Former Brooklyn Police Officer Reverses His Diabetes and Neuropathy....Fast!

I heard Eric Adams, former police officer and now Brooklyn Borough President, speak this past weekend when I did a "1 Dayer" to the 2nd Annual Preventive Cardiology Conference at Montefiore in the Bronx, NY. While there was some great physicians speakers, Mr. Adams was the best. His dramatic diabetes reversal story along with his passion to help people in general, and especially the people in Brooklyn, and especially, especially, the children of that borough is tremendously inspiring. Read this content and watch this video (5 minutes). Share it with a loved one with diabetes. Then go to my web page of resources for Diabetes Reversal. This is an example of how fast (3 months) and out-of-control diabetic can reverse their disease (and neuropathy) with a whole food plant based diet.

Watch This Powerful 5 Minute Video About Eric Adams: https://youtu.be/UjA-1xI3kbQ

Read This: https://www.forksoverknives.com/reversing-diabetes-plant-based-brooklyn-president-eric-adams/

This is one of the most powerful videos and talks I have heard. Share it!

Be and Stay Well,

Kirk

You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday   916-489-4400    KwikerMedical.com     StayingHealthyToday.com     Kirk's Healthy Living Tips
Kirk's FREE "21 Day Healthy Living Program"  Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs"

Stop or Reverse Kidney Disease By Treating Fructose Toxicity and Alkalizing the Body

The interview I did with nephrologist Dr. Patanay Teng-umnuay, MD, PhD (Molecular Cell Biology), who is also the Vice President of the American Academy of AntiAging Medicine, Thailand, really opened my eyes to the value of a simple test that really should be done on all routine exams, especially if you have any type of kidney disease (or really hypertension, diabetes, bone loss, heart disease, etc), and that is a simple uric acid level. While we all know to check uric acid levels for gout and put people on lower meat protein diets, reduce cheeses and alcohol what I didn't know was how extremely important it was to lower uric acid levels by medication or diet to prevent or reverse kidney disease. It goes something like this. Fructose which comes from soft drinks, any confectionery food (along with the wrong type of fats), artificial sweeteners and fruit consumption is metabolized through the liver (unlike glucose). Its metabolism ends up increasing uric acid which can lead to an acid state in the body and progressive kidney disease. So to combat kidney disease (and other conditions, like bone loss, obesity, hypertension, diabetes, heart disease, etc. ) stop all artificial sources of fructose (i.e. soft drinks, confectionery foods, etc.) and even fruit in some cases. Or limit to 2-3 pieces per day. Dr. Patana uses the old drug allopurinol to lower uric acid and buffers the blood with sodium bicarbonate to slow or reverse kidney disease. This is definitely a podcast to read and/or listen to! Very relevant to many people!

Be and Stay Well,

Kirk

You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday   916-489-4400    KwikerMedical.com     StayingHealthyToday.com     Kirk's Healthy Living Tips
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Reduce Heart Disease Mortality and Improve Your Heart Function With A Combination of CoQ10 and Selenium - An Interview with Cardiologist Urban Alehagen, MD, PhD

Getting ready to head to the airport....Sunday in Bangkok (back at SFO 8:30 pm Sunday)...trying to finish editing and posting one of two interviews I did from the American Academy of Anti-Aging Medicine Meeting (Bangkok, Thailand). This was with a Professor of Cardiology from the University of Linkoping, Sweden, Dr. Urban Alehagen, on the benefit of yeast bound selenium 100 mcg 2 x daily and CoQ10 (ubiquinone) 100 mg 2 x daily on reducing cardiac death, cardiovascular disease and improving heart function by reducing inflammation and the "stiffening" in the arteries and fibrosis in the heart. I think you will find it informative, practical and easy to understand. Yes diet first, mostly plants, then judicious supplementation if needed.

Be and Stay Well,

Kirk

You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday   916-489-4400    KwikerMedical.com     StayingHealthyToday.com     Kirk's Healthy Living Tips
Kirk's FREE "21 Day Healthy Living Program"  Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs"

You Can Know Your Real Heart Attack Risk By CT Angiography and Coronary Calcium Scoring - An Interview with Cardiologist Warrick Bishop

An "Ah-Hah" Moment on "Real" Heart Attack Risk Assessment
Cardiologist Dr. Warrick Bishop had an enlightening experience of helping resuscitate an individual on the side of the road from a cardiac event only to find out later that this person had been a patient of his which he had cleared from significant cardiovascular risk two years prior with a stress EKG. This challenged him to look at what really needs to be done to evaluate someone's true risk of a heart attack and intervene accordingly. He became aware of and began to utilize the three dimensional CT scan (xray) of the heart  for coronary calcium accumulation (without contrast dye) and with contrast (CT angiography) as excellent low risk, low cost tests that could tell the practitioner and patient the status of the  plaque in the coronary arteries and what specific treatment approaches to employ, and to what level of intensity, to reduce the patients heart attack risk. The analogy of the coronary artery calcium testing would be analogous to that of the routine mammogram for breast cancer. The difference is heart disease is the number one killer in men AND WOMEN and many more women's lives are lost to heart disease than breast cancer so this raises the question of why not screening all women starting at 60 for heart disease with this technology (and men at age 50)?

