Wednesday, October 7, 2009

Case: 45 yo Female, Perfect Framingham, Perfect Cholesterol, Perfect PLAQUE PROGRESSION

When I see a female with Peripheral Vascular Disease (plaque in the legs) or angina/CAD (heart disease: plaque in the coronary arteries) or Chronic Kidney Disease (plaque in the kidney arteries)... invariably Lp(a) and low HDL2b are the PRIME factors for plaque buildup.

Another factor is a positive family history of a coronary event in the father prior to age 60 yo.

Review: Goals for Regression

Dr. Hecht has ten case studies which I will review one by one here. Earlier (Cardio Controversies: Dr. Hecht) we reviewed the success case study of the the young male with strong family CAD history, high Lp(a) and 15% EBCT regression after only 15 months on niacin 4000mg daily (and low low dose weak statin). This gentleman had regression after doubling the HDL2b from 12% to 24% and the small LDL shifted to buoyant Pattern 'A' LDL subspecies. Most notably, his Trigs started in the 200s then reduced to only 30s. O-u-t-s-t-a-n-d-i-n-g. Drugs alone? No. He must have lost weight, changed the diet, gained some body recomposition and started a good exercise program. Drugs alone cannot lower to Final Trigs 30s from the 200s. TYP goal for Trigs is 60 mg/dl however this is typically exceeded by most members especially those who are able to shift to Pattern 'A' and reach the other TYP goals. Trigs are an expression of our carbohydrates in our diet (starchy and sweet foods/beverages), saturated fats, and omega-3 fatty acids (ALA flaxseed; EPA DHA fish oil). As Trigs drop, buoyancy goes to the particles, both LDL and the HDLs. HDL-2b, the regression particle is the most buoyant, largest HDL subspecies. HDL-2b is associated with extreme longevity in centenarians, cancer-protection in remission cases and vascular regression of plaque in heart trials and at TYP.

HDL-2b are like good, loyal friends who watch out for you and your family.

Can you ever have too much?

Case Study: Perfect Scores, Perfect P L A Q U E

Dr. Hecht presents a case of a young female, no symptoms, with perfect plaque progression. She has a double-digit coronary calcification score of 95 which takes her to the top 98th percent for her age for plaque. Normal heart disease stratification at this time in conventional medicine uses the Framingham score. With her perfect baseline lipids, her score is quite good.
The Framingham 10-year risk is calculated to be < 1%.

Translation: 0-10% = 'low risk'. (10-20%=mod; >20%=high)

Her risk, in fact, is estimated to be insignificant, negligible risk.

No worries???

Yes, worry.

Alarmingly, she has the highest heart calcifications and the 'real age' of a 98 year old female.

Real Age, Real Baloney: Coronary Calcification Tells Age

Some experts Dr. Hecht discusses want to use EBCT or MDCT percentile scores as the 'real age'. This makes sense to me. It is the internal metabolic milieu, chaos and entropy which reflect our longevity and status.

Just as well, the internal metabolic calm reflect our regression and control of lifespan.

Advanced Metabolic Testing
Her results for the metabolic testing show perfect CRP (C-reactive protein). CRP is bunk. It could be elevated if you sneeze. If it is chronically elevated, then you have issues but it is no more telling of plaque than the traditional, conventional lipid panel.

On further examination, the metabolic testing which is identical to what we look at TYP program shows:
--elevated apoB (goal < 60-70)
--mildly elevated homocysteine (goal < 8.0)

Both of these indicators are related to inflammation and high carbohydrate intake. Inflammation may stem from excessive omega-6 and/or fructose, deficiencies (n-3 omegas, vitamins ADEK, B-vitamins B3 B6 B1 folate B12, minerals Magnesium Selenium Zinc Chromium Iodine Iodine, vitamin C, vitamin "O" optimism *haa*, carotenoids, mitochondrial components Carnosine CoQ10 ALCAR Carnitine; hormones adiponectin T E2 E2 P preg DHEA, etc), food allergies (wheat, gluten, A1 casein, nuts, etc), heavy metal and environmental toxicity (mercury from seafood, estrogenic pesticides, etc).

Ultimate Testing Lipoprotein Subfractionation:

The 'death band' is evident.

