Traveling through the internet, it is easy to find all kinds of conspiracy theories.  Most are wild and crazy, full of half truths, and fairly easy to see through as being created for political reasons or just entertainment.  But every once in awhile one is found to be true.    The health care system does not want to change the current cardiac system because of money. I would go as far as to say I believe health care professionals discourage people to even care for their heart on their own.

Thank you very much for blogging about your experiences on cardiac prevention.  At the moment practicing prevention seems to be at the grass roots level, but I hope with continued success, over time that will change.  I've never been much of a cause person, but feel getting the word out on cardiac prevention is important - I forward your blog to friends and family so they can learn how best to take care of their heart.  To quote our 16th President "You can fool some of the people all of the time, and all of the people some of the time, but you can not fool all of the people all of the time."

Dr. Davis,

Having become acquainted with the TrackYourPlaque program in the last several weeks, the issue you raise in this post is one I'm extremely puzzled by.  It's this:

Why are almost all cardiologists and virtually all general practitioners virtually clueless about the few simple elements you outline in your book and in the TrackYourPlaque program?

The importance of getting a heart scan score, figuring out why plaque is accumulating with lipid testing, and doing something about high scores with diet, exercise, and supplements ought to be pretty easy to explain to just about everyone.

So, why aren't more physicians doing it?

Your post today essentially says that it's all about the money.  That may be true but I keep thinking that there has to be another reason.  Can so many people dedicating their lives to the health of others really have been waylaid, consciously or without thinking, into ignoring what amount to best treatment practices?

That video from the Charlie Rose show last week on Heart Disease is now up.  CT scanning is mentioned briefly but nuanced lipid analysis warranted not a word.  And this, mind you, was a conversation among physicians friendly to prevention.

My second viewing of that session made more clear a point you repeatedly make.  Cardiologists are worried about costs of scanning and also about CT scans that show artery narrowing resulting in unnecessary procedures being done.

Meanwhile, in the same conversation, the point is made that most heart attacks don't occur at artery narrowing junctures.

Here's a link to the video.  It's video #9.

pfizer.com/think/think_cr_science.jsp

The video from 00:14:00.000 to 00:20:30.000 is an interesting window.  CT scans are discussed during 00:29:00 to 00:31:00.

If you watch from 00:47:00.000, Steven Nissen gets around to making your point that money plays an enormous role in outcomes.

But if you're suffering from coronary artery disease, this is a maddening video to watch.

-   Not a single mention of the importance of calcium score.

-   Not a single mention of blood lipid subfraction analysis.

-   Not a single mention of treatments for the lipid subfraction measurements that are closely linked to heart attack.

This cardiologists are among the most well informed in the country and yet the tying together of diagnostic technology (CT scans), causal analysis (lipid analysis), and preventive measures (diet and supplements) is never put together coherently.

The token prevention cardiologist on the panel speaks at such a general level that anything said is of no use.  Seems to me that she is completely unaware of the kind of preventative measures that the TYP program entails.

Seems to me that if this discussion is the best cardiology has to offer the field is in a sorry state indeed.

Our community, like others I bet, is planning to build a "heart hospital". We already have three hospitals. Once, and soon I hope, your approach becomes mainstream, we might need only a "heart trailer". If I was a wealthy philanthropist, I would fund more research in this area, including things like apo A1 Milano. Thank you for everything, Dr. Davis.

It's maddening, isn't it?

I actually practiced in Cleveland until 1994. Back then, the town was focused on building procedural volume, obsessed with that path, in fact. That same bias persists.

One of the perverse realities of all of medicine, but cardiology moreso than other areas, is it's not worth pursuing unless a large profit-potential can be extracted. ApoA1 Milano, for instance, was indeed pursued by Steve Nissen. But this will likely carry a cost of about $2500 per dose for a multiple dose course.

The Track Your Plaque-type approach doesn't make anybody a lot of money. (It did pay for a meeting we once had over dinner.) Such are the economic realities.

All you and I can do is keep agitating. I am confident that, at some point, truth will win out.

Didn't even Charlie Rose avoid U.S. cardiologists? I recall that he went to Europe for his heart (valve?) surgery...  was that 2001? Had a baby that year so everything's a fog!

Ironically, I believe it is this approach, i.e., prevention of heart diseaes a la Track Your Plaque, that would save the U.S. untold sums of money, billions of dollars. Of course, that money would then be denied to hospitals, the medical-industrial complex that supports modern medicine, and my colleagues. It's the same reason that the oil industry has not contributed to development of the 100 mpg automobile.

I believe the media does over-hype almost all health related issues, including drug drug interactions and adverse reactions.  With regards to taking your medication though, there have been several reports that confirm if you are non-adherent to your medication, you raise the risk of having another heart attack and possibly dying.

