes to vitamin D. He also has some of the best understanding of this issue of anyone around.

    We are overdue for a donation to his cause, also. Thanks for reminding me.

  • karl

    2/26/2009 3:18:00 PM |

    I would like your opinions of the resveratrol studies - they are now combining it with D3.

  • Anonymous

    2/26/2009 3:34:00 PM |

    "Chest pain—Not the chest pain of heart disease, but a chronic gnawing, toothache-like pain in the sternum that is relieved within days of initiating vitamin D. I don’t know precisely why this happens, but I speculate that, with vitamin D deficiency, there is disordered calcium metabolism, and perhaps the sternal pain represents cellular (osteoclastic) activity that is eroding sternal calcium for the purpose of maintaining blood calcium, since intestinal absorption of calcium is poor. Replace vitamin D and the abnormal calcium uptake ceases. Just my guess". interesting? I have hypothyroid and high blood calcium, made me confused as to taking vitamin D or not. i have chest pain on left side. changing my medication from synthroid to armour and starting on the Iodine drops brought body temperature, brain fog, moon face, gained weight, depression, and confusion to normal but chest pain is still there. i thought about vitamin D but avoided because of already high blood calcium. But what you just speculated above does makes sense. I am in winnipeg and should be taking vitamin D all the time. I will start on vitamin D and see if it will make any difference? The other problem here is going to see a doctor is like going to a principal's office in high school. They never Liston, treat you like numbers and most of them are sick themselves and never up to date or they never want to tell. you have to educate your self in order to save your health, relationships and jobs which are connected to one's well being.

  • Anna

    2/27/2009 4:51:00 AM |

    I made a donation to the Vitamin D Council in late 2007, but forgot to do so in 2008.  I rectified that the other day when I received the latest VDC newsletter - this time I made a $100 donation.  And the Grassroots Health office is in my town, so I have volunteered to help stuff test kit envelopes so they can save on envelope stuffing service fees.  

    I really feel the VDC is doing important work.  Except for the friends and family who "listen" to me and take enough D3, everyone I know who tests is either deficient or very low in the reference range.  

    Reading The Vitamin D Cure book now.  While I have some issue with the diet advice, the info about determining sun exposure and supplementation dose is very good.

  • TedHutchinson

    2/27/2009 1:09:00 PM |

    Vitamin D and Cardiovascular Disease Prevention
    http://www.youtube.com/watch?v=NJHfdUKSD2A
    another in the series of Vitamin D talks sponsored by Grassrootshealth.org and hosted by University of Califorian television.
    Allow 45minutes and it may be a good idea to download it if you are not familiar with the research. There is a lot of information (the conference it is taken from was aimed at doctors rather than the general public) and as it is complex you may need to listen to it twice.

    I think this particular video is worthy of Dr Davis's scrutiny. I am sure if Dr Davis devoted a specific blog to the highlight this video, he could make a better job of explaining some of the slides.

    Listen right to the end to the last question from the floor for the rather cynical audience response.

  • Anonymous

    2/27/2009 5:56:00 PM |

    Dr. Cannell knows quite a bit about vitamin D, but his understanding of vitamin A is abysmal.  He's telling people that they do not need any preformed vitamin A in their diets because it blocks vitamin D action.  This is a partial truth, but the message is all wrong.  If he spreads this message far emough, we'll be entering into an era of subclinical vitamin A deficiency and night blindness.  Until he changes, or at least clarifies, his stance on vitamin A, I cannot support him.

  • mike V

    2/28/2009 6:56:00 PM |

    To Anonymous on Vitamin A.

    Presuming your characterization is correct, it is my best guess that Dr Cannell is saving many more lives by popularizing the existence of wide Vitamin D deficiency.

    Can we get any info you may have on the relative hazards of existing Vitamin A deficiency?

    Why not pass it on? He may well appreciate your insight as much as a contribution!

    Thanks.

    Mike V

  • homertobias

    3/1/2009 12:03:00 AM |

    Ted, Dr. David Sane's presentation was fair, in my opinion.  We have alot of association data, plausability, potential for multiple mechanisms of action, but a paucity of studies showing that supplementing works to prevent cardiovascular disease.  They will come.  Alot of us are still disappointed and cautious after mistakenly recommending high dose folate for hyperhomosystienemia.  

    Interesting to me was the German data looking not only at 25-oh levels but 1-25-oh vitamin D levels being independently associated with CHD.  Can't figure it out.

    Also very interesting was the Italian data showing correlation between CIMT and Vit D levels in diabetics. I wonder if low Vitamin D levels correllate with MDCT?  OK Dr. Davis.  Does it?  From my reading, cholesterol levels, NMR lipoprofile, HSCRP, LPPLA2, do NOT correlate with coronary calcium scores.  (Dr. Hecht's data) Will D???

  • Trinkwasser

    3/2/2009 1:41:00 PM |

    Anecdotal, but I suffer chronic atypical depression with symptoms related to SAD. Venlafaxine 225mg has been my best treatment to date (tricyclics work better but with more side effects, SSRIs don't work well at all and then stop, the connection seems to be to dopamine and norepinephrine)

    Getting my BG in line (I used to mostly do not-diabetic-yet highs dropping to not-quite-hypo lows several times a day) and I have dropped this to 37.5mg

    Taking D3 over a prolonged period and despite the appallingly dull winter I have had singificantly fewer SAD symptoms (while a lot of non-sufferers have been worse!)

    I've been taking tabs BUT with flax oil, EPO and actual complete fish so maybe the oil is helping the disposition, I'll replace them with gelcaps when I run out.

    Now the sun has finally started to come out and my energy levels have improved as they often do around this time of year (waking up from hibernation) I have dropped the venlafaxine to 17.75 mg and doing if anything even better.