Recall according to Krauss, goal LDL IVb is less than zero. Just kidding, the goal is to get this subfraction which is the most dense, most lethal to as low as possible. In patients with large amounts of plaque where stenosis was > 30%, Krauss found < 2.5% of LDL-IVb was highly statistically significant for regression on angiogram. For those with 'less' plaque (read: less stable), LDL-IVb of 2.5% was still too high for regression to occur. What is good? I believe as low as possible. We see at TYP even when LDL-IVb is 1.5%, EBCT progression still occurs at 10-25%.

I don't find this acceptable.

The death band should be as low as possible. Or none.

Ultimate goal: Shift the LDL from dense to buoyant (known as LDL1 + LDL2a+b on BHL) and annihilate the 'death band'. Stop stuffing the face with fructose (fruit). Cut back olive oil and replace with some saturated fats.

Major Risk Factors for CAD: Low HDL2b, Lp(a)

Diagnosis: This young lady has extensive 98th-percentile plaque. Dense LDL, the death band LDLIVb, low HDL2b, and Lp(a).

Conventional Prognosis: No action on her doctor's part until she comes in with throbbing, painful legs or shortness of breath, back ache, jaw pain, heartburn (extensive plaque leads to vague, non-specific anginal symptoms in females). Worse case scenarios: tries to run a half-marathon or marathon and has a coronary event and is resuscitated with brain damage. Or SCD (sudden coronary death) where the first sign of heart disease is silent and fatal.
Unconventional TYP Prognosis: Longevity and shifting 98th-percentile calcifications to 15-50th-percentile less each year. Shortly... her real age will be 17 years old.

Yes, shaving YEARS off of her real age, coronary calcification percentile rank.

Hecht-Treatment: Hecht discusses niacin 4 grams per day and some statin (why? I dunno why because he contradicts himself when it comes to bashing LDL and LDL-goals; I sense some 'cognitive dissonance' on his part). Most cardiologists and physicians don't know a lick about diet, nutrition, what organs/hearts require, and basic micro- macronutrients. Didn't the father of medicine, once say 'let food be thy medicine'? We in the Paleo/Primal and TYP communities already know food can be poison (e.g. gluten, wheat, grains, legumes).

Is Hecht's therapeutic strategies enough? No. Some cases are 'treatment failures' which we'll later breakdown why.

Optimal Longevity Treatment To Reverse Vascular Dysfunction:

(1) Statin-less (statins increase Lp(a), OxLDL, OxLDL/apoB, %-dense LDL and prevent shifting from pattern B to A+++; causes autoimmunity and auto-antibodies, cellular level mitochondrial and myocyte damage, depletes antioxidants ubiquinols and coenzyme Q10; Crestor is associated with higher incidences of diabetes and kidney problems (proteinuria) in clinical trials)

(2) Niacin

(3) Omega-3 fish oil 6000++ mg EPA DHA daily for Lp(a), low HDL2b, high dense LDL, shift to pattern A, optimize n-6:3 ratio (goal ~1.5-2.0 per Dr. Barry Sears PhD and medical literature involving CKD patients)

(4) Correct Vitamin D deficiency (goal [25OHD] 60-80 ng/ml)

(5) Correct Saturated Fatty Acid Deficiency: Stop the AHA-low-fat-low-cholesterol-diet. Obtain Saturated Fats 15-20+% daily to increase HDL-2b, lower the death band LDLIVb, shift to Pattern 'A', and lower the atherogenicity of Lp(a)

(6) Correct Vitamin K2 deficiency (Sources: fermented cod liver oil, casein-free butter, hard cheeses if not allergic, natto, vitamin K2 100mcg daily MK7)

(7) Correct thyroid and adrenals by initially supporting (egg yolks, vitamins ADEK K2 Bs C; tocopherols, tocotrienols, minerals: Magnesium Selenium Zinc Chromium Iodine Iodide; saturated fatty acids, omega-3 fats ALA EPA DHA, carotenoids, avoidance of n-6 PUFAs) and if not sufficient then thyroid replacement (Armour +/- T4) and adrenal support (read HERE and HERE) to achieve optimal metabolism and stable core body temperatures 98.2 - 98.6 degrees F.

