Defiant Health Radio with Dr. William Davis
Defiant Health Radio with Dr. William Davis
The REAL way to stop or reverse heart disease
LDL cholesterol, apoprotein B, saturated fat, TMAO, statin cholesterol drugs: Over the last 40 years, we have been inundated with misguided advice on how to reduce your risk for coronary heart disease, i.e., risk for such things as heart attack, need for heart procedures such as stent implantation or bypass surgery, or sudden cardiac death, serious and often life-threatening events. Has it worked? 80 million Americans now take statin drugs to reduce cholesterol yet there has been no meaningful reduction in such events and, in fact, I’ll bet some of your local hospitals have added multi-million dollar wings for cardiac care, the number one moneymaker for hospitals and healthcare.
The tragedy of all this is that the focus on issues like cholesterol have taken everyone’s focus off the REAL causes of heart disease that are, in reality, easy to identify and manage. And it involves no pharmaceuticals, no restriction of dietary fat, but draws from a handful of common sense and natural strategies that, time and again, have allowed people to stop or even reverse coronary atherosclerosis.
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LDL cholesterol, apoprotein B, saturated fat, t-mayo, statin cholesterol drugs. Over the last 40 years, we have been inundated with misguided advice on how to reduce your risk for coronary heart disease. That is, risk for such things as heart attack, need for heart procedures such as stent implantation or bypass surgery, or even sudden cardiac death, serious and often life-threatening events. Has it worked Well? 80 million Americans now take statin cholesterol drugs to reduce cholesterol, yet there has been no meaningful reduction in such events and in fact, I'll bet some of your local hospitals have added multi-million dollar wings for cardiac care. It's the number one moneymaker for hospitals and healthcare. The tragedy of all this is that the focus on issues like cholesterol have taken everyone's focus off the real causes of heart disease that are, in reality, easy to identify and manage. And it involves no pharmaceuticals, no restriction of dietary fat, no need to reduce cholesterol, but draws from a handful of common sense and natural strategies that, time and again, have allowed people to stop or even reverse coronary atherosclerosis. So in this episode of the Defiant Health Podcast, let's discuss all these unique and effective ways to put a stop or even reverse coronary disease. Let me tell you about how I've been reversing heart disease for the last 20 some years. It's quite easy and fairly straightforward. You don't hear much about it because it doesn't make a lot of money.
Speaker 1:Now there's a lot of misinformation about heart disease. By heart disease, of course, I'm talking about coronary disease, that is, atherosclerosis in the coronary arteries, the three coronary arteries. That causes heart attack, sudden cardiac death. You get it stented or bypassed. That's the stuff that grows in your coronary arteries. I'm not going to talk about other forms of heart disease valvular heart disease, heart muscle diseases, cardiomyopathies and many other rhythm diseases. Let's focus specifically on this most common form of heart disease coronary disease. When I say heart disease in this context, I mean coronary disease. There's a lot of misinformation in this world because a lot of money is being made by mismanaging and not preventing this disease. So you may have noticed, for instance, maybe your hospital added an $80 million wing for cardiac care because they make a lot of money. Heart disease is the number one moneymaker, number one source of revenue for hospitals and the healthcare system. So there's a ton of money at stake here and it's allowed.
Speaker 1:Proliferation of the silliest ideas like reducing cholesterol prevents heart disease. It does not. Let's be very clear on that. You do not have to reduce cholesterol.
Speaker 1:Cholesterol is nothing more than a crude indirect marker that was meant to represent the lipoproteins, the fat-carrying proteins in the bloodstream that do cause heart disease. So, starting in the 1950s and 1960s, because they couldn't really quantify tiny microscopic particles in the bloodstream that cause heart disease, so they said let's measure one component, one ingredient in these lipoproteins. Let's measure one component, one ingredient in these lipoproteins. They could have chosen apoprotein B, one of the main proteins in those particles. They could have chosen triglycerides, they could have chosen many other things. As an indirect way to guesstimate the number of particles in the bloodstream that cause heart disease. They chose cholesterol. It's easy to measure. And then they showed that the various fractions of blood that layer out when you spin it down in a centrifuge. You could use cholesterol to very crudely guesstimate how many particles are in each layer the high density layer, low density layer, very low density layer, and so on. Well, it became. People started to view cholesterol as the cause for heart disease and then the appearance of cholesterol-reducing drugs pretty much firmly implanted this idea into the public's perception as well as my colleagues and they thought, everyone thought that reducing cholesterol was the way to reduce heart disease. It is not. If you take a cholesterol-reducing drug, it has almost no effect.