    Meanwhile in Scotland a GP is finding clinical cases of Rickets for the first time in her career.

    One wonders whether apart from the too low RDA there are other factors interfering in D metabolism which have become commoner than in the past. Maybe the low fat diet prevents absorbtion? Maybe statins break one of the pathways? Otherwise surely someone would have noticed all these recent findings long ago?

  • mbarnes

    3/23/2009 4:20:00 PM |

    It is amazing how much concern folk raise about the potential toxicity of vitamin D when the literature clearly shows you can take as much as 10,000units per day without problems and there was a phase I study in MS patients that used 40,000IU per day without side effects. here is another good site on vitamin D with lots of reviews of the anti cancer data:
    www.vitaminD3world.com

  • Anonymous

    12/2/2009 5:50:47 PM |

    How interesting. I have been taking oral gelcap vitamin D for some years now and I never seem to get ill when other people all around me are stuck down with terrible symptoms. Or, if my husband has flown-blown flu, I might have a sore throat for a day and feel a bit more tired than usual for a day and then I'm fine.

    I was wondering whether my apparently amazing ability not to get sick might be because I have MGUS (monoclonal gammopathy of unknown significance) -- I was wondering if it might be that my immune system is so 'good' it is also attacking me too -- whether there might be some link, that at some point in the future will be my undoing. ? But I much prefer the more optimistic vitamin D theory of my lack of colds and flu etc.

  • Anonymous

    12/2/2009 6:05:01 PM |

    To the person who asked about vitamin D and pregnancy, and to the other person who asked about tablets vs oil gel caps, I was taking tablets for years without it raising my serum D levels, It was when I switched to D3 oil gel caps as a result of reading this blog, that my levels started to climb. When I finally went up to 6000IUs that seemed to help a lot.

    When I became pregnant, I asked my (high risk) maternal foetal medicine doctor about it, and he said that is that was the level of supplementation it was taking to keep my vitamin D levels up to normal, I should keep taking it. He also said that I should continue to try to get some sun every day (I am not in a hot sunny place) that would be important too. He seemed to be saying that just taking the supplements is not enough. You need both.

  • Anonymous

    12/30/2009 3:45:58 PM |

    Hello!!! heartscanblog.blogspot.com is one of the most outstanding innovative websites of its kind. I take advantage of reading it every day. I will be back.

  • DougCuk

    1/9/2010 10:05:34 PM |

    I do not as a rule take any supplements - but I am now recommending all my family and friends to take high dose Vitamin D. I have been researching this topic for the last two months - I have a degree in Zoology and worked in Bio-Physics - and the more I read the more convinced I have become. I have created my own webpage with links to the best Vitamin D websites, charts and videos. Anything I find gets posted here: http://www.stargateuk.info/vitamind

  • Anonymous

    2/9/2010 5:16:44 PM |

    On Vitamin D and pregnancy, here's a quote about recent studies:

    "In two U.S. government-funded studies, Hollis is studying vitamin D supplementation of up to 6,000 IU daily in nursing women, and 4,000 units per day in pregnant women. So far "not one single adverse event" has been observed in women on the highest doses, he said in an interview."

  • Anonymous

    2/19/2010 8:06:00 PM |

    Dr Davis,
    I eliminated cereals from my diet 6 month ago and since then I haven't have an herpes outbreak that used to plague me if I didn't take VALACICLOVIR 500 mg every day I would get an outbreak 7 days after I did't take the pill, now I'm supplementing 6000 iu of vitamin D a day I hope that I will stay outbreak free for longer!!!! I have to tell you that I stopped eating cereals specially wheat after reading this blog   and have felt better than ever!!!

  • Anonymous

    3/7/2010 9:08:28 PM |

    Vitamin D controls T cell antigen receptor signaling and activation of human T cells. WOW

    http://www.nature.com/ni/journal/vaop/ncurrent/full/ni.1851.html

    Regards
    Niels

  • vitamin D

    5/17/2010 5:23:29 AM |

    According to me after read this post I think that vitamin D is more good to take for better health because it helps blood to stay in normal level.

  • Anonymous

    8/24/2010 8:15:39 AM |

    I've suffered from depression for many years, along with joint pain that flares up from time to time, but have never tested positive for any antibodies, so have no idea what it is that causes the problem. I've just learned to deal with the pain and stiffness myself and only use over the counter anti-inflamatories when the pain gets too bad to handle without using anything because they've always upset my stomach.

    These last couple of years fatigue has plagued me as well. Last year my dr detected low levels of vitamin D and suggested I took 1,000 units a day. A couple of weeks ago, he retested my levels only to find that they had dropped significantly, from 36 to 20 (normal range 50-75). I am now on 2,000 units a day. Within 24 hours I began to feel more energy than I'd felt in years and my mood had lifted. I've always been aware that in winter I had less energy and was more morose, but never connected the dots. My daughter also suffers from depression and a couple of weeks was going through a really bad patch. I insisted the dr measured her D3 levels and sure enough she was low on D3.She started on 2,000 units of D3 and improved within 36 hours from being a crying mess to being full of energy.

    For someone like me who's always been a vitamin skeptic, I'm amazed at the difference in such a short time. I'm 3 weeks into taking 2,000 units a day and can't see any effect on my joints yet but have my fingers well and truely crossed on this one.

    Does anyone know if low D3 levels are also connected with chronic gastritis? I has diagnosed last year and have developed gastric intestinal metaplasia (which explains why I get stomach pain if I take NSAIDS or aspirin). However, there has been no cause established for me developing this condition and since I rarely take the NSAIDS that's not the cause either. I tested negative for HP infection and have never smoked and rarely drink alcohol. I'm now wondering if this condition is also due to low D3 levels.