(8) Correct insulin disparities (exercise, C-A-R-B RESTRICTION, stress reduction, SLEEP, yoga, resistance train, weight loss, ketosis (diet, intermittent fasting), insulin-sensitizers: R-alpha lipoic acid, L-carnitine, Chromium, Leucine, Taurine, Glutamine, whey protein, flaxseed and fish oil, bittermelon, celery, pycnogenol, krill oil, astaxanthin, other antioxidants and proanthocyanidins, etc)

(9) Correct other calcified organ dysfunction: pineal (melatonin), hypothalamus (yoga, relaxation, breathing ex, etc), thyroid (see above), pancreas (see insulin above + digestive enzymes), gallbladder (digestive enzymes), colon (probiotics)

(10) No w-o-r-r-i-e-s ! *winky*

What about 4 grams per day of vitamin B3, niacin?

Does overdosing on niacin aid the above? Unfortunately 'no'. The mechanism of action is that niacin mimics all of the above (increases hGH, testosterone, steroids, ketosis, fasting and exercise). Adverse effects of niacin include: gout, diabetes and liver test elevations. Again I like niacin b/c it works but I don't love it. It doesn't appear to work on everyone in the year 2008-2009 and likely the future. Numerous nutritional and environmental toxicities apparently have shifted the cardiology and endocrinology playing field since the niacin trials were published, including the HATS 2001 NEJM publication by BG Brown et al.

Dr. Davis' Nutritional Wisdom and Recent TYP Topics (Members) to Reverse Vascular Dysfunction:

o Fructose: Dangerous at Any Level?
o Anthocyanidins: Eat Purple
o S-L-E-E-P -- Quality and Quantity
o Iodine Deficiency -- Importance for Heart Health
o Thermoregulation -- Thyroid and Adrenal Dysfunction
o TYP Part 3 Diet: 40% Fat Diet for Lp(a) and read more HERE


Anonymous said...

Hi Dr.
Great post, scary yet informative!
Could you expand a little on whey protein as an insulin sensitizer? I just had an experience with this following two weeks' of dr. eades' new "belly fat" program. I didn't continue, but I noticed that my blood sugars, after two weeks of lots of whey protein, dropped from high normal to almost always in the 80's. I was happy but puzzled. Could that have been a result of the whey? Maybe I should continue using it?



Dr. B G said...

Hey Maggie,

Scary, that is right. At the last San Jose (Calif) Half-marathon two people in their 30s passed away. One was female.

From the Mercury:
"Medical personnel were unsuccessful in trying revive 35-year-old Brandon Whitehurst of Antioch and 34-year-old Rose Lo of South San Francisco during the Sunday event... At a Rock 'n' Roll Half Marathon in Virginia last month a 23-year-old male runner died."

The causes will probably be revealed later but one I know for certain -- the cause was not breast cancer...

Whey protein contains many of the essential and non-essential amino acids for strong immune and endocrine systems. Source Naturals (and other brands)whey protein is from grassfed cows and has immunoglobulins and lactoferrins which strengthen the immune system. Jay Robbs is a fairly decent brand too (and casein-free, unlike Source).

Happy immune systems control inflammation which control our endocrine tissues like the pancreas and adipose. Both insulin secretion and resistance improves. This is true for other immune-modulating agents. I've had some people tell me their glucoses improved significantly after only starting digestive enzymes!

The Eades are great -- I've read all their books but yet have to order their latest and greatest. Their program controls diabetes and Lp(a). Yes, Whey protein works!! (the amino acids activate mTOR which activate PPAR)


Anonymous said...

Hey Dr. B G!

I'll second Maggie on that thought about this post of yours, scary yet informative indeed!! I always knew the stuff in whey, like lactoferrin and that other substance, colostrum(???) was good for the immune system but I hadn't put it together yet about the inflammation part, but when one reads a post written by you, the idea of all the systems connecting is easier to fathom--thanks so much for what you do!!

I do have a question regarding that monster-in-my-closet: Lp(a)...