Since I am the subject of your blog, I'd be happy to comment.  The point of the story is that there are things you can do to prevent heart disease and an MI.  I don't believe this was spun by the media and I was happy to be part of it.  In fact I am confident that if people take this advice on warning signs seriously they have a better chance of survival and it could even save lives.  I'm happy I took part in the article, you should stop your scare tactics of the industry that albeit profitable is saving lives.

Brian Connell

I'll be damned if I stop criticizing the status quo in heart care.

You are entitled to your opinions. People are entitled to continue submitting their lives and health to the endless appetites of a procedure-obsessed health care system. I personally would rather seize control over my health and be provided truly effective preventive strategies. You clearly have not been provided this information.

I felt that your post was highly enlightening. http://www.howtorelievestress.org
has a lot of tips on managing your stress! I find this website very useful.It definitely helped me, and I can see an improvement in my condition already.

Yes - the media hypes almost everything to excess whether it be the weather, economy or health related procedures. I find it highly unlikely that prevention will ever be hyped in the mainstream since prevention is not a money maker and is not "exciting". Too much pharma revenue would be lost even if people took the simple step of normalizing vitamin D levels let alone any other "provocative" measures such as reducing sugar intake etc.


Bob

Surely there is a place for education in both prevention and emergency treatment. The problem is achieving a balance of emphasis.
While I have clearly benefited from the preventive approach, (0  score at 72) my wifes maternal uncles all died of MI in their 40's and 50's except for the one who made it to 60's inspite of a stroke. Her mother made it to 90following two MI's and with conventional treatment including two cabg's.
Until the better preventive approaches are given equal time, and a couple of generations have benefited, we will need both kinds of awareness.
Typical media articles (and cardiac advice) reflect the lifestyles, errors and distortions of the past 30 years. Dr D's advice is excellent, and I appreciate his frustrations at the long uphill battle.
mikeV

Mr. Connell,

(You're the second Brian to blog and start some *umm* drama) I'm sorry to hear about your event but I agree with you, it's good to get the news out.  

By generous measures, according to the statistics, you life will require 'saving' yet again in approx 15 yrs if you follow 'conventional' wisdom and your docs in Bakersfield (no doubt there adequate but not as good as DR. Davis and TYP -- Track Your Plaque program).  

(you are aware i hope that statins won't save your life, right?)

Good luck.

(FYI ask your Bakerfield docs to check: lipoprotein (a), homocysteine, and glucose -- you need to improve these to prevent those native vessels, bypassed vessels and stents from clogging up)

g

Hey Mike V., what have your preventitive measures been these past 72 years?

Thanks, Daniel

Hello g,

Not trying to start controversy, quite the opposite. My doctors are in Boston, not California, and the article that was posted by this ABC affiliate was never viewed by me, it was their edit of the AP.

Here's the real story URL:

http://www.cnn.com/2008/HEALTH/conditions/02/18/hm.young.heart.attack/

I participated in this article to provide a hopeful message which I believe is a much more positive headline and message and aired on CNN Headline news this past week.

All the best to all of you with your efforts for heart health and heart disease prevention.

Brian Connell

Dr. Davis --
Interesting discussion.
I assure you that I take my job as a journalist as seriously as you take your job as a doctor. I would never presume to assume that your motives were anything other than to do your job well.
While I may agree with many of your points (i.e. procedure-obsessed health care system, preventive health care strategies), I take issue with your assumptions of how I go about my work as member of "the media" -- IN NO WAY was my intention to over-hype anything.
The area we live in has an unusually high number of people with heart problems and heart attack deaths.
Is there no value in this story?

Nothing too surprising Daniel.

About 10 years ago I lost faith in the 'prevention' of the time which was low fat. I needed gall bladder surgery inspite of my 15 to 20 miles per week walking/running to offset sedentary profession.
Moved away from excessive carbs, and towards whole foods. Supplement a few places where diet and lifestyle still don't quite make it. Independently ended up surprisingly close to Dr D's recommendations emphasizing fish oil (3Gm), vitamin D3 (4000iu  depending on season), magnesium citrate, CO Q10.  
Diet leans toward mediterranean.
Oils: Limited to ev olive 20%, light olive and canola 40% ea. No other.
Wine: Pinot Noir. Tea: green and black.

Plenty of greens, small berry fruit, citrus.
Big on cheeses. Esp strong flavored, fermented varieties.
Omega 3 eggs
Throw in some spices, cocoa, walnuts, p-nuts,
I try to maintain variety, and not to get too hung up on any one nutrient.
My HDL moved from low 30's in my 40's to about 50 now.
No long term meds. except thyroid. Have not had a cold or flu this year. Tendency to tendonitis sometimes limits excercise to treadmill. Resting pulse 50.

FWIW My father passed with MI @ 76 (had signs of prior MI) Mother passed @ 92. Chief complaints: CHF, ARMD

Hope this is helpful.
MikeV

You summarized one of the main ideas propogated by this type of media: "1) Get yourself to a hospital ASAP for any symptoms even vaguely suspicious of heart disease, because they will know what to do. You'll be doomed if you don't."