  • Rhett

    9/29/2010 12:18:36 PM |

    I was recently diagnosed as severely vitamin D deficient and was unable to find a decent place dedicated to vitamin D discussion, so I decided to start my own forum http://www.vitamindforum.com . I would love to hear everyones experiences!

  • Philip Gower

    10/4/2010 3:27:38 AM |

    I have upped my daily dosage of D3to 15,000U,and feel great ! My lifelong psoriasis has largely melted away, and occasional angina has stopped. At age 73 I am able to walk our dogs in hills for hours daily, and I take no prescription medications.I also supplement with SSKI drops, and follow a low carb diet.In 6 months I have dropped 50 lbs, and seem to be levelled off at about 150 lbs.I am about to test for the "25" D3 blood level, mostly out of curiosity. I have stopped getting colds or flu !

  • buy jeans

    11/3/2010 2:53:06 PM |

    --Relief from claustrophobia—This one has me stumped. But one man’s vivid description of his previously terrifying experiences in elevators and other enclosed spaces, now entirely gone raises some fascinating questions. For instance, how much psychological disease is nothing more than the expression of disordered metabolism from vitamin D deficiency?

  • aashvi

    11/9/2010 10:31:42 AM |

    There can be several kinds of chest pen but when it is related to heart disease, it becomes dangerous.  It’s very important that we should keep this in mind. Dilse India provides information about  chest pain. The information can be helpful for those who have chest pain and there is danger of heart disease.
    Website : Risk of chest pain

  • online pharmacy

    3/7/2011 8:49:40 AM |

    Previous research has suggested that vitamin D levels were inherited, in part, but a new study of 33,996 people has found three specific genetic variants that seem to correlate with a person's levels of vitamin D.

  • Shashin Patel

    6/7/2011 1:04:18 PM |

    This is a great post. It contains a lot of important information about Vitamin D and how much should its requirement be. I came across one nice article about Vitamin D and wonder if you like it. To know more click on the link  below:
    Boca Wellness and Nutrition

  • Rohan

    6/9/2011 5:51:38 PM |

    Fruits and vegetables are excellent sources of potassium which helps to regulate fluids and maintain normal blood pressure. That includes bananas, sweet potatoes, avocados and cantaloupes in your diet.
    You may find more information on Boca Wellness and Nutrition

  • Shashin Patel

    6/15/2011 3:42:48 PM |

    Nice video about Vitamin D and its facts. You can find it at
    http://www.youtube.com/watch?v=mhWK6ktRI1Y

  • [...] around 50ng/ml. I've read others experiencing similar.   "Unique vitamin D observations"  Unique vitamin D observations | Track Your Plaque Blog  snippet:    ...–Immunity from viral infections–I first learned of this association [...]

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Coenzyme Q10 and statin drugs

Coenzyme Q10 and statin drugs

Although drug manufacturers claim that muscle side effects from statin drugs occurs in only around 2% or people or less, my experience is very different.

I see muscle weakness and achiness develop in the majority of people taking Lipitor, Crestor, Zocor, Vytorin, etc. I'd estimate that nearly 90% of people get these feelings sooner or later.

Thankfully, the majority of the time these feelings are annoyances and do not lead to any impairment. Full-blown muscle destruction is truly rare--I've seen it once in over 10 years and thousands of patients.

The higher the dose of statin drug and the longer you take it, the more likely you're going to have muscle aches.

I experienced a strange phemomenon myself today. I worked outdoors for about 4 hours, pulling weeds, digging in the dirt, spreading topsoil. (I have an area of overgrowth in the front yard.) Admittedly, I worked pretty hard and it was a warm, humid day.

I was sore, as you'd expect at age 49. But, much more than that, I was exhausted--my muscles ached and I had barely enough strength to get up the stairs.

Hoping for some relief, I took an extra dose of coenzyme Q10. I usually take 50-100 mg per day. Today, when I felt this overwhelming muscle fatigue, I took an additional 200 mg. Within 10 minutes, I felt a surge of energy. It was, in fact, a perceptible, quite dramatic feeling.

I am thoroughly convinced, through my own experiences on Lipitor (I have a high LDL particle number despite a healthy lifestyle, among other abnormalities), and the experiences of many other people, that coenzyme Q10 can be an extremely useful tool to minimize the muscle aches and weakness of the statin drugs.

If you do indeed need to take one of these agents, coenzyme Q10 is worth knowing about. Supplementing coenzyme Q10 has, for me, been a real lifesaver. For many people, LDL reduction is a crucial part of their heart scan score control program. In my experience, many of them would not be able to take the drug without eozyme Q10.
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Is niacin as bad as it sounds?

Is niacin as bad as it sounds?

A popular health newsletter, Everyday Health, carried this headline:

A Cholesterol-Busting Vitamin?

Did you know that niacin, one of the B vitamins, is also a potent cholesterol fighter?
Find out how niacin can help reduce choleseterol.


At doses way above the Recommended Dietary Allowance — say 1,000–2,500 mg a day (1–2.5 grams) — crystalline nicotinic acid acts as a drug instead of a vitamin. It can reduce total cholesterol levels by up to 25%, lowering LDL and raising HDL levels, and can rapidly lower the blood level of triglycerides. It does so by reducing the liver’s production of VLDL, which is ordinarily converted into LDL.


I'd agree with that, except that it is rare to require doses higher than 1000-1500 mg per day unless you are treating lipoprotein(a) and using niacin as a tool for dramatic drops in LDL. But for just raising HDL, shifting HDL into the healthy large class, reducing small LDL, and for reduction of heart attack risk, 1000-1500 mg is usually sufficient; taking more yields little or no further effect.

