Cortisol Replacement Patients Using IsoCort Or Medications Should Recheck Cortisol Levels Periodically

Many people who have experienced chronic stress or illness may find that they have cortisol imbalances, often called “adrenal fatigue” or “adrenal insufficiency”, that are contributing to their health problems. A few may find they have full-blown Addison’s Disease which is often a life-long condition in which the adrenal glands are unable to produce much, if any, cortisol.

Those who have low cortisol levels are often advised to boost their cortisol using medications such as hydrocortisone or supplements such as IsoCort and/or licorice root. These treatments can be very helpful to patients, and often the positive effects are obvious within days.

However, long-term it may be the cortisol boosting treatments may turn into problems. This is because often the adrenal glands start to heal and their production of cortisol ramps up. Unless the dosage of cortisol boosting treatment is lowered, you can go from normal levels of cortisol to high levels. This can happen even after your dosages of the cortisol boosting agents have been stable for many months.

What is particularly confusing about this is that many of the symptoms of high levels of cortisol may remind the patient of having low levels of cortisol. The lack of energy, problems sleeping, and a vague sense of illness that you get from chronically high cortisol levels can be very similar to what you experienced with low levels. There are certainly differences, but when you add in the normal variations in mood, nutrition, typical minor infectious illnesses, and stress it can be very hard to pick out what symptoms are from what causes. Thus it is quite possible for a patient who has been doing well on a particular dosage of replacement IsoCort or hydrocortisone (or analogs such as prednisone) to start feeling not so well again and be unclear as to why.

There are vital signs you can inexpensively monitor to help detect that your cortisol levels might be going out of balance. Anybody who is trying to raise or lower cortisol should be watching these signs on a regular basis because they may provide an early warning of a change in their condition that could require dosage changes.
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Fructose Sugar A Chronic Poison, High Intake Causes Obesity, Type 2 Diabetes, Fatty Liver Disease

In 2009, Dr. Robert H. Lustig of the University of California at San Francisco presented enlightening insights on why the campaign by mainstream medical doctors and the US government to have people eat a lower fat diet has caused skyrocketing rates of obesity, type 2 diabetes, and cardiovascular disease. Since the, more than two million have viewed the video of his presentation but far more have never heard of it.


Sugar: The Bitter Truth

Lowering fat intake can lower LDL cholesterol, as suggested by observations of the Japanese and Italian diets. But that is not what the modern American diet pushed by the government does. Lustig presents much evidence that this is because the American diet uses high levels of sugars, particularly fructose, to make low-fat foods more appealing.

Making Cardboard Taste Good

Low-fat foods tend to taste like cardboard. Obviously this is not good for sales of these foods, so the companies making them wanted to find ways to obey the government’s directives while not destroying the sales of their products. To make these low-fat foods palatable, manufacturers increased the amount of sugar used in their products. To make it cheap, they switched from table sugar (sucrose) which has a 50/50 mix of glucose and fructose to using high fructose corn syrup (HFCS) which tends to have higher levels of fructose than table sugar.

Fructose Is Much Like Ethanol Alcohol

In the presentation, Lustig shows how fructose is metabolized in the liver much like ethanol alcohol. It is not exactly the same because the brain can metabolize ethanol whereas it cannot metabolize fructose. This accounts for why ethanol intake causes acute neurological symptoms whereas fructose does not. Aside from this difference, however, they are highly similar in their effects on the liver and the rest of the body.
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Sugary Drinks Alter Metabolism to Boost Fat Gain Similar to Diabetes

In a recent study publishing by Bangor University in UK, researchers showed that healthy thin young people who consumed soft drinks sporadically experienced marked changes in metabolism after increasing their soft drink consumption by about a drink per day.

After four weeks of drinking sugary beverages containing about 140 grams sugar per day (what you would get from about two to five servings of a typical soft drink or fruit juice), participants had gained about one kilogram (2.2 pounds) and showed higher fasting glucose levels. Muscle biopsies showed that genetic markers were altered by the sugary drinks indicating reduced fat metabolism in the muscles. Signs of developing insulin resistance were also seen after four weeks of increased sugar consumption.

Researchers believe that the consumption of sugary drinks, such as soda and fruit juices, hurts health at least two ways beyond simply adding calories. First, it desensitizes the body to sweet tastes and thereby encourages eating and drinking even more sugar. Secondly, it alters metabolism to cause muscles to burn more sugar in place of fat. This speeds up fat gain in the body, contributing to the development of obesity and type 2 diabetes.