I had "heartburn" for a week before I went to the ER, got an EKG and blood workup and was sent home with some antacids, feeling foolish for overreacting.  Two days later, after spending the whole night alternating puking and screaming, hubby took me back to the ER and they decided to transport me in an ambulance to another hospital for an emergency angio, which was followed up by a CABG.  In short, two days after a "good" EKG, I needed two surgeries to repair my heart.

I asked our internist to refer my husband for a heart scan and he wrote referrals for an EKG and stress test instead.  We skipped them and the heart scan is next month.  

A stress test doesn't show anything unless there's an actual *blockage* - a heart scan shows arteriosclerosis before it gets to that point.  And my own experience is that an EKG doesn't show anything even two days before an MI.  To hell with that.  

If hubby gets anything other than a zero calcium score, next step is a VAP lipid test to begin correcting his issues.

The whole *point* of the exercise is for him to *avoid* what happened to me.  Yes, it's wonderful they can do angios and bypasses, but... it's been EIGHT MONTHS since mine, and I still can't go back to work!

So yes, I'm alive and all, but it'd be damned preferable had I gone at it from a prevention standpoint a few years earlier.

Thanks Mike V, That's intersting - but it sounds like until you were 62 you practiced the low fat diet? Daniel

I didn't really have the scare tactics.  My heart attack was out of the blue.  I was in perfect health.  Or so I thought.  My PCP did say I had High cholesterol and was on meds for that.
2 weeks before I had my first MI(in the gym no less ) I had been going to my PCP with nausea.
I've been wondering if this was a precursor to the MI.
2 months latter I had a massive heart attack (the widow maker as you say ) causing a lot of damage to the heart muscle.  My EF was 25 it is now around 30.  My cardiologist reccomended an ICD which I have now.
I have devoted my blogg to helping people with their feelings in dealing with CHF and other heart problems, by telling my story.  It's very theraputic for me.
But I may be giving wrong advise.
I am no Dr. just a patient with heart problems.
Thank you for taking time with your blogg and for the information.
Some time when you have nothing to do, which I'm sure is rare. Check out my blog @ www.richosea.blogspot.com
I might have a lot of missinformation.  I also have an article coming out this month in EP Digest.  "A patient's perspective"
Thanks again
Rick O'shea

Over a decade ago, I was diagnosed with coronary artery disease.  I was told I needed a multiple bypass operation.   I was threatened with likely death if I did not agree to surgery.  Actually, I probably was close to having a plaque rupture, but I knew that surgery was not the answer.  I knew I had to get my dietary habits under control.  Because of metabolic syndrome, I also needed some additional medication.  

I got my diet under control.  My wife and I focused on home cooking with fresh foods rather than processed foods.  I have taken a truckload of pills during the past decade.  I began exercising regularly.  I changed careers to reduce my stress levels.  I had my cardiologist do check-ups on me quarterly.  But, I have been steadfast about declining stents and bypass surgery.  

Most recently, my wife and I have eliminated wheat and wheat flour from our diets, after reading Dr. Davis' book, "Wheatbelly".  This step actually substantially eliminated my exercise induced angina!  

I look forward to many more years of improved health.  I particularly enjoy sending some of my early interventional cardiologists annual Christmas cards containing greetings along the lines of the old Timex commercials, "Takes a licking and keeps on ticking."

That's excellent, Mark!

You bucked the hungry revenue-generating medical system.

Hi Mark:  Bravo on your choices.  I am being pressured to have a cath by a pushy cardio nurse.  My choice at this point is to have a C-RP test, since I have NO symptoms, just what the cardio MD SAYS showed up on the EKG, and 2 short episodes when I was wearing the heart monitor.  I don't like fear-mongering.  Not my style, and I'm inclined to push against that.

Any comments/suggestions will be appreciated.  I have, since a stroke @ 59, 14 years ago, made a living as a very active, ladder climbing painting contractor.

Bill in Charlotte

How about acupuncture and chinese medicine? Anecdotally, they will be able to help you through monitored use of chinese herbs and acupuncture.

I'd also like to add that if one can't get good thyroid care inside an HMO network or "universal" healthcare system, it can be money well spent to go "outside" the system  for private care.  Granted, paying for non-reimbursable care isn't cheap and one has to do a lot of investigating to make sure one isn't paying for more of the same inadequate care (or worse care).  But I think too many people who can afford to pay for private care suffer needlessly by doggedly sticking to inadequate care because alternatives cause a financial dent.  But in the long run, if one can find good care even though there is added expense, it can save a tremendous amount of suffering, as well as saving money.

When I was seeing a thyroid doc out of my HMO network, I was still able to get my lab work done by the HMO approved lab  and covered by my HMO insurance (the lab faxed the results to the out-of state doc without question), though the results did go into the computerized file at my HMO network, so was visible to any HMO doc.  And my HMO insurance Rx plan covered the conventional meds prescribed by the out-of-network doc without question (but not the compounded Rx).  Yes, it cost me a few hundred dollars a year to see the doc once year, a few telephone consults, and the non-covered compounded Rx, but it well worth it.  I was finally feeling and functioning better.