Speaker 1:Some of the most recent evidence, for instance the HEARTS trial and the EVAPORATE trial these are two very nice studies, both using CT, coronary angiography. That is, a CT scanner that creates three-dimensional images of the coronary arteries and gives you intense detail, very detailed breakdown of how much lipid tissue there is, fatty tissue, how much is fibrous, how much is calcific. It breaks down the components of atherosclerotic plaque very nicely. Now please don't hear get that test done. I would not do that test. I'll talk about other ways to look at coronary disease, because that test packs a lot of radiation about 300 chest x-rays worth of radiation. It's a useful test, very beautiful pictures, but it gets you exposed to a lot of radiation. So there's a time and place for that, but not here. We're not going to talk about that today. Nonetheless, those two trials the HARTS and the EVAPORATE trial showed very interestingly that statin drugs do not regress carinatory atherosclerotic plaque. In fact, it allows significant progression. Interestingly, these were studies of omega-3 fatty acids and higher doses, typically more than 3,300 milligrams of EPA and DHA per day, did achieve regression of carinatory atherosclerotic plaque, principally the fatty component. That's very important because the fatty component is the stuff that ruptures and that causes a heart attack and death.
Speaker 1:So people think of coronary disease as a progressive disease gets worse and worse and worse 50%, 70%, 90% and then 100%. That's not how coronary disease works. It's a 30% 40 percent plaque, that is, it's not obstructing flow but it erupts because that plaque is inflamed. Underneath its cap there's inflamed tissue and that causes that plaque to rupture. That's how you go from, say, a 30 percent blockage to a 100 percent blockage. Because when it ruptures, kind of like a little volcano or a pimple, the underlying tissue is exposed to blood and it causes blood clotting. So that's how a 30 percent or 40 percent blockage can rupture, cause a heart attack. That's why it's very difficult to predict heart attacks because it comes from what would be regarded as a minor plaque. There are exceptions, but that is in general, general the rule.
Speaker 1:So how can we regress this? Well, it's not going to be a statin cholesterol drug. So you can do this, you can regress, you can stop or regress coronary disease without drugs. You do not need any drugs to do this. So how do you do it?
Speaker 1:Well, first of all you have to know what causes heart disease, coronary disease, and there's a handful of things. There's two lipoprotein classes of particles. There's very low-density lipoprotein, vldl, and small LDL particles, not LDL cholesterol. The indirect way to guesstimate these particles you can actually measure these particles VLDL and small LDL. Measure these particles, vldl and small LDL. Small LDL is a very vicious little thing because it's very adherent to the artery wall. It's very prone to glycation and oxidation, making it much more aggressive and causing heart disease. If it gains entry into the artery wall, it provokes inflammation and small LDL particles last about five to seven days in the bloodstream as compared to a large LDL particle, a normal LDL particle that persists for 24 hours one day.
Speaker 1:So large LDL particles come from consuming fats and oils. Small LDL particles come from consuming fats, wheat, grains and sugars. It's the amylopectin A you need to wheat and grains and sugars that promote formation of small LDL. So bear with me, this is how it works. So you eat, let's say, a bowl of breakfast cereal or other junk food that has wheat, grains and sugars in it. Okay, your blood sugar, of course, goes way high when you do that 170 would be very common but your liver is very good at taking those sugars, the amylopectin A of grains or sugars, and converting them to triglycerides. And that process is called liver or hepatic de novo lipogenesis. And all that means is your liver's ability to convert carbohydrates to fats, triglycerides.
Speaker 1:Well, triglycerides can't float freely in the bloodstream because if they did, they would coalesce, just like in salad dressing. The oil separates from the aqueous, from the water, right Water and vinegar. Same thing here. Triglycerides can't float freely in the bloodstream. It would be very dangerous, you'd die. So the liver packages triglycerides into a water-soluble particle that's VLDL, very low-density lipoprotein, and it's very triglyceride rich, so that VLDL is itself able to enter the artery wall and contribute to coronary atherosclerosis. And that VLDL, triglyceride-rich VLDL particle interacts with LDL particles and there's a series of enzymatic reactions that cause that LDL particle to become small. That's the cause.
Speaker 1:So VLDL, small LDL, and you can measure these things using lipoprotein testing, not lipid testing, cholesterol testing, but lipoprotein. So the way that's most readily available is nuclear magnetic resonance, nmr, lipoprotein analysis. It's easy to get If your doctor says, oh, we don't do that around here, or insurance doesn't cover it, or that's not accepted, it's experimental. Those are all lies, those are all bald lies. None of this is true. It's covered by insurance. It's been around. There are 55 clinical trials human clinical trials showing that small LDL is the cause for coronary disease. So don't take those kinds of excuses.