I'm sure you've seen the countless websites advocating the use of high-dose ascorbic acid combined with high-dose L-Lysine as 'Lp(a) inhibitors or binders'. I even stumbled across the famous 'patent' that Linus Pauling and Matthias Rath purportedly 'applied' for as not only a treatment for Lp(a), but a potential cure for heart disease.
Of course, I want to believe this is indeed true, and when these sites throw around the words (and even youtube videos) of Dr. Pauling advocating this treatment, the desire to want to believe increases exponentially.

As a Dr. and scientist, do you have any experience treating patients with this stuff? I'd love to hear your thoughts on it--I was using it religiously until recently--I finally got tired of living with an unstable bathroom agenda!!

Thanks again!!
-Adam Wilk

Dr. B G said...

Hi Adam,

Appreciate all your thoughts!

Hey -- colostrum is wonderful AMAZING stuff :) It cured one of my gym owners chronic colds (along with vit D, and other stuff I forgot what I gave). Read DR. Ayers Cooling Inflammation blog on 'lactoferrin'.

Babies survive on ketones and colostrum for the first 2 wks of life. It keeps them healthy, strong, and viable. *haa*

I think the Pauling protocol is great for 50% of those with Lp(a). It doesn't work for everyone at TYP. You can see the trial where low fat, high veggies RAISED Lp(a)?

Silaste ML atvb 2004

In all the Lp(a) trials, there are 'responders' and nonresponders.

The vitamin C from the high-vegetable treatment group had some great Lp(a) reduction. These are responders to vitamin C. Even with low sat fat, the vit C gave them an edge and it lowered the Lp(a).

But at a cost. They now have increased sdLDL and lower HDL2b. Not good.

Other responders have lowered Lp(a) with higher meat consumption. Why? Meat contains proline, lysine and Vitamin C. Yes, who knew?! Meat also has fat (50/50 sat fat and mono).

Beef tongue has the most PROLINE:

Yes -- I see often Lp(a) drops within 1 mon (from 260s to 140s with a Lacto-Paleo minimal fruit diet) but sometimes 6-18mos later. Supplements can help but usually it is the diet that controls Lp(a) the best from what I have observed.

I see HUGE Lp(a) drops and HDL2 tripling even when people are totally low thyroid, with very simple diet changes. :)

Diet is everything when diet sucks.

Fruit is toxic. Some of our more 'resistant' TYP members with increasing coronary calcium for some reason appear to not be able to control their intake of orange juice, fruit and berries. Paleolithically, these foods not only didn't exist but definitely were not prevalent on a daily 24/7 basis.


David said...

Adam- I hear you on the Pauling protocol. I had my Lp(a) tested when I was 20 and it was 76 mg/dl. Definitely high, and something I'll be keeping an eye on for the rest of my life. I'm 26 now, and am doing the best I can to eat the best "Lp(a) diet" (high saturated fat, low carb) possible to get things under control while I'm young. Like G pointed out, I think the best strategy has to have a good diet at the foundation.

I was a total Pauling/Rath junkie before I found Dr. Davis' blog one day. I really wanted to believe that it was the whole answer to heart disease.

So when I stumbled across Dr. Davis' blog a couple years back, I suffered a little bit of cognitive dissonance. He seemed to make a lot of sense, but it seemed so complicated! I mean, according to Pauling and Rath, Lp(a) causes heart disease. Period. Simple, right? I like simple. Then here comes Dr. Davis. Small LDL, HDL2b, IDL, vitamin D, Apoprotein B, stop eating wheat.... It wasn't simple anymore, so I didn't really want to believe it at first. But the more I read, the more sense he made, and the more my world expanded. Now I know more about heart disease than I ever would have had I stuck only with Pauling and Rath.

Don't get me wrong. Pauling and Rath were on to something, but that was years ago, and heart disease is more than just Lp(a) now. We've advanced in our understanding, and that's a good thing.

That being said, I think the Pauling protocol is definitely worth trying by those with Lp(a). My dad tried it once, and after about a year only had an Lp(a) reduction of a few points. And we moved on. Definitely doesn't work for everyone, but certainly seems to be a very good thing for some people.

If you end up trying it, I'd sure be interested in hearing how it goes for you.


Peter said...