But after that positive comment comes this:

Niacin is safe — except in people with chronic liver disease or certain other conditions, including diabetes and peptic ulcer. . . However, it has numerous side effects. It can cause rashes and aggravate gout, diabetes, or peptic ulcers. Early in therapy, it can cause facial flushing for several minutes soon after a dose, although this response often stops after about two weeks of therapy and can be reduced by taking aspirin or ibuprofen half an hour before taking the niacin. A sustained-release preparation of niacin (Niaspan) appears to have fewer side effects, but may cause more liver function abnormalities, especially when combined with a statin.


Strange. After a headline clearly designed to pull readers in, clearly stating niacin's benefits, the article then proceeds to share the pants off you with side-effects.

But look to the side and above the text: Ah . . . two prominent advertisements for Lipitor, complete with Dr. Robert Jarvik's photo. "I've studied the human heart for a lifetime. I trust Lipitor to keep my heart healthy."

Sounds like bait and switch to me. "You could try niacin--if you dare. But you could also try Lipitor."

Who is Dr. Jarvik, anyway, that he stands as the spokesman (or at least figurehead) for this $13 billion dollar a year drug. Of course, he is the 1982 inventor of the Jarvik artificial heart, surely an admirable accomplishment. But does that qualify him to speak about heart disease prevention and cholesterol drugs? Jarvik has, never actually prescribed Lipitor, since he never completed any formal medical training beyond obtaining his Medical Doctor degree, nor has he ever had a license to practice medicine. He does, however, continue in his effort to provide artificial heart devices, principally for implantation as a "bridge" to transplantation, i.e., to sustain a patient temporarily who is dying of end-stage heart failure.

So where does his expertise in heart disease prevention come from?
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Are jelly beans heart healthy?

Are jelly beans heart healthy?

Total Fat

3 g or less

Less than 6.5 g





Saturated Fat



1 g or less

1 g or less





Cholesterol

20 mg or less

20 mg or less





Sodium

480 mg or less per RACC* & labeled serving

480 mg or less per RACC* & labeled serving





Nutrients

Contain 10 percent or more of the daily value of 1 of 6 nutrients; vitamin A, vitamin C, iron, calcium, protein or dietary fiber



Contain 10 percent or more of the daily value of 1of 6 nutrients; vitamin A, vitamin C, iron, calcium, protein or dietary fiber





Trans fat

Less than 0.5 g per RACC* and labeled serving



Less than 0.5 g per RACC* and labeled serving





Whole Grain

N/A



51 percent by weight/RACC*







Minimum Dietary Fiber



N/A

1.7 g/RACC of 30 g

2.5 g/RACC of 45 g

2.8 g/RACC of 50 g

3.0 g/RACC of 55 g





(RACC=Reference Amount Customarily Consumed)
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Diabetes is a choice you make

Diabetes is a choice you make

Tim had heart disease identified as a young man. He had his first heart attack followed by a quadruple bypass surgery at age 38. Recurrent anginal chest pain and another small heart attack led to several stents over three procedures in the first four years after bypass.

Tim finally came to us, interested in improving his prevention program. You name it, he had it: small LDL, low HDL (28 mg/dl), lipoprotein(a), etc. The problem was that Tim was also clearly pre-diabetic. At 5 ft 10 inches, he weighed 272 lbs--easily 80 or more pounds overweight.

Tim was willing to make the medication and nutritional supplement changes to gain control over his seeminglly relentless disease. He even turned up his exercise program and lost 28 lbs in the beginning. But as time passed and no symptoms recurred, he became lax.

Tim regained all the weight he'd lost and some more. Now Tim was diabetic.

"I don't get it. I eat good foods that shouldn't raise my insulin. I almost never eat sweets."

I stressed to Tim that diabetes and pre-diabetes, while provoked acutely by sugar-equivalent foods (wheat products, breads, breakfast cereals, crackers, etc.), is caused chronically by excess weight. If Tim wants to regain control over his heart disease, he needed to lost the weight.

Unlike, say, leukemia, an unfortunate disease that has little to do with lifestyle choices, diabetes is a choice you make over 90% of the time. In other words, if you become diabetic (adult variety, not children's variety) as an adult, that's because you've chosen to follow that path. You've neglected physical activity, or indulged in too many calories or poor food choices, or simply allowed weight to balloon out of control.

But diabetes is also a path most people can choose not to take. And it is a painfully common choice: Nearly two-thirds of the adults in my office have patterns of pre-diabetes or diabetes when I first meet them.

Let me stress this: For the vast majority of adults, diabetes is a choice, not an inevitability.
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The Wheat Deficiency Syndrome

The Wheat Deficiency Syndrome

Beware the dreaded Wheat Deficiency Syndrome.

Like any other syndrome, you can recognize this condition by its many tell-tale signs:

--Flat abdomen
--Rapid weight loss
--High energy
--Less mood swings
--Better sleep
--Diminished appetite
--Reduced blood sugar
--Reduced blood pressure
--Reduced small LDL and total LDL
--Increased HDL
--Reduced triglycerides
--Reduced C-reactive protein and other inflammatory measures


Of course, you could choose to cure yourself of this syndrome simply by taking the antidote: foods made with wheat flour, like bread, breakfast cereals, pastas, pretzels, crackers, and muffins.

All the signs of the syndrome will then disappear and you can have back your protuberant abdomen, irrational mood swings, exagerrated appetite, higher blood sugar, etc.

Comments (21) -

  • Scott Miller

    11/26/2008 5:39:00 PM |

    Dr. D,

    Maybe you can reveal your bodyfat?  I assume you've been on the no-wheat diet for a while.  I don't eat any grains, with rare exceptions.  (I have 15 grams of oatmeal every morning, and the occasional slice of pizza.)  My bodyfat is ~10%.  But, I'm pretty hard core on my diet overall, including intermittent fasting.