Speaker 1:So NMR lipoproteins will identify the VLDL and small LDL and you want as close to zero small LDL as possible. Less than 200 nanomoles per liter is probably okay, but we want it close to zero as possible. So what causes formation of small LDL and VLDL? Wheat, grains and sugars. Period, not bacon, fat, not butter, not olive oil, not fatty cuts of meat, wheat, grains and sugar. So if you start, let's say you get your NMR lipoprotein testing and you have 1,800, say, nanomoles per liter, particle count per volume, wheat grain, sugar elimination, right, and your small LDL typically drops to zero and all kinds of other things happen.
Speaker 1:Your HDL goes up, triglycerides go down. You don't really have to follow VLDL. By the way, you can follow triglycerides. Vldl tracks so well with triglycerides. You can use a basic triglyceride measure on a cholesterol panel. Ironically, total cholesterol, ldl cholesterol, are worthless. They're worthless. Cross them out with a big black magic marker. But the triglyceride value is useful. That's the one that's usually ignored and you want that at 60 millirems per deciliter or less. That's usually ignored and you want that at 60 millirems per deciliter or less. That tells you you have very little VLDL that is causing heart disease and you have very little VLDL interacting with LDL to make small LDL particles. So wheat grain and sugar elimination works incredibly well. So those are the lipoprotein causes of heart disease.
Speaker 1:Now, when you get that NMR panel, by the way, the first time you get it also specify lipoprotein A. We say lipoprotein little a little a in parentheses. That's a genetic pattern, because there's a bit of a different way to approach this. If you had that specific genetic marker. If you don't have it, never have to test it again. Okay, because you can't get it. It's genetically determined. And how do we manage that? That's a topic for another day. But so NMR lipoproteins with lipoprotein A, at least the first time. It also helps to get a thyroid panel, tsh, free T3, free T4, thyroid antibodies and reverse T3, because even a little bit of hypothyroidism can contribute to coronary atherosclerosis. So we try to keep that TSH, for instance, at two microunits per liter or less, between 0.2 and 2.0. That's an ideal area, ideal range.
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Speaker 1:We also check a 25-hydroxy vitamin D blood level so important because vitamin D is extremely important. I want a very, extremely important component of your program to prevent or reverse coronary atherosclerosis. Okay, so we're going to follow the diet that eliminates the expression of VLDL and small LDL. We're going to address nutrients that are largely lacking in modern life, that influence insulin resistance and inflammation. So insulin resistance and inflammation amplify liver de novo, lipogenesis, it makes it worse, and a high blood glucose glycates those small LDL parts. You see that it's all tied together right.
Speaker 1:So we're going to supplement four things. We're going to supplement omega-3 fatty acids, because that's what's necessary for regression of coronary disease, and we're going to use a dose of at least 3,600 milligrams of EPA DHA per day. We also add vitamin D at a dose sufficient to raise your 25-hydroxy vitamin D blood level to 60 to 70 nanograms per milliliter. Okay, typically typical dose it varies on body size, but a typical dose would be 6,000 units in an oil-based gel cap only, never tablets. Tablets are radically absorbed. So you want oil-based gel caps. They're very inexpensive and you want to wait three months after you start vitamin D before you check a blood level. If you want to check a blood level, it takes three months for the level to stabilize.
Speaker 1:We're going to add magnesium because we live in a magnesium deficient society. Your drinking water is filtered. You have to right, you have to filter your water that removes all magnesium. And modern produce is very magnesium depleted because of modern farming methods. So we have to supplement magnesium.
Speaker 1:There are many choices magnesium glycinate, bisglycinate, chelate, malate, malate, many of them. We want to get about four to five hundred milligrams of the magnesium component in those, those compounds. So if you buy, let's say, magnesium malate, 1300 milligram tablets, you don't care about the 1300 million, you want to know how much magnesium is in there, and something like 133 milligrams of magnesium in the magnesium malate, because the rest of the weight is the malic acid. Okay, so you want about 400 to 500 milligrams of magnesium per day. And then, lastly, iodine. We want iodine because most people aren't getting sufficient iodine. Iodine is necessary for your thyroid, to make thyroid hormones. So we try to get somewhere around 300 micrograms or so higher than the RDA, the recommended daily allowance for iodine, because I think that's insufficient. So we try to get a larger quantity, about 300, 350. They're about doesn't have to be absolutely precise, and the easiest way to do that is just to buy inexpensive kelp tablets. So if your kelp tablets, if it says 30 milligrams, provides 100 micrograms of iodine, you're going to need about three of those. Okay, very, very, very easy. So those are the four nutrients largely lacking in modern life that, when you put them together, it minimizes insulin resistance and inflammation, helps you turn off hepatic de novo lipogenesis that would have been causing VLDL small LDL. Now, the diet we talked about also prevents your blood glucose from going high and it prevents glycation of the small LDL particles. This all fits together very well.