The study suggests that drinking a sugary drink once in a while is not a big threat to health. But when people make sugar consumption a habit, then the body adapts by modifying its operations to use up the sugar and pile on the fat.

Although much of the publicity around this study focuses on soft drinks as the enemy, it appears that any kind of high sugar drink can have similar effects. Fruit juices misleadingly marketed at “healthy” are therefore similarly dangerous as soft drinks.
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Increased Vitamin K Consumption May Slow Progression of Insulin Resistance and Lower Diabetes Risk

Over the past decade, increasing amounts of research are tying higher vitamin K intakes to lower risks of insulin resistance, metabolic syndrome, diabetes, and related cardiovascular diseases. Mainstream recommendations coming out of the Institute of Medicine for vitamin K claim that 120 mcg (micrograms) per day for adult men and 90 mcg for adult women is “adequate intake”. But research increasingly indicates this is not enough to get the full benefits of vitamin K. Additionally, there is no adequate intake recommendation specifically for the distinct K1 and K2 forms even though both are clearly important in different ways.

Generally an intake of somewhere above 50 mcg per day of vitamin K1 is viewed as enough to support blood clotting functions. Without that minimal amount of vitamin K, the body cannot create enough clotting proteins necessary to stop bleeding normally. In fact very low levels of vitamin K can even produce abnormal bleeding even without any obvious injury, as was shown by early vitamin K researchers who showed they could cause internal bleeding in chickens by depriving them of vitamin K. However, the level of intake adequate to stop abnormal bleeding is insufficient to preserve or improve health in other areas such as brain, bone, and cardiovascular health. Additionally, for those health effects the vitamin K2 form is far more important, especially since the human body is not good at converting K1 to K2.

A Dutch study of 38,094 participants found that vitamin K1 intake is far greater than K2 and that higher intakes of vitamin K1 and K2 were both connected to lower rates of diabetes. Higher K2 intake was also linked to improved blood lipids and lower C-reactive protein, both common markers for cardiovascular health.

Quoted from Greater vitamin K intake associated with lower diabetes risk

Vitamin K1 intake among the study participants averaged 200 micrograms per day and vitamin K2 intake averaged 31 micrograms per day. Over a median follow-up period of 10.3 years, 918 cases of type 2 diabetes were diagnosed. Adjusted analysis of the data uncovered a 19 percent lower risk of developing diabetes in men and women whose vitamin K1 intake was among the highest 25 percent of subjects compared with those whose intake was among the lowest fourth.

A linear inverse relationship was observed between vitamin K2 and the development of diabetes. For each 10 microgram increment increase in intake, a 7 percent reduction in risk was noted. Greater consumption of vitamin K2 was also associated with improved blood lipids and reduced levels of C-reactive protein, a marker of inflammation.

However, in the US the typical American adult gets far less vitamin K1 than those in the Dutch study. Researchers from Tufts University estimated in 1996 that the average American adult only gets around 59 to 82 mcg per day of vitamin K1.

Vitamin K Can Help Insulin Work Better

A Tufts University study of 355 men and women ages 60 to 80 published in 2008 looked at how vitamin K supplementation slowed the development of insulin resistance associated with metabolic syndrome and diabetes. This study used 500 mcg (micrograms) per day of vitamin K1 supplementation, the form most common in plant food products such as vegetables.

The authors reported that the supplements helped men’s bodies use insulin more effectively but did not not appear to help women.

“Men who received vitamin K supplementation had less progression in their insulin resistance by the end of the clinical trial,” said Sarah L. Booth, PhD, senior author and director of the Vitamin K Laboratory at the USDA HNRCA. “Conversely, we saw progression in insulin resistance in women who received vitamin K supplementation, and in the men or women who were not given vitamin K supplements.”

The researchers speculate the vitamin K supplements may not have helped the women in the study because they had a higher rate of obesity and high body weight. It is possible that vitamin K at 500 mcg (micrograms) per day may not be adequate to overcome the metabolic effects of obesity.

Vitamin K2 Has Distinct Benefits

Researchers suspect that pharmacological grade vitamin K1 supplements beyond 1000 mcg (or 1 mg) per day probably won’t be absorbed well by the human digestive tract. Vitamin K2, however, can be absorbed at much higher levels. Japanese doctors have been using 45 mg of vitamin K2 per day, generally three doses of 15 mg each, to treat osteoporosis for more than a decade.