And when I went back to my HMO eventually (mostly because of travel scheduling difficulties in seeing the out-of-state doc), I was in a better position to make a case for similar care with the HMO endo (I told him flat out I'd had trouble getting good thyroid care from primary care physicians in the HMO and so went "private" for a couple years, but wanted to find someone local in the HMO for convenience) .  He doesn't do compounded Rx, and typically prescribes only Synthroid, but he accepted that I prefered T3 with the T4 (and he "accepted" the "odd" way I adjust my T4 dose with different amounts of 50 mcg Levoxyl on different days to get an overall weekly dose that works - the 50 mcg tablet has no dyes added and he accepted that I preferred Levoxyl over Synthroid).  So for the first time with the HMO system, I feel my thyroid care is more of a team effort that includes my input, instead of being at the mercy of whatever is dished out to me.  And if the situation changes, I will promptly go outside the HMO again.

I would also suggest using the Armour site to look for prescriber's.  Their site has a little 'doctor finder' feature.

It doesn't mean they'll necessarily treat you, but they tend to be more open-minded that doctors who prescribe Synthroid only.

Most doctors won't use body temperature as a guide, by the way. And most won't treat Hashimoto's unless your TSH is >5. I know it's wrong, but that's how it is.

Supplementing iodine may be helpful, unless you do have Hashimoto's, then it could make it worse (so you know). But you won't know you have Hashimoto's until you get your thyroid antibodies tested.

A couple of other suggestions:

Ask your doctor for Free T3/T4 AND thyroid antibodies. If your TSH >3 and your anitbodies are high, it really improves your odds of getting treatment. Many doctors ignore antibodies, but some do pay attention to them.

If your TSH or antibodies are high at all, ask your doctor for a thyroid ultrasound. If the ultrasound is abnormal at all, it improves your odds of getting treatment too.

Just going to a doctor with a TSH of 1.5-2.0 and normal T3/T4, it'd probably be close to impossible to get treatment. It really helps if you have the antibodies or ultrasound or something else to show the doctor.

No person should break the law.

However, there might be people within the arctic circle who don't have easy access to a physician who is willing to prescribe natural thyroid, including armour thyroid.

What to do in a situation like that?

One solution:  Find a site on the internet that provides for ordering and shipping thyroid, including Armour Thyroid, without a prescription.  There is at least one site that can be found via google that will do this.

Warning:  There are significant dangers in supplementing thyroid without being under a doctors care.

Thanks, Anna.

Regarding the thyroid issues Dr. Davis has been commenting on lately, and wondering why it seems so prevalent, have you considered the possibility that diet is playing a role.

And when I say diet, it's probably not in the way you think --

Carbohydrate restriction can lower thyroid hormone output, especially conversion of T4 to T3. Those who practice caloric restriction tend to have lower levels of T3 too.

If Dr. Davis is seeing somewhat low, but still in 'normal' range T3/T4, with perhaps sluggish T3 levels, in patients AFTER they change to a no wheat, low carb diet, perhaps that is the reason why? Or perhaps that's why Dr. Davis' own thyroid had somewhat sluggish numbers?

But if people all have high thyroid antibodies too, or all have crummy thyroid levels while eating tons of carbs, that wouldn't be a reason then.

Just throwing that out there to think about.

for those who are willing to do the research and check their tsh levels then ordering online is an option. start with a low dose 15 to 30 grains and then ck your tsh. Increase dose to normnal tsh levels.  There are multiple sites for armour and synthoid that do not require a prescription. When you take this road to self medication you must realize you are toally responsible for your actions and well being. Be sure you know what you are doing
Don

Lately I've been giving a lot of thought to the LC packaged foods that many people turn to when they first embark on a LC diet, such as low carb breads, crackers, etc.  For me, it was LC pita bread a few years ago, before I essentially went grain-free.  These products, in addition to usually having a lot of soy in them, also have added wheat gluten, to reduce the starch and boost the protein content.  Low carb they are, and generally will help with the BG control and overall weight reduction or maintenance.

Both gluten-containing and soy foods are relatively new foods to the human diet (only consumed since the age of agriculture) and modern industrial processing bypasses many of the steps that earlier humans took to render them safer to consume.  Soy can be a powerful thyroid inhibitor (goitrogen)  and gluten can trigger an auto-immune response in susceptible people (genetic predisposition to gluten sensitivity is much more common than previously thought, though how widespread is subject to debate).  There does seem to be a strong connection to autoimmune thyroid conditions and issues with gluten.

So people who eat a lot of soy and gluten-enhanced LC foods might be literally be shooting themselves in the thyroid, especially those who overconsume  consume them (dieters don't ever become overzealous, do they?  ), instead of foods that are naturally low carb and/or have a longer history in the human diet.