Speaker 1:Next, we address the microbiome, the gastrointestinal microbiome. So if you have coronary disease, if you had a stent or a heart attack or had a high coronary calcium score, you have SIBO small intestinal bacterial overgrowth. And if you've been following my conversation, you know what that means. It means that you've allowed fecal microbes that were supposed to be in the colon only to over proliferate and then ascend into the 24 feet of small intestine. Small intestine is very permeable because that's where you absorb nutrients like vitamins and minerals and amino acids. But when fecal microbes infest the 24 feet of small intestine, they live and die rapidly. Microbes only live for a few hours and you're having trillions of microbes dying and shedding their toxic compounds into the intestine and then into the bloodstream. That's called endotoxemia. That's a major driver of coronary disease, as well as weight gain, hypertension, atrial fibrillation, cardiomyopathies, dementia, risk for numerous forms of cancer, autoimmune disease. In other words, if you address endotoxin, if you address SIBO and endotoxemia, you have taken huge control over your health and you gain numerous health advantages, among which is facilitating regression of your carotid atherosclerotic plaque.
Speaker 1:How do we do that? That's a conversation all of its own, but we do it, and my way of doing it. We make something called SIBO yogurt. It's not yogurt, don't be confused. It's not like the stuff in the store. It happens to look and smell like yogurt, so we call it SIBO yogurt.
Speaker 1:But the rationale is this we're going to choose microbes three of them that we're going to ferment, using a prolonged fermentation, to get very high microbial counts of about 300 billion per half cup or 120 milliliters serving. So three microbes Lactobacillus roteri, lactobacillus gasseri. Those two microbes take up residence in the small intestine where SIBO occurs and they're very good at producing bacteriocins. These are natural antibiotics that kill those invading fecal microbes. I like to throw in Bacillus subtilis. The original recipe was Bacillus coagulans. I replaced it with Bacillus subtilis because it's a better microbe for producing bacteriocins. It's a spore former also, so it doesn't really colonize the small intestine, but it germinates in the small intestine. We co-ferment those three as yogurt and there's some other variations on this, but for the moment let's just talk about making the yogurt. We ferment for 36 hours in the presence of some added prebiotic fibers. We get those super duper counts and then we consume a half cup per day and so far, when consumed over four weeks, it has gotten rid of SIBO in about 90% of people. My experience it's superior to antibiotics to correct SIBO.
Speaker 1:Now one of the ways you can verify this is to get one of these devices. This is called the AIR device. You blow into it, talk to your smartphone, registers hydrogen on your breath on a 0 to 10 scale, because microbes produce hydrogen gas. But we can't Humans cannot and there's a very specific protocol we follow. It's all detailed in my SuperGet book. So how to use the device? Okay, it's about $150, $200, something like that. The good thing about it is you can use it forever, over and over and over again, unlike the testing in a laboratory clinic where you have to pay about $400 or $500 every time you do it. This one you can do over and over and over. You can share it with people you're close to also. But you don't need the device.
Speaker 1:This is in case you wanted to verify whether or not you have SIBO. But if you don't care because the solution is just so simple, right? If the solution is something that looks and smells like yogurt you make in your kitchen that costs you a few dollars to make because you have to buy I use organic, half and half a very minimal cost, and so you can just proceed with the yogurt. Because, even though I call it SIBO yogurt, it has numerous health benefits beyond just reversing SIBO. You get better skin, you get a reduction in wrinkles, men can experience a rise in testosterone, women can experience restoration of youthful moisture in their vaginal tract. There's an increase in all the effects of oxytocin, like generosity, closeness, affection for other people close to you, acceptance of other people's opinions, a return of youthful musculature. In other words, if there's no downside except a little bit of hassle in making it, then you don't have to be absolutely confident you have SIBO or not. So the air device only if you want to validate, verify whether you have it or not. But you can just go ahead, because if you have coronary disease, you've got SIBO.