Vitamin K2 is known to be more concentrated in certain areas in the human body including the brain, salivary glands, and pancreas which is the organ that produces insulin. Researchers believe that the human body is able to inefficiently convert K1 to K2 in small quantities. Thus it is possible that supplementation with vitamin K2 could produce a different, quite possibly superior, effect than seen with K1.
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Vitamin K2 Deficiency May Have Role in Neurological Diseases Including Parkinson’s, Alzheimer’s, and Multiple Sclerosis

While reading up on vitamin K2 recently, I’ve noticed a number of connections that have me wondering if one of the culprits behind several widely occurring neurological diseases might be a relative scarcity of this vitamin in many people’s diets. Unfortunately, there is little research yet on using vitamin K2 to treat neurological conditions in humans. What research exists shows that vitamin K and particular the K2 MK4 form are capable of protecting brain cells in vitro from certain types of damage that could be connected to many neurological diseases. There is also a much larger research base showing that vitamin K2 helps prevent cardiovascular system damage. As the brain is a major user of blood flow, it is relatively obvious that improvements in blood flow could improve brain function. Thus vitamin K2 could offer a multifaceted protection mechanisms for the brain against some of the driving factors suspected to be involved in neurodegenerative diseases.

Vitamin K: Not Just A Single Vitamin

Vitamin K is one of the more poorly understood and under-appreciated vitamins. There are three known major forms: K1, K2, and K3. Of these, K1 and K2 are naturally occurring and K3 is synthetic.

Among the K2 form, there are multiple variations. The most commonly researched ones are MK4 (an abbreviation for menaquinone-4 that is also known as menatetronone) and MK7 (an abbreviation for menaquinone-7). MK4 is more commonly produced in animals and MK7 (along with some others such as MK5 to MK14) are made by bacteria. Many animals can convert vitamin K1 to K2 MK4. Humans can do this also, but not as efficiently.

Vitamin K3 is synthetic. Perhaps not coincidentally, it is the only K form found to be toxic to humans.

Historically much of the research on vitamin K focused on the K1 form found predominantly in plants. But in recent years, researchers have started to understand that the K2 forms produced in animals and by bacteria may function very differently in the human body. In general, they have found that K1 seems to be widely dispersed throughout the body and to be necessary for proper blood clotting function. Of obvious concern might be that too much vitamin K1 could produce too much clotting. In general, this is not true as vitamin K1 activates clotting proteins via a chemical process known as carboxylation but does not actually create the clotting proteins. But people taking warfarin, a dangerous and overused anticoagulation drug, are often advised to avoid or severely limit their vitamin K intake because warfarin’s function in the body is to interfere with vitamin K carboxylation in order to reduce the blood’s ability to clot.

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How Much Vitamin D Do I Need?

If you have paid the least bit of attention to health care coverage in the past few years, you probably have noticed the growing number of studies citing that insufficient levels of vitamin D contribute to elevated disease risk from myriad illnesses ranging from autoimmune disorders, cardiovascular disease, and osteoporosis all the way to cancer and diabetes. So you might be wondering, how much vitamin D do I need each day?

The answer to this question is a bit complicated because there are significant variations in vitamin D needs for some people. First I’ll give a rule of thumb that works reasonably well for most people. Later I’ll add some additional considerations that may significantly affect appropriate dosage.

Basic Guidelines for Vitamin D3

A simple rule of thumb you can use to determine how much vitamin D you should consume each day is based upon the observation that 100 IU of vitamin D3 will raise the blood level of an adult by about 1 ng/mL. Vitamin D researchers are widely recommending blood levels of between 40 to 60 ng/mL (conservative) or 50 to 80 ng/mL (newer recommendation with growing acceptance). For a typical adult getting little vitamin D from food or sun (the common case), supplementing with vitamin D3 at 4000 IU to 8000 IU per day is appropriate depending upon your target for your vitamin D blood test.

In the past couple of years as vitamin D3 dosages recommendations have been raised, 5000 IU vitamin D3 softgels have become very inexpensive. Most such products use tiny softgels that are easy to swallow even for senior citizens. Another reason I like the 5000 IU softgels is that their vitamin D3 is already dissolved in an oily fat. Compared to powders, powder capsules, and tablets, this makes it more likely the active ingredients will be absorbed in the digestive tract.