I think ordering prescription medication over the internet from a less than reputable pharmacy, without a prescription, is a real bad idea. And if they don't require a prescription, that pretty much automatically makes them less than reputable.

And don't assume thyroid medications are completely benign. They can have side effects too.
And especially in patients with heart disease. You have to be titrated slowly and need to be under a doctor's care.

DIY Armour/NTH treatments can be troublesome. If you are suffering from adrenal fatigue, starting immediately on thyroid replacement can cause heart palpitations and other symptoms of physical and mental anxiety. If you have low cortisol and DHEA (they invariably go together), you will probably need to take a low-dose steroid and/or DHEA replacement for a month before beginning thyroid. It is best to get these things tested first, even if you have to do it on your own. I think the Stop The Thyroid Madness author has put together some lab test packages for people to get the right things tested. And when you're taking the replacement steroids and hormones, you need to keep monitoring your levels every month at first, then every three-four months once you stabilise.

Google for the "Top Thyroid Docs" list by Mary Shomon for sympathetic doctor suggestions/review.

I forgot to add, the thyroid books by Dr Broda Barnes are good reading, easy to understand if you're a layman too. He had one on incidence of heart disease in patients with corrected thyroid function which is very interesting. I don't recall he mentioned wheat, but he certainly believed that we should eat good old saturated fats like butter, lard, coconut, etc, to support good health and thyroid.

Anecdotally along with the iodine I've heard a brazil nut per day suggested for the selenium. Where I live is not selenium deficient, thanks to the end of the Ice Age glaciation: this is reputed to be one reason for the longevity here. Next time I catch a doctor I'll ask if there's much thyroid disease here (they will diagnose and treat here, my TSH was 0.99 so something is working!)

That iodine dose may still be too low. Remember the RDA was set at a level just to prevent goiter, not for optimal health. Check out www.breastcancerchoices.org.
Healthy Japanese get 12.5mg (12500 mcg) of iodine per day. Probably we are all low in iodine and bromine competes for binding sites. Bromine is ubiquitous in our chemically laden environment and is used as a dough conditioner by commercial bakeries---they used to use iodine. The thyroid gets the bulk of our low iodine but it turns out that iodine is also concentrated in our gonads, adrenals and especially the breasts. Our epidemic of breast cancer and fibrocystic disease may be due to iodine deficiency.

If you cannot get this treatment on HMO, then you should look at going private. Believe me, it is not something that you can ignore

Dr. Davis,

I realize that you aren't in the business of diagnosing ailments or conditions via the internet, but I've recently experienced some hypothyroidism symptoms (low body temp. average of 96.7, fatigue, weight gain, hair loss, etc..) that my Doctor insists are unrelated to the disease.  In addition, he has also just put me on a combination of Crestor and Trilipix for an abnormally high triglyceride reading, despite this reading being a one-time fluke.

My labs are as follows:
TSH:       2.761
Thyroxine (T4): 6.4

He was not interested in doing any more thyroid testing beyond these two.

Lipids:
Total Cholesterol: 165
Triglycerides:     415
HDL:               22
LDL:               N/A

After a week on the Crestor (10mg) / Trilipx (135mg) combo, I was stricken with muscle aches and pains, tinnitus, popping ears, dizziness and a foggy out-of-it feeling.  After two weeks and finding your site, I discontinued the use of the two cholesterol medications against the Doctor's advice.  I've since starting taking an Omega 3-6-9 supplement three times daily along with my daily multi-vitamin.  I also take diazide/HCTZ for slightly elevated BP (130/96) and have recently begun following a strick low-carb diet and exercise routine.

Again, I don't expect a diagnosis from you, but would appreciate if if you could voice your thoughts on the viability of me continuing to find a doctor willing to be more open minded to thyroid issues as well as pursuing more natural remedies to lipid issues.  

Thanks for providing such a valuable resource for those of us who are getting fed up with the flawed standard of care that is currently being forced on so many people.



My labs show the following.

I agree on the iodine dose question.

The difficulty comes in trying to generate conversation through the blog for people who may or may not, for instance, have underlying Hashimoto's thyroiditis or thyroid nodules, in which case taking higher doses of iodine can trigger extreme excesses of thyroid hormone.

I had been on Sythyroid for a few years but no one had ever mentioned or tested for Hashimoto's. Still feeling horrible, I found a holistic MD, and was diagnosed with Hashimoto's and started on Armour.
Do I still have Hashimoto's or is it quiet now that I am taking a different hormone?
The holistic said it would "kill" my thyroid and move on to another area, like adrenals.
I did have a positive ANA for many years and tested for Lupus, RA, etc. many times. Then routine testing showed my ANA had returned to normal values.  
Any ideas because my current endo. sure isn't forthcoming with any and doesn't/hasn't tested for antibodies.  He feels I am just hypothyroid.
I appreciate all your information!