  • David

    11/26/2008 5:56:00 PM |

    Dr. Davis,

    I have recently acquired wheat deficiency syndrome... please, don't cure me!!

    -David

  • Anonymous

    11/26/2008 6:44:00 PM |

    But when you have to have wheat, use sprouted grain bread. The seeds are sprouted, then milled. These breads are naturally low glycemic and more nutritious.  

    The process of germination changes the composition of grain and seeds in numerous ways. Sprouting increases vitamin content. Sprouting neutralizes phytic acid – a substance present in grains – that inhibits absorption of nutrients and more important Sprouting neutralizes or "predigests" if you will, grains through enzymatic activity. The enzymes produced during our natural sprouting process "in effect" breaks down amino acid protein bonds to promote digestibility of the entire grain.

    Sprouted grain bread has numerous advantages over "enriched" wheat flour breads. These breads are made from the endosperm of the wheat kernel (the inside portion), which contains primarily carbohydrates and few vitamins and minerals. The milling of grain into white flour requires the removal of the bran and the germ. This results in the loss of natural fiber, bran and 22 vitamins and minerals. To compensate, five vitamins and minerals (thiamine, riboflavin, niacin, iron and folic acid) are added back in, "enriching" the flour. Sometimes calcium is added back as well.
    https://www.foodforlife.com/sprouted-grain-difference.html#Ezekiel-4-9

  • Craig

    11/26/2008 10:29:00 PM |

    I get the picture on wheat and have a couple of questions...first, is sprouted wheat as used in flourless breads like Ezekial, a problem?  Is authentic sourdough bread any less reactive to the system? I guess I understand what is not acceptable, but I was wondering what grain products are okay to eat, if any.

    Thanks.

  • Anne

    11/27/2008 12:09:00 AM |

    How funny - how true. Of course I did not get the full wheat deficiency syndrome until I cut out all grains and dropped the sugars.

    Thanks for the laugh. I really needed that after opening my email today to find that Pace products are no longer gluten free. That made me cry. Boo to Campbell's.

  • Harry

    11/27/2008 1:42:00 AM |

    I just wanted to drop by and thank you for your excellent blog, Dr. Davis.

    I hope you and yours having a very happy Thanksgiving.

  • baldsue

    11/27/2008 5:48:00 AM |

    I am thankful that I've been able to find a way to live happily with WDS.

    Happy Turkey Day!

  • Zbigniew

    11/27/2008 10:49:00 AM |

    Scott Miller, can you reveal your weight and height?
    I am 186cm (73.5 in) tall and weigh in 81.5kg (180 lbs).
    My scales show 19% fat (but it's a crappy model bought in Lidl (cheap discount in Europe)).
    The thing is that I am already slim and to pursue such a bf percentage I would need to lose 8.2kg more (18 lbs) and then my target weight would be 73 kg (162 lbs) which seems too low even though know I am not a Schwarzenneger Smile
    Just would like to compare myself with someone with 10% BF Smile

  • Andrew

    11/27/2008 10:11:00 PM |

    Zbigniew - Your BF% has little to do with your actual weight.  I am technically "overweight", as I'm 5'11", 185 lbs, yet my bodyfat is between 8-10%, depending on how steadfastly I stick to my diet.  Muscle weighs more than fat, so if you diet and exercise, you can replace the weight of the fat with weight in muscle.  This can mean you can gain weight, but lose bodyfat, so I wouldn't say "I have to lose X amount of weight to get to X% body fat."

  • Scott Miller

    11/28/2008 4:51:00 PM |

    Sure, I'm 5'7", 160 lbs.  I do not do any cardio. Visit the gym twice a wk, 45 visits, doing a very high intensity routine. In other words, I don't do 3 sets of one movement, I do a pyramid like this: warm-up weight (15-ish reps), moderate weight (8-10 reps), failure weight (3-6 reps).  Done, next. And, do these with no more than 30 secs rest between, just enough time to change the weights, which will keep your heart rate high, but lets the lactic acid drain. Additional, focus on movements that force your entire body to move, like chin-ups, squats, deadlifts and dips.

    I track over 100 health stats, and at 47 yrs old, I try to keep my stats at the level of a 25-yr-old, including hormone levels (via hormone supplementation). There's nothing I can't do now that I couldn't do in my 20's--I'm in athletic shape, always energetic, never sick. The idea of aging seems like a foreign concept still.

    I use a LOT of other techniques to stay young, too. You can visit the forums at ImmInst.org to join a large community of "life extensionists" who are typically well ahead of the knowledge curve on health matters. I'm known as "DukeNukem" over there.

  • darwinstable

    11/30/2008 10:34:00 AM |

    Ha, great post I loved it. Yes I think I am starting to suffer from wheat deficiency syndrome, at least I hope I am.

  • Anonymous

    12/1/2008 1:10:00 AM |

    You list reduced LDL as a benefit of low-carb eating.  After a year of eating low-carb, my triglycerides have remained about 40, my HDL is up to 88, my total cholesterol up to 278, and my LDL way up to 182.  This last number has not caused me concern because of my favorable TRI/HDL ratio.  Should it?

    Thanks.

  • Nyn

    12/1/2008 2:52:00 PM |

    It is my wish that someone who has successfully eliminated wheat products (and starches) will write a diary or how-to-live-this-way book about their experiences, and publish it for others who are struggling with the concept.

    It sounds easy in theory, but I'd love to read how to actually do it for those who have IBS or aren't able to ingest dairy very well. And how to incorporate this into a modern lifestyle that means working away from a kitchen about 12 hrs a day. One day...maybe.