For adults, 5000 IU per day is a good “rule of thumb” starting point for vitamin D3 supplementation. This 5000 IU per day also applies to teenagers who are roughly adult-sized, typically those around 14 years of age or older.

For teenagers and adults, a suitable inexpensive product that has tiny softgels of 5000 IU each is Swanson Health Care Products High Potency Vitamin D-3 5000 IU that features 250 softgels for $8.99. That’s about as inexpensive as vitamin D3 supplements can be unless you find a good sale. So for around $1 per month with that product, most adults can get enough vitamin D3 via supplementation. A good alternative is NOW Foods Vitamin D3 5000 IU 240 softgels, but this usually runs about $14 per bottle.

Preschool kids need about 1000 IU of vitamin D3 per day. As they are often unable or unwilling to swallow softgels, you may find it easiest to add this to their food via vitamin D3 drops. Customer reviews of Carlson Labs Carlson For Kids Liquid Vitamin D3 Drops, 400 IU, 365 drops 10ml suggest this is a good product for kids because it has no taste and can mix unobtrusively and easily with any drink or food containing some fat. You could easily put a drop of this in the food or drink for each meal to get about 1200 IU of vitamin D3 per day. Some report using these drops successfully directly in the mouth of their kids, also.

School age kids prior to growing to near the size of adults would benefit from around 2000 IU to 3000 IU of vitamin D3 per day, either drops or the usually cheaper softgels if you can get the kids to swallow them. For kids who can’t handle tiny softgels, you might try Carlson Labs D Drops Liquid Vitamin D3 4000 IU every other day or four drops per weeks as they are 4000 IU per drop and are also tasteless.

If your kids will swallow softgels, the high potency 5000 IU softgel products I mentioned should be fine for them simply by taking them less often than every day. For example, for a school age kid prior to teenagers in high school, swallowing three or four of the 5000 IU softgels per week is about right to get around 2000 IU to 3000 IU per day on average. Unless water soluble vitamins (most forms of B and C vitamins in particular), this works because vitamin D3 is fat soluble and the body stores it for future use.

If you have trouble getting your kids or yourself to take vitamin D3 supplements every day, it is fine to take all of them for the week at once with a big meal containing fat for best absorption. Even if you sometimes accidentally give two big doses per week because you forgot when the last dose was, it is unlikely to create any health problem unless you do this often.

Safe Upper Limits for Vitamin D3

According to Dr. John Cannell of the Vitamin D Council, overdose from taking a massive quantity of vitamin D3 during one day is less likely than overdose from water, aspirin, or Tylenol. To further drive this home, there is no known successful suicide attempt using vitamin D. The estimated LD50 (lethal dose for 50% of the patients taking it) for vitamin D3 in humans would be approximately 168 bottles containing 250 capsules of 1000 IU each or about 33 bottles containing 250 softgels of 5000 IU each. Can you imagine taking even one bottle of vitamin D capsules or softgels in one day? If you’re still not convinced that vitamin D is not likely to kill anybody in one or two attempts even if they tried very hard to do themselves in with it, see How Much Vitamin D is Too Much? Take This Vitamin D Quiz to Find Out!.

The main risks for vitamin D are not acute overdose but instead chronic overconsumption risks that show up not via death but by initially mild symptoms that can easily be reversed simply by lowering an overly high vitamin D intake. According to Dr. Michael Holick, the generally safe upper limits for long-term daily vitamin D3 intake for healthy weight people are 10,000 IU per day for adults (and similar size teens), 5000 IU per day for preschool and school age kids, and 2000 IU per day for kids under 1 year old.
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How Terry Wahls Reversed Her Own Multiple Sclerosis

University of Iowa medical school professor Dr. Terry Wahls suffered multiple sclerosis so severe that over the years she became wheelchair-bound as the disease progressed. Despite the receiving top notch mainstream medical care, she saw what she enjoyed in her life slipping away from her due to worsening symptoms. She realized what her doctors had to offer her was inadequate to even stabilize her declining health and far from enough to reverse the damage to her body. She needed better options and needed them soon.