Hi G,

Thanks for the info on the Pauling protocol. I'd wondered if any TYPers had gone this route. You can see the logic but it always struck me as a drug like use of a vitamin. You know, a sticking plaster. Possibly a good one, but not getting at the root cause... Bit like B3 for schizophrenia.

Cracking set of posts BTW.


lightcan said...

Is whey protein not insulinotropic, elevating serum concentration of IGF-1 and androgens, causing cellular proliferation in skin and other tissues? It's funny that the paper was written by the Eadeses and Cordain (Hyperinsulinemic diseases of civilisation) I still have acne after low carbing for a year, and I have skin tags which point, according to the paper to previous high insulin levels.
How can one find an acceptable level of insulin for their body based on inclusion of whey that has so many health benefits? Just by measuring glucose regularly?

lightcan said...

I wish somebody could tell me what is really the story with the 'eat purple' mantra. Peter doesn't think it matters. I've read that plasma concentration of polyphenols does not raise significantly after consumption of high flavonoids foods, they're eliminated quickly, and the antioxidant effect might be due to the uric acid and I read that pomegranate and grape extract reduces oxidation of LDL. So what is it?

For example:
and this guy Halliwell has another review too

and on pomegranate inhibiting LDL oxidation:$=relatedreviews&logdbfrom=pubmed said...

I'm already taking many of the supplements you recommend, but just reading your comments makes me feel even better. Apparently, your blog has a nice placebo effect!

Now I'm going to eat some eggs for breakfast.

acanthusbk said...

Lightcan: For me, whey protein concentrate causes insulin issues, but whey protein isolate doesn't. This may or may not work for you, but I'd suggest trying Jay Robb's whey protein, which is isolate only.

Anonymous said...

David, man, where have you been? I've been waiting for you to jump in with your words of wisdom!
I've been doing the Pauling/Rath protocol for years, but--um, it turned out to be difficult to adhere to, only because I insisted on doing it via capsule ingestion, instead of the many formulas one can purchase online--but even the power mixes wreaked havoc on my stomach. This is going to sound horrendously foolish for a gentleman as learned and intelligent as I, but actually avoid getting blood work done, only because 1) My primary looks at me like I'm nuts when I throw around terms like Lp(a) or 'small-dense LDL', etc., and then I am admonished for not taking my Lipitor to bring my total cholesterol down from 250.
So, I tend to shotgun certain nutrients, hoping they all will help prevent any problems that could arise--it's not a perfect system, but I'd rather do that than ingest a statin. And you're right, diet is key, believe it or not, I'm struggling to take in a healthy amount of saturated fat (like found in Dr. B G's postings)--the Omega 3 fish oil? that's easy--a couple of tablespoons daily--saturated fat--that's really tough--I just began adding coconut oil to my coffee in the mornings--so far, so good.
But for now, it's Omega 3 fish oil, mixed vitamin E (hello Brothers Shute!!) tocotrienols, arjuna, B complex including Benfotiamine, Probiotics before bed with Serrapeptase thrown in for good measure, Alpha Lipoic Acid, Pomegranate extract, Vitamin D3(15k/day) Vitamin K2(600mcgs/day) and a couple of other goodies that give me peace of mind. Crazy, right?
Oh, and yes, I don't eat carbs, although I have pizza sometimes when it just gets too painful ;-)
Good talking to you, David.

David said...

Quick question, G.

I know by observation that higher levels of vitamin D (60-80 ng/ml) seem to be better, and it makes sense to shoot for this to duplicate the higher levels acheieved by healthy individuals in sun-rich environments, but do you know of any studies in the scientific literature that actually achieve levels this high purposely, or even recommend levels as high as 60? Seems like most of the research I come across only goes up to 50 ng at best. I'm working on a paper and am trying to decide how to frame the reasons for the higher level.

Dr. B G said...