  • Zbig

    12/2/2008 10:49:00 AM |

    Scott - congrats on you performance, although this may prove you were weak in your twenties not otherwise (kidding Smile.

    I looked at the immortality institute site, the guys over there take supplements by tons, some of them 100+ substances daily. I think this is over the top, the healthiest centenarians seem to be "simpletons" (I hope this doesn't sound very rude to a native English ear).

    Andrew - my computations were made with an assumption that I don't lose nor gain muscles (which is likely due to my laziness, unfortunately).

  • Rabbi Hirsch Meisels

    12/8/2008 2:28:00 PM |

    WOuld you give permission to reprint this post? credit will of course be given where it;s due.

  • Dr. William Davis

    12/9/2008 12:33:00 PM |

    Rabbi Meisels--

    Please feel free to reproduce this post.

  • TedHutchinson

    12/12/2008 7:50:00 PM |

    I wonder if you could include this link to
    Gluten Sensitivity: Celiac Disease is the Tip of the Iceberg
    It's a blog by Stephan Whole Health Source, in which he explains why wheat may be so dangerous.
    http://tinyurl.com/5u3z5z

  • Anonymous

    1/21/2009 4:05:00 AM |

    Dr. Davis,

    Do you know if Wheatgrass which is sold in health food stores has the same effect on triglycerides as wheat products?  Does anyone have opinions about Wheatgrass and whether it is harmful to to your heart and blood profile to consume.

  • Tina

    10/10/2009 7:27:08 AM |

    Im 5"3 and weigh between 7 and 7.5 stone. Its the same weight i have been for years (im 27yrs) my doctor yesterday suggested i have a wheat deficency as I ate more than the average person and can not put on weight. Im concerned I wont be able to enjoy foods like i do if my blood test results show I have it :-(

  • Dr. William Davis

    10/10/2009 12:39:20 PM |

    Tina--

    Are you and your doctor serious?

    Perhaps you didn't catch the tongue-in-cheek message: There is no such thing!

  • buy jeans

    11/2/2010 8:46:31 PM |

    Of course, you could choose to cure yourself of this syndrome simply by taking the antidote: foods made with wheat flour, like bread, breakfast cereals, pastas, pretzels, crackers, and muffins.

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Fish oil: What's the difference?

Fish oil: What's the difference?

Ultra-purified, pharmaceutical grade, molecularly distilled. Over-the-counter vs. prescription. Gelcap, liquid, emulsion.

There's a mind-boggling variety of choices in fish oil today. A visit to any health food store, or any "big box" store for that matter, will yield at least several, if not dozens, of choices, all with varying and often extravagant claims of purity and potency.

So what's the real story?

Given the analyses conducted over the years, along with my experience with dozens of different preparations, I believe that several conclusions can be reached about fish oil:

Fish oil is free of contamination with mercury, dioxin, PCBs, or furans. To my knowledge, only one fish oil preparation has been found to have a slight excess of PCBs. (This is different from cod liver oil that has been found by one source to have a slight excess of PCBs.)

Oxidative breakdown products differ among the various brands. Consumer Lab (http://www.consumerlab.org/), for instance, has found that several widely available brands of fish oil contained excessive oxidative breakdown products (TOTOX). You can perform you own simple test of oxidative breakdown products: Sniff it. Your fish oil should pass the "sniff test." High quality fish oil should smell non-fishy to lightly fishy. Rancid fish oil with excessive quantities of oxidative breakdown products will smell nasty fishy.

FDA approval does not necessarily mean greater potency, purity, or effectiveness. It just means that somebody assembled the hundreds of millions of dollars to obtain FDA approval, followed by lots of marketing savvy to squash the competition.

This means that there are a number of excellent fish oil products available. My favorites are the liquid fish oils from Pharmax, Nordic Naturals, and Barleans. Capsules from Carlson, PharmaNutrients, and Fisol have also performed consistently. The "big box" capsules from Sam's Club and Costco have also performed well and are wonderfully affordable.

Comments (27) -

  • Bill Millan

    12/10/2010 3:01:47 PM |

    I have engaged in more discussion about fish oil than any other supplement. Just remember we could care less about the fish oil, what we are after is the EPA+DHA Omega 3 in the oil. The rule of thumb is, "the higher the price, the more Omega 3." You can save money and get the 30% in the Kirkland or Sam's Club brand or spend a lot more money and get the 50% to 70% brands.

  • Bill Millan

    12/10/2010 3:01:47 PM |

    I have engaged in more discussion about fish oil than any other supplement. Just remember we could care less about the fish oil, what we are after is the EPA+DHA Omega 3 in the oil. The rule of thumb is, "the higher the price, the more Omega 3." You can save money and get the 30% in the Kirkland or Sam's Club brand or spend a lot more money and get the 50% to 70% brands.

  • arnoud

    12/10/2010 3:11:11 PM |

    Often I have wondered about the benefits, if any, of krill oil versus regular fish oil.    
    It seems that the Phospholipids in the Krill oil play a role in HDL quality.

    I have not yet found a good paper explaining this, but Neptune Technologies is doing some research on this.  I prefer whole foods, rather than drugs, but the research on this topic looks interesting.

    From their website on a research on concentrated phospholipids form krill oil:
    Neptune Technologies & Bioressources Inc. Reports Completion of Acasti Pharma Comparative Benchmarking Program versus Lovaza®



    Laval, Québec, CANADA – November 25, 2010 – Neptune Technologies & Bioressources Inc. (“Neptune”) (NASDAQ: NEPT - TSX.V: NTB) subsidiary, Acasti Pharma Inc. (“Acasti”), reports the completion of its  preclinical program designed to compare the lipid management effects of Acasti’s drug candidate CaPreâ„¢ versus prescription drug Lovaza®.  Blood lipids were monitored in two animal models in order to assess and compare the efficacy of CaPreâ„¢ and Lovaza® over a 12-week treatment period.