She began to do a lot of reading about research on neurodegenerative diseases, hoping to find some clues on what she herself could do to reverse her declining health. One thing she noticed that is common to many neurodegenerative diseases including Alzheimer’s, Parkinson’s, MS, and many chronic fatigue and pain diseases such as fibromyalgia and chronic fatigue syndrome is the poor health of the mitochondria. Mitochondria are tiny little biochemical power plants that reside in each human cell numbering from about two to 1500 per cell, depending upon the cell type. They provide around 95% of the available energy used by cells to perform their normal functions. Energy-intensive cell types such as those in the brain, heart, kidney, and liver tend to have more mitochondria to keep them running than cells that don’t need as much energy to perform their functions.

In the scientific community focused on slowing and reversing aging processors, the mitochondrial theory of aging has wide acceptance as one of the key elements in aging and chronic diseases of aging. This theory attempts to explain many aging and disease processes by focusing on how health worsens markedly as people suffer increasing levels of damage to their mitochondria, a decline in the numbers of mitochondria in their cells, and impairment of their mitochondrial functionality due to biochemical dysfunction such as shortage of critical nutrients.

Wahls reasoned that taking steps to support her mitochondria could be a key to halting and perhaps reversing the decline of her health. At first, Wahls tried to simply add a few supplements that are well known to support mitochondrial health including fish oil, creatine, and CoQ10 to her daily regimen. She found that this seemed to slow the progression of MS, but did not reverse it for her.

Encouraged, she continued to do more reading on the latest biomedical research. And what she found is that many people with neurodegenerative and other chronic diseases are lacking in many other important nutrients in their diets. After creating a new diet for herself focused on improving her mitochondrial health, her MS began to reverse. She reasons that science has yet to identify probably hundreds and even thousands of nutrients found in the healthy nutrient-rich foods she advocates and therefore a good diet is important as today’s nutritional supplements are not enough to overcome the impact of poor diet.
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Sjögren’s Syndrome Patients and Others With Dry Mouth May Benefit from Oral Probiotics

While I was writing about a difficult autoimmune illness called Sjogren’s syndrome, it occurred to me that one the products I use regularly for my own health might be very helpful to people with this illness. One of the chief symptoms that these people have is very low levels of saliva production. Besides the the obvious problems of how that interferes with eating and good digestion, low saliva tends to destroy the health of the mouth. “Dry mouth” from Sjogren’s and other causes produces a strong tendency to develop many dental cavities, accelerated accumulation of plaque, severe gum disease and jaw bone loss involving periodontitis, and frequent and possibly chronic infections in the mouth with yeast, Candida, and other pathogens. Wounds or sores in the mouth also tend to be slower at healing due to low saliva levels.

In more than half of its victims, Sjogren’s syndrome also products chronic pain and fatigue symptoms that are poorly understood. It occurred to me that one of the biggest sources of chronic pain is chronic inflammation and that one of the biggest culprits behind systemic inflammation is poor dental health. An infected mouth tends to spew inflammatory cytokines throughout the body. This effect has been tied to elevated cardiovascular disease risk and even to higher risk for Alzheimer’s Disease. In my opinion, it could also explain part of the chronic pain and fatigue problems these people suffer.

Combatting dry mouth complications is difficult. For Sjogen’s patients and others with dry mouth, many mouthwashes (particularly those with alcohol) are problematic because they tend to further dry out mouth tissues. Toothpastes with sodium lauryl sulphate, a detergent used in many soaps, shampoos, and toothpastes, are also reputed to dry out mouth tissues and trigger more infections and canker sores.

Biotene brand toothpastes and mouthwashes have been suggested by many as a good alternative for Sjogren’s patients as they do not use sodium lauryl sulfate. The reviews are pretty good, enough that for somebody with dental health problems including dry mouth and inflammation that it would probably be worth a try.

The reasoning behind them makes sense to me, but I’m not convinced that everybody is equally sensitive to alcohol in mouthwashes or sodium lauryl sulfate in toothpaste. It is my opinion these products may help some and not help others, but in any case they are not going to be a total solution for somebody with severe dry mouth as many Sjogren’s patients have.

There is class of products called oral probiotics introduced starting around 2008 or 2009 that I have used myself that I think would make an excellent option for Sjogren’s patients or pretty much anybody else with less than stellar dental health to at least try for a few months. They can be used with or without the more health-safe toothpastes and mouthwashes. The cost per year is probably less than you’d pay for dental cleanings and exams and could be less than you’d pay for special toothpastes and mouthwashes. Based upon my own experience, oral probiotics may also make it possible for you to reduce your use of mouthwashes.