Speaker 1:You can look for other telltale signs also, like fat droplets in the toilet. Intolerance to foods could be nightshades histamine-containing foods, fodmaps, legumes Just about any food intolerance tells you you have SIBO, causing the food intolerance. And the food intolerance almost always goes away by taking the SIBO yogurt. Now some people have really bad SIBO. If you say, for instance, I took Anabiox for four years for whatever condition, you may have SIBO really bad, you probably want to do the yogurt for many months, not just four weeks. And even if you don't have bad SIBO, it's a good idea to continue intermittent consumption of that yogurt, maybe three times a week or so, because SIBO loves to come back and you want all those benefits like better skin, deeper sleep, libido, all that kind of stuff. So the diet, the four nutrients that synergize to minimize insulin resistance and inflammation, and then addressing the microbiome, the gastrointestinal microbiome, but specifically addressing the SIBO that is very likely to be present when you have coronary disease.
Speaker 1:Now one way to track this is to do a CT heart scan for coronary calcium score. Not that CT coronary angiography I talked about earlier with high radiation, just a simple CT heart scan that generates a value as a coronary calcium score. That's about 10 chest x-rays worth of radiation. So it's not zero. But it's not terrible either and it's very inexpensive. You can get it, typically for about $100.
Speaker 1:Most hospitals have it. They're offering it now because they think of it as a lost leader. They want you to have a really high score so they can trick you into getting more testing that CT, carotid angiogram, heart catheterization, a stent even if you don't need it. How often is that done? All the time it's done all the time. So be very careful. If you talk to any of the doctors or the staff when you get your cardiac, they may try to twist your arm into more testing. Don't fall for it. They're trying to use the calcium score as a loss leader. They don't make much money on it, so they try to get you to buy more things. You know, if they talk you into heart catheterization and stent now you've got a bill of $50,000 to $100,000. They make a ton of money doing this. So be very, very careful.
Speaker 1:But you can use that calcium score. So a normal score is zero and then the scores go up to the thousands and it tells you how much plaque you have in your arteries. People say things like well, I don't care about hard plaque, calcium, I don't want to know much soft plaque. No, no, no, calcium is an index of total plaque. Okay, soft and hard and fibrous elements, so you can use that score. So let's say your score is 400 and you're a, let's say, 55, 55-year-old guy or maybe a 63-year-old woman, score 400. What if you do nothing? How high would the score go? 25% per year. So a year from now, 500. Another year, 625. So at a score of 400, you're about seven, eight years away from dying or having a heart attack or needing a procedure, really needing a procedure.
Speaker 1:Well, what if you took a baby aspirin, 40 milligrams of Lipitor, cut the fat and saturated fat in your diet and exercised a serious exercise program? How fast will that score increase? 25% per year, it has zero impact on that score. It's ridiculous, but that is the prevailing standard of care. My colleagues, even to this day, call that ridiculous mix of things optimal medical therapy. No joke, they actually call it that, which is absurd, right?
Speaker 1:So we're going to do the things I talked about. We're going to follow a diet that generates elimination of VLDL and small LDL, no wheat, grains or sugars, and, of course, you eat whole foods. Right, you eat foods like beef, pork, fish, avocados, green leafy vegetables. You know the drill healthy whole foods, not fast foods, not junk foods, not preservatives containing foods, not ultra processed foods, real food but no wheat, grains or sugars. That triggers formation of small LDL and VLDL. We're going to combine those four nutrients iodine, omega-3 fatty acids, magnesium and vitamin D that synergize to minimize insulin resistance and inflammation.
Speaker 1:Then we're going to address the microbiome and we're going to do so by making something called SIBO yogurt that pushes back invading fecal microbes in the small intestine. Now that's what we do in a nutshell. There's more. There's more you can do for the microbiome, for instance, like fermented foods, restoration of other keystone species, fibers. So there's more to that.
Speaker 1:I invite you to take a look at my Super Gut book where, by the way, the source of all the microbes we use is in the Supercut book. Also, in my blog, williamdavismdcom, it has these recipes where to source the microbes. I also invite you to join me in conversations in my innercircledrdavisinfantthealthcom I know it's a mouthful and there we have tons of educational materials, discussions, videos, hundreds of videos, and we have a weekly two-way Zoom where it's typically a hundred, some people, and we talk about these kinds of things. You can say things like well, I tried to make the seabull yogurt and it didn't turn out right. You can talk about these kinds of things. We help you problem solve. So that's once again innercircledrdavisinfinitehealthcom. So we're here to try to help you. The program works. We've seen it over and over and over again People produce their carotid calcium scores not 100%, but close.