To test for Hashimoto's you need your TPO and TGAB antibodies tested. If they are above normal range, you probably have it. The definitive diagnosis is via a biopsy, but without a nodule that isn't usually done. An ultrasound is another diagnostic tool -- if your thyroid looks enlarged, nodular or all lumpy, along with antibodies, it's pretty safe to say you have Hashimoto's.

I have never read, or heard of, Hashimoto's 'attacking' other organs after your thyroid is burnt out. That theory seems a bit out there to me.

Antibodies can fluctuate, and with thyroid hormones usually become lower over time.  Inflammation tends to be reduces with hormones too.

OK I caught one of our GPs yesterday, the selenium in the soil connection appears to be a non-starter. Her experience was that she found hypothyroid "quite often" predominantly in post-menopausal women and with incidence increasing with age. It's impossible to compare numbers with other areas since they actively look for the condition here and don't elsewhere. Also we have a lot of local longevity so more patients with systems wearing out purely through ageing.

I always wonder about something I hear frequently - the issue of "soil mineral depletion".  Not that it isn't possible, but how significant is this and how widespread?  People don't generally eat "locally" produced food anymore; food supplies are distributed from all over the globe now, though agriculture is quite intense in some places, like the Central Valley of California, or cornfield in Iowa.  Wouldn't the shipping of food products all over sort of "average out" the minerals like iodine and selenium?  Or are  all the major agricultural regions of the world growing with depleted soil propped up with little more than NPK replacement?  

I'm actually more into local, seasonal organic food than worldwide food.  LIving near the coast, presumably there is adequate iodine in the soil, but here I am, hypothyroid anyway.  Just wondering...

Hard to tell about the soil mineral depletion thing, there are major regional variations which can show in animal diseases and require supplementation, salt licks etc. as well as human disease clusters. Deficiencies can show before "deficiency diseases"

I trialled several different supplements but none of them made any discernible difference, probably a widely varying diet helps, plus fish, and local farmers who use high levels of organic manure and feed the soil as a whole rather than (increasingly expensive) stuff out of a bag and treat the soil as a sterile growing medium. Grass-fed rather than grain-fed meat, and game, probably helps too in picking up trace elements

The downside of World Trade may be that while you get more trace elements from crops from different regions you are probably also getting more pesticides some of which are banned in the West

I've been doing so great after taking 1 1/2 gr nature-Throid brand of thyroid since october 08 and stopping all statins. Taking the Now D-3 at 5,000 per softgel. Now if I can just get back in the forums again....LOL   Dennis  still no 4th heart attack since 12/04

I wish my family doctor was open to new things. I asked him about Armour thyroid he said that he has hundreds of patients on Synthroid with no problems and I don't want to start a new prescription without my family doctor knowing about it. I'm on 75mcg of Synthroid and would really like to try Armour thyroid...might have to wait until he retires (could be soon) before I see if I can get Armour..

What about supplementation with tyrosine along side the iodine? Tyrosine is a precursor to thyroxine, and there have been a few interesting studies, like this one:

Psychoneuroendocrine effects of combined thyroxine and triiodothyronine versus tyrosine during prolonged Antarctic residence. Sure, the tyrosine may be working indirectly (going into neurotransmitters more than thyroxine) ... but at the end of a day, it seems to reduce TSH by about a third, while raising free T3 by 6%, while improving mood.

Dr. Brownstein (Family physician, holistic doc in Michigan) in his book, "Iodine, Why You need it, Why You can't live without it" makes an interesting case for temporarily increased TSH (5-30mU/L higher) after correcting iodine deficiency.

In addition to just stimulating thyroid hormone production, TSH also increases the production of the iodine transport cells (NIS). Without more NIS available, iodine couldn't enter the cells and be utilized. Therefore, increased TSH makes sense during the initial phase of iodine correction.

As one increases their iodine consumption, they could experience this increase in TSH for as long as several months. As long as the T3 and T4 levels are normal, then the TSH elevation probably isn't a sign of hypothyroidism.

If you haven't yet read this book, it's worth the 2 hours it took me to get through it.

I cut back on bread somewhat before coming to TYP, without a specific intent to lose weight.  I was happy to drop 9 lbs over four months just the same, but thought I was done when I reached 165lbs, my weight as a high school senior (I am 54 years old now, and no one thought I was overweight at 174 lbs. - I am 5'10", so BMI was at the top of the normal range at 174 lbs)

In Jan. 2009 I joined TYP, further cut my wheat intake to one modest helping a day and reduced sugar and fructose to maybe 10g or 15g a day (that is not the most rigorous TYP diet, to be sure; this is really only moderate compliance).  More weight dropped off (again, I had no real intention or desire to lose weight).  

Now I am 156 lbs, which probably was where I was as a high school sophomore.  I feel great, and have been playing better lacrosse and soccer than I have in years.