Truthfully, I know of only a few prospective studies which achieved higher vitamin D blood levels with positive measured outcomes:
--dialysis studies (but few had blood levels measured incl the regression study Treat-To-Goal)
--Dr. Davis' publication (regression occurred in ~50% of treated pts with 25OHD = 60-70 ng/ml)
--Nebraska breast cancer 1100 IU daily with 73% risk reduction with increasing 25OHD from 28 to 38 ng/ml (Lappe, ajcn 2007)

Grassroots put together a neat 'graphic' depiction of all kinds of chronic disease protection with vitamin D sufficiency. They plot vitamin D blood levels (diasorin -- most are observational or clinical trials) to the autoimmune disorders, falls, rickets, many cancers and heart attack risk:

The problem with the current lab and self-home testing is that they are not based on Diasorin -- the gold standard used in most clinical and lab trials. Quest and the others are fine but they often 'underestimate' the true 25OHD according to experts (like my husband, who works in diagnostics) by 40-80% at this time. Lab reproducibility and accuracy however I think are getting much better -- so a value of 80 ng/ml is probably more like 68 ng/ml. That is not toxic for most individuals. I would not push it past 80 ng/ml just to be on the safe side.

For me, my asthma returns when the my levels go below 70 ng/ml. My asthma is also definitely related to my hormone status and as you know vitamin D supplies the cholesterol-derivatives for many of our steroidal sex hormones. Many of the male pts have a tripling of the their free testosterone after vitamin D replenishment. There really is something to be said for 60-80 ng/ml which observational studies of lifeguards and people naturally outdoors all support (young, no chronic diseases, even consuming wheat/gluten).

I think all the outcomes from statin trials are measly, pathetic and sad compared with niacin trials... When statins are not implicated in causing rhabdomyolysis, autimmune disease, death, and nerve damage, the only reason statins even 'semi-work' is that they raise vitamin D levels, and vitamin D raises HDL2b:
Crestor raises vitamin D ~250% from 14 to 36.3 ng/ml after 8wks

The research you are looking for doesn't exist yet...and may not. All future NIH trials for vit D are using wimpy *ss doses like 1000-2000 IU daily. These are literally doses advised by the Academy of Pediatrics for 12mon-old and 6-yr olds, respectively.

Do you want Dr. Davis' PDF? I don't recall if the vit D blood levels were published but I have some of the raw data -- we can get his permission for 'personal communication'. The benefits are mixed in with extreme wt loss, omega-3 fish oil 3-6g/day and niacin/statin so... it's not 'clean'.


Dr. B G said...

Hi Peter,

*ha* R U holding ur hat?!

The beef tallow mention was a hat-tip to you, my dearest. :) And for your lovely wife, the NFkB finds... which y'll probably aware of anyway.

Some at TYP have had great success reported with the Pauling protocol, but some of these are also the advanced members on mod-high saturated fat diets or alternatively they've burned 25 stones of palmitic acid off their cute little behinds... so ummm.... hard for me to SAY what is working...

Yes, root causes... *aha*


Dr. B G said...

Oh Acanthusbk!

That's it -- you hold so many of the answers for me! And others!! The whey concentrates (like in Source and Whole Foods brands) do make my heart race but I couldn't figure out if that was from the artificial sweeteners or what. (No, I haven't tried Jay Robb's so that will be my next experiment).

Your input is always MUCH appreciated :)


Dr. B G said...


IGF-1 is also related to human growth hormone, one of the master hormones necessary for tissue rejuvenation, repair and maintenance. We need obviously some insulin, but not a lot. Too much causes skin tags. Insulin is a growth hormone itself -- it grows everything... cancer, plaque, warts, skin tags, malignant as well as benign tumours/meningiomas, muscles (yeah, body builders TOTALLY abuse this stuff), etc.

Often when people have their insulin checked 1-2hr post-prandial (after meals) it can go from baseline 3-10 to 200s.

No kidding.

These are people with any chronic conditions or taking drugs (like my synthetic $%&(@#$#&* levonorgestrel, or girls on oral contracepts like YASMIN or YAZ cr*p). I believe statins + low fat AHA diet may fit in this category and explain their lack of benefits. The oxLDL generated from statins added to high carbs ruin pancreas and adipose tissues, subsequently leading to hyperinsulinemia after carb loads (like fruit, oat meal, starches, grains).

OK flavonoids -- I kinda believe in them. My father-in-law had dramatic reduction in the lightening of his many age-spots from pycnogenol which has been shown to reverse epidermis photodamage in vitro and in mice. Some of my patients have noticed the same as well (scars fade, etc). Oxidative damage shows up on our skin (that is why carb-eaters have more WRINKLES, not just the smokers).