        * A low daily human equivalent dose of 1g CaPreâ„¢ reduced LDL-C (bad cholesterol) levels by 40% and increased HDL-C (good cholesterol) by 180% in a normal rat model (“SD”) while 4gr of Lovaza® did not show any significant effect.
        * An even lower daily human equivalent dose of 0.5g CaPreâ„¢ was shown to be as efficient as 4g of Lovaza® in reducing triglycerides levels by 40-50% in obese rats with severe diabetes and high triglycerides (“ZDF”)


    “These results suggest that a low (0.5g to 1g) daily dosing of CaPreâ„¢ is more effective than 4g Lovaza® in elevating HDL-C and lowering LDL-C and triglycerides.  These effects become even more striking considering that a 1g daily dose of CaPreâ„¢ contains 8.9 times less EPA and 11.1 times less DHA than the recommended 4g daily dose of Lovaza®. It is also important to note that the triglycerides reduction was observed only after 4 weeks and was maintained throughout the study suggesting a significant metabolic impact of CaPreâ„¢,” said Dr. Bruno Battistini, Senior Director, Pharmaceutical R&D of Acasti.

  • Geoffrey Levens

    12/10/2010 4:38:02 PM |

    If one brand showed slight excess of PCB's, does that mean all the rest also contained PCB's only just the right amount?

    What are the benefits to cardiovascular health of taking plant/algae sourced DHA vs fish sourced EPA/DHA?

  • Anonymous

    12/10/2010 4:54:31 PM |

    What do you think of the conclusions in this blog post?
    http://thehealthyskeptic.org/when-it-comes-to-fish-oil-more-is-not-better

    For a "healthy" person are your recommendations the same- as in make sure to get a high quality fish oil?

    I really appreciate you taking the time to write on this blog.  Thank you!
    Char

  • Jack

    12/10/2010 5:00:58 PM |

    or you could just eat natural food sources of omega-3, like wild salmon, tuna, sardines, grass fed butter, eggs from pastured chickens, fermented cod liver oil. then you wont need supplements.

    cheers
    jack k

  • Eric

    12/10/2010 5:20:40 PM |

    What if you can't stand the taste of fish like salmon and sardines or fermented cod liver oil?

    I'm hoping Carlsson's is good, that's what I've been taking for the past few months and I love how it tastes like lemon oil, not fishy at all.

  • Dr. William Davis

    12/10/2010 7:48:29 PM |

    While there is debate on the reduction in cardiovascular events with omega-3 fatty acids, I use them to achieve correction of a number of physiologic parameters:

    1) Reduction of triglycerides
    2) Acceleration of clearance of postprandial lipoproteins, such as chylomicrons, chylomicron remnants, and VLDL
    3) Reduction of lipoprotein(a)

    The data on the likelihood of cardiovascular mortality correlates inversely with RBC omega-3 EPA + DHA; the relationship is quite strong. While we lack prospective trials outside of GISSI Prevenzione on the reduction of cardiovascular death with higher levels, given the overall improved surrogate measures of risk, I believe that the data overall are sufficiently compelling.

  • Anonymous

    12/10/2010 8:49:01 PM |

    Funny, I've been reading up about this lately. I like the fact that if we can - there is the possibility of actualy getting the appropriate amount of EPA+DHA Omega 3's by eating fish. I recently started buying sardines just for this purpose and I'm going to try real hard to incorporate oily fishes. I like it when people help others minimize the amounts of supplements they use.

  • Anonymous

    12/10/2010 10:03:22 PM |

    dr. davis

    i can't smell anything rancid in my distilled fish oil with orange flavour but its so weird its too heavy barely digests and stays as if stuck in the chest. feels horrible.

    not sure what to make of it.

  • Pater_Fortunatos

    12/10/2010 10:07:40 PM |

    There are a few benefits of a plant based diet: avoiding acid load, toxin accumulation in the food chain, and another one, high lipid peroxidation level of the longer chain EFA.
    So I just heard that "Reduction of triglycerides" using fish oil, is an effect of liver damage.

    Just search for this book:
    "Fatty acids in foods and their health implications" - Ching Kuang Chow
    I just quote from the chapter V. MEMBRANE UNSATURATION AND LONGEVITY
    _______________________________
    In summary, the above mentioned studies provide a correlation between the maximum longevity of animals and the degree of unsaturation of membrane fatty acids. That correlation joins the previously stated one between the rate of mitochondrial oxygen radical generation and the maximum
    longevity of animals. In long-lived homeothermic vertebrates, both free-radical production and the
    membrane fatty acid unsaturation are lower, offering an explanation for some of the main causes of
    the low aging rate peculiar to these animals. No studies have been carried out on these aspects in
    relation to dietary fat and, as it will be stated below, this is another notable aspect of fatty acids and
    aging.
    _______________________________

  • John

    12/11/2010 2:35:55 AM |

    Is there an over-the-counter brand of fish oil that closely matches prescription Lovaza?

  • Jack M.

    12/11/2010 3:37:59 AM |

    westonaprice.org has very informative articles on this. Type "cod liver oil" in the search box to find their articles.  There is great info on how the better brands are manufactured.