One clue -- my triglycerides never were too high, 70 or 80 over the years (LDL, well that is another matter).  Even on my good but not great TYP diet, trigs dropped like a stone, 29 the last time tested.  I think trigs are a great measure of wheat and sugar sensitivity.  If they are above 100, by all means restrict wheat and sugar and see if they don't get to a much healthier 60.  Even if not over 100, watch the trigs number go down and watch the lbs go down too.

My son lost six pounds over the summer cutting down vastly on wheat and sugar but eating everything else like a horse.  Neither of us has any interest in denying ourselves whatever quantity of food we want.  He was not trying to lose weight either.

Family members are not used to seeing me on the thin side, so I have gotten some comments asking if I am anorexic etc.  No, but I do get full with less food nowadays.

Thanks, Bark.

I agree on the triglyceride issue: It is a very sensitive gauge of carbohydrate, specificaly wheat, exposure.

I had a high weight of 245 - now I'm at an ideal weight of 185 and maintaining it with out cravings.

I used the AHA recommended low fat diet earlier with limited success and many health problems (back problems - gastic problems). Felt miserable all the time and failed to lose and keep the weight off. I thought I would never run again. I now sprint uphill for a block twice a day.

What a difference..

Thanks, Karl.

Pictures of your experience?

Although I started studying about my thyroid issue much earlier and did lose some weight, but ever since I started following Dr. Davis’s blog, it has given me confidence that I was on the right track. I did have my thyroid and iodine figured it out from other sources but Dr. Davis helped me to understand the issues with not only the thyroid but vitamin D3, fructose, fish oil, niacin, wheat etc. I have lost 43lb in last 14 months. It seems to me that there are certain percentages of weight connected with different issues. For example, after I gave up alcohol and sugar, I lost about 14lbs from total weight of 243lbs, weight came down to about 229lb. then it stopped at 229lb, even though I was in the gym almost 5 to 6 days a week with full workout. After I changed my thyroid medication to natural thyroid hormones (took synthetic t4 for over 10 years) the weight dropped down further 13lbs or so in matter of few days, shape of the face changed from moon shape/double chin to ordinary long face. Then it kind of stopped at around 213-216lbs. after giving up wheat, reducing carbs, increasing protein intake (whey protein, chicken etc. no soya, no fructose) the weight came down another 14lbs. now it is around 200-202lbs and I am over 6.2 tall with heavy set of bones. I feel better than I have ever in my life. More stamina, more clarity/no fog, more confidence and 99% of the time relaxed and being able to see the situation from multiple angels. I use to be able to drink a liter or more jack denial without a problem in one evening but now can’t stand half a can of beer (I miss JD). Drinking alcohol makes me sick. I sleep well and if I wake up in the middle of the night, I have no problem going back to sleep. No more out of breath stair climbing at all. One other thing, I was use to be the most attractive meal to the mosquitoes but not anymore, this year I haven’t been bitten once. I take my dog to the park everyday and I do not use any mosquito repellent, what a relief. I don’t know if it is because of thyroid, iodine, wheat or something else. Skin texture has changed dramatically; I do not use full soap or shampoo, 20% borax, 10 percent of my soap or shampoo for scent and rest water, mixed in a 500ml bottle, no more dandruff, dry skin, pimples for me. Dr. Davis I am thank full to people like you who have the ability to see beyond what you have been taught and have the guts to say the way it is. Most of us work to make living on daily basis but some make their living while spreading their knowledge to save lives. Dr Davis you are one of those few people. Please keeps it going.

Kris--

Wow! Great story.

I'd like to feature your story as a Heart Scan Blog post to help others understand the various steps involved in losing weight effectively.

OK, I'm sold.  I have been reading your Blog, Dr. Davis, for about 6 months.  My mother had a heart attack at age 59 last year.  She is concerned about me, and for good reason.  I am 39 years old, 5'2' and 215 pounds. I have tried EVERYTHING, and 6 months ago was sold on the lap band.  Then I found your blog.  My cholesterol was 258, and my "new" doctor put me on 10 mg of simvastatin.  My former doctor gave me a lecture.  After 3 months of very little change with the cholesterol, she wanted to up the dosage.  I asked for a chance to try Niacin and fish oil.  3 months later, my overall number was down to 217.  The nurse told me it was a "slight" change...darn, I think 41 points on my cholesterol in 3 months was GREAT!  I go back in October.  My thyroid was "borderline" for years, but I was never given anything to help--only lectures.  "LOSE WEIGHT"..."You're obese"...One doctor told me I was a "prime candidate" for gastric bypass.  I nearly fell off my chair.  If I don't learn how to change my diet, I will be in the same situation post lap band or gastric bypass.  I won't do that to myself.
So, YES, I am sold.  I am going to go wheat (and sugar) free.  I have been doing some food research and some creative shopping.  I will keep you posted!!  Wish me luck!
Thank you for a wonderful, compelling blog, Dr. Davis.