Dr. B G said...

Hey Purdy,

Yes I list a bunch supps but obviously it is FAR far better to obtain from food and natural whole untainted sources if possible:
--pastured bone soup stocks (vit K2, progenitor cells, etc)
--probiotics (Seth Roberts talks a lot about the benefits)
--fermented products (again K2 and other nutrients and happy bacteria to recolonize our guts after toxic antibiotics, grain-damage and to heal 'leaky gut' syndrome)
--grassfed/pastured organ meats (carnitine, carnisone, ALCAR, vitamin ADEK1 K2, carotenoids)
--grassfed/pastured FAT FAT FAT (lard, beef tallow, schmaltz, chicken/ geese/ duck fat HHhhMMmmm...vit ADEK)
--egg yolks as you mentioned
--unrefined palm oil (vit E tocopherols tocotrienol, carotenoids, MCTs, etc)

Many have a hard time getting the above so the supps 'fill in'. Wild seafood is wonderful -- but it also killed my cats -- the PCBs, flame retardants, dioxins are concentrated in all of our ocean's large mammals. Sad.


David said...


My understanding was that although the Diasorin RIA (and LIAISON) is the gold standard, mass spec home test kits, like those from ZRT, correct to the gold standard. How accurately do they do this, do you suppose? When I get a finger-prick kit from Grassroots, am I getting a reasonably accurate result? According to Cannell, these tests don't tend to overestimate the true result (like Quest), but I wouldn't want to have a result too deceivingly low, either.

I'd love to have Dr. Davis' pdf! Just click on my name and you can get my email there under the contact heading.

I'm putting together an article for about vitamin D. Kinda fun. I slipped in as a writer for them, even though they seem to be dominated by vegetarian, low-fat bias a lot of the time. Just had an article published with them that promotes a wheat-free diet for digestion, so it's a start. Haha.


Anonymous said...

Acanthusbk and Dr. BG

The Jay Robb product contains soy.
problem or no problem?



Dr. B G said...

Hey Maggie,

My nutrition store owner finds that Jay Robb and others 'conglomerates' whey protein from many batches (whereas Source is small controlled batches). I don't know exactly what that means or if the quality is affected personally. I like the casein-free part of Jay Robb's because few products are casein-free and that is problematic for a LOTTA people.

I didn't know it contained soy! I wonder how much? I minimize soy but mainly because of the omega-6 (LA) content. It's quite high... Also soy gave my daughter breasts when she was only 12 mos old (after weaning -- baby formula). The Pedi had no idea why. We figured it out 10 yrs later... soy baby formula is equivalent to 2 oral birth control pills.



Anonymous said...

OK, now I'm thinking I overreacted. Here's what the label says:

Contains: Milk by-products (whey) and less than 1% of product Lecithin (soy).


lightcan said...


I couldn't believe my eyes when I saw you write for Natural News. I read them often but only for the underground feel, the rebelliousness that you don't find in the boring, unreliable and dumbing down mass-media. I used to read it every day for articles on nutrition (it led me to some of the interesting supplement pushers for more detail) but moved to better places (like this one *wink* for more intellectual stimulation, accuracy and less new-age, raw foodism)
But it's great that you're spreading the word, as a double agent... Mike likes vitamin D.

lightcan said...

Dear G

So I should check my post-prandial insulin to see if it spikes?
I'll remember that about the pine bark extract. Wouldn't do any harm to make some scars and pigmentation marks disappear ;)

I had a 25(OH)D done recently and I was surprised to see it so high (147 nmol/L), maybe they did overestimate it. I never took more than 3000 IU and only had about 7 days of proper half an hour body exposure this summer. Is Mass spectrometry the method used everywhere?

Thanks for all the invaluable information. And the fun...

Dr. B G said...


Oooohh. Subversive. I'll have to ck out Natural News!


147 nmol/L isn't high actually -- that is equivalent to 48 ng/dl. Depending on where you live, it may dip during the winter 10-20 ng/ml as a result of negligible levels of UVB. Only UVB converts vitamin D in the skin. I think goal for optimum health is 60-80 ng/ml. The only contraindication to vitamin D supplementation is a condition known as sarcoidosis where they body has errant cells producing excessive vit D and its metabolites.