  • William Trumbower

    12/11/2010 3:24:04 PM |

    A product similar in principal to krill oil is Vectomega.  It is a phospholipid bound salmon oil made from salmon heads.  The heads used to be discarded and this is a resource that doesn't deplete the food of whales etc.  According to the companies data, one tablet is the equivalent of eight standard capsules (probably 2.4gm of EPA+DHA).  It is a little pricey, but you will never burp it and it is very portable when you travel.  I suggest to my patients that if they regularly take much more than 2.5gm, that they get AA/EPA ratio available thru many labs.  yourfuturehealth.com,    LEF.org

  • Geoffrey Levens

    12/11/2010 4:57:33 PM |

    Supposedly DHA converts in the body to EPA pretty easily.  Anyone know any data about taking DHA alone vs with EPA?

  • Vlado

    12/11/2010 5:36:56 PM |

    to come from other side, I have started to read Ray Peat's articles and he is big on the dangers and overhype of non saturated fatty acids , in particular omega 3. It makes sense that humans having developed in hot climate require primarily saturated fat to protect from heat, light and oxygen. There is a reason why fish oils smell and why vegetable oils must be deodorized, it's basically our body telling us that non saturated oils are bad for us. Ray Peat says these oils make our membranes "floppy" and our skin prone to photo dammage by the sun. Basically we need all the saturated fat we can get primarily from coconut oil and butter but polyunsaturated fats should be minimum and certainly no supplement. Read up here
    http://raypeat.com/articles/articles/fishoil.shtml
    http://raypeat.com/articles/articles/membranes.shtml
    http://raypeat.com/articles/articles/unsaturatedfats.shtml

  • Anonymous

    12/11/2010 6:57:14 PM |

    I take at least 900 EPA + 600 DHA fish oil daily. I usually take 1-2 softgels with each meal. I continue to experiment with higher doses, but so far, I can't tell the difference between 5 softgels daily vs 10 softgels daily except 10 softgels means 50 extra calories. Sometimes I actually need extra calories, so I've taken as much as 40 softgels in one day.

  • rhc

    12/12/2010 2:30:31 AM |

    I guess I'm the only one who actually LIKES chewing my fishoil capsules. To me they are like a treat! This has the added advantage of knowing for sure if they are rancid. I've been getting Sundown Naturals for over a year - never had a bad one yet. The taste is very mild and I they never make me burp.

  • Anonymous

    12/12/2010 2:53:27 PM |

    dr. davis i d like to know your take on this

    http://raypeat.com/articles/articles/fishoil.shtml

  • Travis Culp

    12/12/2010 7:27:04 PM |

    I've found that Barlean's cod liver oil is least offensive taste-wise, followed by Spectrum. Both are molecularly distilled. I have trouble finding Barlean's, however.

  • Anonymous

    12/12/2010 9:45:55 PM |

    In declaring EPA and DHA to be safe, the FDA neglected to evaluate their antithyroid, immunosuppressive, lipid peroxidative (Song et al., 2000), light sensitizing, and antimitochondrial effects, their depression of glucose oxidation (Delarue et al., 2003), and their contribution to metastatic cancer (Klieveri, et al., 2000), lipofuscinosis and liver damage, among other problems.

  • Anonymous

    12/13/2010 4:56:56 PM |

    Dr. Davis,

    Should Vitamin D gelcaps have an odor? I've been taking a generic drugstore brand and they always have an unpleasant smell, but I assumed they were supposed to.

    Thanks!

  • Vin

    12/13/2010 7:29:14 PM |

    @arnoud - phospholipid-bound Omega-3 appear to get incorporated into membranes 1.5 to 2X more than triglyceride or ethyl ester Omega-3. But Neptune researchers have not explained why krill oil reduces LDL more than Lovaza.

    @Geoffrey Levens - just about every food product has small amounts of PCBs. Yes, fish oil too. Cod and Shark liver oils typically have much higher levels. More on fish oil and PCBs here.

    Retroconversion of DHA to EPA is not very efficient. Roughly 10% of DHA gets converted to EPA. EPA to DHA far less efficient. Several metabolic factors affect these conversions. Bruce Holub at Univ Guelph has done great work on this. Check out PMID: 9507234 and 9076673.

    @John - Several brands have 700 - 900 mg Omega-3 per pill, like Lovaza.

    A few have 20-30% more Omega-3 than Lovaza:
    Minami Nutrition CardiO3
    OmegaVia
    Ocean Blue Professional
    RenewLife come to mind.

    These all have over 1000 mg Omega-3 per pill.

    Next-gen fish oil (pipeline) drugs like Epanova and AMR101 are mostly EPA - so worth looking into high EPA OTC formulas for a fraction of the price.

  • Kevin

    12/14/2010 12:05:36 AM |

    $2000 per month doesn't seem so bad.  For the three of us, two adults and one 18yr old, we pay $2600 per month.  But my wife had cancer twice:  Hodgkins Lymphoma 24 years ago and breast cancer six years ago.  Before doing anything that might be dangerous, I remind myself of the $1500 deductable.  

    kevin

  • Anonymous

    12/15/2010 8:27:27 AM |

    dr. davis

    i did some research and to answer my own question on fish oil...
    for those without heart disease (like me) 1 gram of fish oil is sufficient and should be taken with 4 grams of saturated fat otherwise fish oil slips through the intestines undigested. 4 grams of saturated fat is used for making the liver start bile production.


    -----------------------------------
    original question

    dr. davis

    i can't smell anything rancid in my distilled fish oil with orange flavour but its so weird its too heavy barely digests and stays as if stuck in the chest. feels horrible.

    not sure what to make of it.

  • Buy Resveratrol

    1/13/2011 9:41:21 AM |

    It is good; however the oil came from the liver. It can contain too much Vitamin A and it could be dangerous if u overdose. I suggest sticking with eating a variety of fish.

  • Anonymous

    2/12/2011 10:33:52 PM |

    ah great info.......i live in the UK and I usually take different supplements, plz cud u tell me what should i look for while buying the fish oil....tnx in advance Smile

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