Hi, Tonya--

Please be sure to let us know how it goes in a few weeks.

A question about weight loss and niacin, which has been recommended to me for my high LDL. I notice, Dr Davis, in one of your posts you said that niacin works by blocking release of fatty acids from the fat cells. I've also read that it can somewhat elevate blood sugar--all of which sounds like an insulin response.  Could niacin hinder weight loss?  I've never heard this but the mode of action suggests that it could.

Thanks so much for your excellent blog; I never fill a prescription without checking here first.

Hi, Bonnie--

Theoretically it could. However, this doesn't seem to play out in real life, for reasons I don't understand.

I've witnessed substantial weight while on niacin, so if there's an effect, it must be quite trivial.

I am still quite fat, but have given up on bread and sugars and white flour and the "usual suspects", and the weight is starting to come off, even without being too disciplined to do all the rest of the steps.  I'll get there too, but just had to take those first steps, WHICH ARE WORKING.  

Clothes are looser, energy levels starting to increase dramatically, but more important to me, and something I am not sure if anyone mentioned...my sore legs and knees are starting to feel better.  I'm in my 50's, and know I need to lose for all kinds of reasons, but there is real chronic pain in obesity.  

I know why my joints hurt.  It's not a medical mystery.  But even with my initial slow and steady loss, there is dramatic improvement in my joint symptoms.

I had similar results as Kris with much the same side effects. Dropped processed carbs and fructose 2 years ago, lost 15kg then stalled. Dropped all grains and processed omega6 fats 1 year ago and added saturated fats + D3 + niacin back in and lost another 9kg.
A few other side effects :
- dry lips: I used to use a lot of chap stick for dry and even occasional blisters  on the lips, not any more.
- cold sores: I used to get them every few months, it has been more then a year now since I had them
- body odour: I used to had to wash every few days, not any more, I just rinse (finish with cold water) and brush myself dry.
- Tanning: I used to burn easily and would therefore avoid the sun, now I tan like when I was a kid.
- bleeding gums : gone
- plaque on the back of the tongue : nice and pink now.


And yes, I cannot "handle" my alcohol any more, a few beers and I'll have a terrible hangover.

I have posted my story before, but I will post it again. I went gluten free 6 years ago and went from 145 to 135. I am 5'4". Last year I gave up all grains and greatly reduced my all carbohydrates and another 15 lbs disappeared. I have remained at 120 by staying low carb. Before I went grain free my blood sugar was spiking over 200. Now I can keep my blood sugar under 120 after eating by sticking with the grain free low carb life. My lipid profile has improved greatly without medication since getting off the AHA sanctioned high sugar diet. My hsCRP has dropped from over 13 to 2.19.  

Ten years ago I had cardiac bypass after multiple failed stents. I was only 54 when all this started. As I look back I believe some of the contributing causes to my heart disease were low vitamin D, hypothyroidism, gluten intolerance, insulin resistance. I am still trying to get my thyroid issues optimized. There are often many layers to figure out on our journeys to better health.

Hi Dr., I have been a quiet reader of your blog for a while......I have been experiencing a lots of health problems for what the GPs don't respond seriously at all. SO i am also convinced I am just making up all these....but the probs don't stop like this......now I am experiencing weight issues, over eating, loss of energy, closed ears or I would say it's heavy ears, pain in the nape as if I am stressed.......but i do agree I am a huge wheat eater.......I don't see any route to go to.....though I have got my hearing test in Feb first week....but it seems they will not find any probs as I am convinced it's all in my head.....but the weighing machine is not lying, I get stressed and have no energy but all of a sudden usually i get energetic after sunset, say after about 7 or 8 pm.........need ur advice on this plzz

The video link doesn't work. [You've got an "o" at the end instead of a "0".]
Here's the right one:
http://www.youtube.com/watch?feature=player_embedded&v=y1RXvBveht0

Dear Dr. Davis,
Thank you for providing such life-saving info.  
My husband's uncle is 69 and has already had one bypass and also suffers from advanced renal carcinoma.  In the past, his docs suggested the typical zero fat, very low protein diet.  His heart disease advanced.  Now he is able to eat more protein because he is on dialysis.  His cancer is under control and his doc have informed him that his greaterst health threat is heart disease.  He wants to reverse his placque but conventional medicine and wrong diet advice have failed him.  He is the type who is extremely motivated and will absolutely comply with a big diet overhaul plus exercise (he currently walks half a mile per day but was extremely athletic into his 50s until kidney cancer struck -- then heart disease) and I would like to suggest that he sign up for your Track Your Plaque program and refer him to your blog as well as that of Nephropal.  He lives in Boston and I am wondering if you have  any collegues there who could help him implement and oversee the Track Your Plaque strategies given his grave situation.  He understands that there are no guarantees but what he's done in the past has failed miserably so is ready to try a new approach and is able to eat decent amounts of protein now.  Any suggestions you may have would be most appreciated.

Thanks for catching that John.