Pine bark unfortunately contains little flavonoids. I'd go for the real stuff 'pycnogenol' -- NOW brand and Trader Joe's are surprisingly effective. They're expensive so I don't employ them frequently as much as I'd like. The studies in PubMed are quite supported since it was licensed in France over 50 yrs ago. Curcumin has even more evidence. Ancient cures! Spices are so nice!!


David said...


Yeah, I don't read NaturalNews all that much anymore, either. I get the newsletter, and read something when it looks interesting, but not much beyond that. A lot of the writers don't really seem to know what they're talking about, and I get tired of some of the extreme stuff, too. Oh, and they routinely get it wrong about heart scans, confusing EBT scans with CTA.

The anti-meat stuff on there annoys me too. Obviously.

I thought it would be good to write for them to add a little bit of counter-perspective on some of these things. They're strong on vitamin D, but the whole diet thing is usually lacking. My article on digestion seemed to be pretty popular. You get to put up an adsense code on your article, and they say you usually make an average of between $5 and $25 from that in the first three days. Mine make like $75, so I guess people were finding it interesting!

I agree with you - this blog and others like it (Dr. Davis', Stehpan's, Dr. T's, Dr. Eades', etc), are far above what you find on NaturalNews. Truly top notch stuff.


acanthusbk said...

Maggie, I avoid soy as much as possible so understand your concern. Unless you're using lots and lots of whey protein (or what's more likely to cause a problem, taking supplemental phosphatidylcholine, which is what lecithin is) I can't imagine the phytoestrogen content would be anything other than minuscule. Isoflavone can be found in small quantity in soy lecithin but the majority is removed during processing along with nearly all of the soy protein, which is apparently why very few people have soy allergy issues with lecithin.

Anonymous said...


Thanks for your kind reply. It's so nice to be taken seriously!

I think I shall buy some and take it as a meal replacement a few times a week.


Dr. B G said...


I concur w/ Acanthusbk -- she's brilliant.


lightcan said...

Dear G.

Maybe I'm wrong, which brings the result closer to reality but I used the conversion on my lab result.
80nmol/L equivalent to 32 ng/ml means 147 is 58.8.
Not to worry. As vit A needs to go with D and my Solgar has it at around 3 to 1 can I take 5000 units of vit D with 15000 units of vit A knowing I might eat some liver too, besides the eggs or should I find a vit D only? What do you think?
Thank you for going back to previous posts and answering the questions although you moved on.

Dr. B G said...


You're right! Sorry about the miscalc. Liver is one of the highest sources of vitamin A! No need to supplement the A when one is eating liver since it is so rich and dense with vitamin A. As you aware too much A can be toxic just like too much vitamin D. Signs are the same as deficiency: cracked lips/skin, hair loss, headache, muscle aches, nausea. I gave myself toxicity > 15 yrs ago when I ate 3/4 container of delish PATE (was totally vit D and K2 deficient at the time). My daughter's cheilitis (cracked lips) completely was cured with vitamin A. She is a big veggie eater (less meat), but it apparently was not enough (or she is a poor converter from beta-carotene to retinol). When I forget to give her vit A, the lip cracking returns.

Personally, I use both a combo D (NOW vit A+D and D 5000 IU caps) and fermented cod liver oil depending on what I am eating (or not). Topically, also, I use the combo vit A and D on wounds and have noticed FAR far FAR less scarring, darkening and infections! I get kinda banged up at Crossfit!! Coconut oil is good but NOT as good as topical vit A+D oils. (you know that is a baby diaper ointment too? combined with carcinogenic petrolatum)

If vitamins ADEK1 K2 are sufficient, probably toxicity from vitamin A would not be as harmful, but since most people aren't replete on all of these (esp vitamin E, the tocopherols tocotrienols) and antioxidant minerals (Se Zn Mg etc) then excessive vit A should be avoided since it accumulates. Interestingly, for high inflammatory states like cancer, there are some oncology protocols at Jefferson that employ REALLY high doses combined with vitamin D and n-3 PUFAs.