I’ve been thrilled with the results from the oral probiotic product I have used and would recommend trying it or another of this class of products for at least six months between typical dental checkups for anybody suffering from Sjogren’s or any other condition causing dry mouth, gum disease, or who is having trouble with excessive numbers of cavities or mouth sores.
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Sjögren’s Syndrome Patients May Suffer Symptoms Similar to Fibromyalgia, Chronic Fatigue Syndrome, and Multiple Sclerosis

Recently I have been reviewing chronic fatigue and pain symptoms for somebody I know. Most of the symptoms sound a lot like those of fibromyalgia or chronic fatigue syndrome, but this person also has chronic dry eyes with blurry vision going back years and a history of poor dental health including rapid dental plaque buildup and periodontitis (gum disease) despite what seem to be good efforts at dental care. One possible cause for these problems is Sjögren’s syndrome. This is an autoimmune disorder of unknown cause that in most patients shows up most obviously via symptoms including dry eyes, little saliva output, dry skin, and in some by pain and fatigue symptoms similar to those you see in fibromyalgia, chronic fatigue syndrome, and multiple sclerosis. Many of these symptoms are directly related to immune system attacks on exocrine glands that make components of tears and saliva.

Sjögren’s Syndrome is not a recent discovery. It was named and the symptoms were well-documented in the 1930’s. But medical education continues to lag many decades behind science as many doctors today remain unfamiliar with this common disease.

Sjogren’s is reportedly one of the most common autoimmune conditions in the US but is severely underdiagnosed. Estimates are that it affects possibly as many as 4 million Americans about 1.5% of the population. About 90% of those diagnosed are women, but men can also suffer from it. Researchers suspect that hormonal changes associated with aging may have some involvement in the disorder, but some patients are young and therefore there may be other factors at work.


Sjögren’s Syndrome: A Place To Begin

Probably the most famous Sjogren’s patient is Venus Williams, the American tennis star who dropped out of playing in the 2011 US Open tournament due to the disease’s impact on her health:

Venus Williams pulls out of U.S. Open due to autoimmune disease

Minutes before she was due to play her second-round match at the U.S. Open, Venus Williams withdrew from the tournament due to an autoimmune disease with which she was recently diagnosed.

“I’m really disappointed to have to withdraw from this year’s U.S. Open,” Williams said in a statement. “I have recently been diagnosed with Sjögren’s syndrome, an autoimmune disease which is an ongoing medical condition that affects my energy level and causes fatigue and joint pain.”

Williams’ announcement has helped raise awareness for Sjogen’s and some medical education programs for doctors have now added the disease to the material they cover. This may help many get a more accurate diagnosis in a reasonable amount of time rather than the 7+ years it is typically for today’s patients to get a diagnosis after they initially reported the symptoms of the disease to their doctors.

More than half of Sjogren’s patients have systemic symptoms going beyond the typical dry eyes, mouth, and skin. These often include what are classic pain, fatigue, weakness, and cognitive impairment symptoms of fibromyalgia, chronic fatigue syndrome, and multiple sclerosis.
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Lowering CT Heart Scan Calcium Score and Heart Attack Risk Via Diet and Supplement Changes

One of the notable developments in the past decade of cardiovascular medicine has been the increasing use of a CT scan of the heart to determine calcification in the cardiovascular system. The relative level of calcification is quantified as a “calcium score” that reflects how much calcium there is on the plaque on the inside of the blood vessels and heart. Those with no measurable calcification get a score of 0 which is excellent. Those with higher scores are viewed to be at increasingly high risk of heart attacks, even if they have no other blood markers in typical tests (such as cholesterol tests) that might suggest elevated cardiovascular disease risk.

Conventional Tests Often Fail To Detect Those At High Heart Attack Risk

Dr. William Davis of Milwaukee, Wisconsin, is a cardiologist who is a strong advocate of using the calcium score to determine the level of aggressiveness needed to treating cardiovascular disease. He views calcium score as a more direct measurement of heart attack and cardiovascular disease than commonly used risk factors such as LDL cholesterol. As he points out in his writings, there are a significant number of people who appear to be at low risk for heart attack based upon widely used LDL cholesterol tests but who fall over dead from sudden cardiac death due to cardiovascular calcification.
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