Coronary Calcium Screening
It is Dr. Warrick's belief that coronary calcium testing (noninvasive, without contrast dye) is the "gate keeper" in that if no coronary calcium is found in the coronary arteries (and if the patient has no cardiac symptoms i.e. chest pain, shortness of breath, or significant risk factors like elevated lipids, family history, diabetes, etc.) then no further study is needed, nor treatment for coronary arterial plaque accumulation.  But if there is ANY calcification found then a CT angiogram is warranted because he has seen cases where the calcification is small but the non-calcified "soft" plaque is large, and/or the plaque is located in a dangerous place anatomically in the coronary artery, and/or there is significant stenosis (narrowing) of the coronary artery warranting more aggressive treatment.

Hard (Calcified) and Soft (Non-Calcified) Plaque
The coronary calcium test without dye is a 10 minute, three dimensional scan (xray) of the moving heart that measures the calcium buildup in the coronary arteries or the "calcified plaque". This calcified plaque may be a protective response by the body to seal off small "microvascular" ruptures of plaque with calcium to prevent penetration of the inner artery wall. This is usually a smaller percentage of the total plaque burden (i.e. generalization 20% calcified plaque and 80% non-calcified plaque; % can vary). To "see" this soft, non-calcified plaque (amount, location), which is thought to be the more dangerous plaque because it can rupture leading to clot formation in a coronary artery (heart attack), artery in the brain (stroke), lung (pulmonary embolism/thrombosis) or leg (DVT - deep vein thrombosis) the CT angiogram with dye is needed. The soft plaque (generally 3 types - unstable necrotic core or low attenuation plaque of inflamed lipids more likely to rupture; a more stable fibro-fatty plaque, a mixture of lipids and fibrous material; and a fibrous plaque or fibrous cap that is more stable that might turn into more calcified plaque) is measured by the CT angiogram which requires dye to be injected prior to the exact same test and machine (scanner) that gave you the original calcium score.

Biochemical Testing
While Dr. Bishop uses biochemical markers of cardiometabolic status such as cholesterol, triglycerides, LDL and HDL cholesterol, homocysteine, fasting insulin, Lp (a), HS-CRP among others, the bottom line is what he sees in the coronary arteries really is the main determinant of the extent and aggressiveness of his cardiopreventive approach for that individual patient.

Lifestyle, Central Weight and Insulin Resistance
Dr. Warrick feels that insulin resistance and central weight (adiposity) and the diabetic "leaning" patients should be treated with a lifestyle program focused on weight reduction and reduction of carbohydrates, especially processed carbohydrates. He uses dietician counseling to support his medical program.

Nutraceuticals
He uses some nutraceuticals such as coenzyme Q10 for some statin users with some anecdotal benefit and for some types of heart failure; fish oil for elevated triglycerides and insulin resistance; and slow release niacin (500-1000 mg daily) for low HDL levels and high Lp (a).

Professional Awareness of Coronary CT Scanning
Dr. Warrick wishes there was greater receptivity with his professional colleagues both general practitioners and cardiovascular specialists to this technology (coronary calcium scoring and CT angiography). He continues to try and educate professionals on this technology.

Patient Education
An educated patient gets the best medical care according to Dr. Bishop. So being able to tell them the real status of their plaque and anatomy of their coronary arteries using coronary calcium testing and CT angiography, along with some biochemical determinants and lifestyle, allows him to create with the patient a specific heart attack prevention program.

______

About Cardiologist Dr. Warrick Bishop
Doctor Warrick Bishop is a practicing cardiologist, bestselling author and key-note speaker who has a passion to help prevent heart disease on a global scale by early detection. Assessment tools he champions are coronary calcium screening and the appropriate use of CT angiography (CTA). With a detailed assessment of what is happening within the coronary arteries an individualized preventive strategy can be employed.

Dr. Bishop graduated from the University of Tasmania, School of Medicine, in 1988. He completed his advanced training in cardiology in Hobart, Tasmania, becoming a fellow of the Royal Australian College of Physicians.

He is the author of: “Know Your Real Risk of Heart Attack” 2018, pages 158.

Warrick Bishop, MD, Calvary Hospital Consulting Rooms, 49 Augusta Rd, Lenah Valley TAS 7008, Phone: (03) 6278 9220 warrick@drwarrickbishop.com  www.drwarrickbishop.com

Be and Stay Well,

Kirk

You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday   916-489-4400    KwikerMedical.com     StayingHealthyToday.com     Kirk's Healthy Living Tips
Kirk's FREE "21 Day Healthy Living Program"  Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs"

Beans are A Superfood Found in Every Blue Zone… Enjoy!

About a week ago I took a can of organic black beans, threw in some onion and garlic powder, with cilantro, parsley, dill, oregano, basil and chive flakes with some salt and pepper mixed with some organic baby spinach. Heated and stirred it all up till the spinach leaves were slightly wilted and just ate it. It was simple but great tasting! Greens and beans… Slow release carbohydrate from the beans (with protein too) contains fiber that is good food for your intestinal bacteria and greens are greens. That is why the biggest animals in the world literally live off tons of greens because they are so nutritious. Also a consistent dietary staple of  ALL the Blue Zones in the world…. where people live the longest and without much chronic disease… is beans! Enjoy these simple recipes!

Fava Bean Salad
Mint Lemonade Chickpea Salad
Easy Black Bean Salad
Fresca Bean Salad
Chickpea Avocado Salad
Cauliflower Rice Salad

Be and Stay Well,

Kirk

You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday   916-489-4400    KwikerMedical.com     StayingHealthyToday.com      
Kirk's FREE "21 Day Healthy Living Program"  Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs"

Rice and Beans are Super Foods for Health and Longevity!

Rice and beans have been used for millennia by cultures without epidemics of obesity and without “carb phobia”. They have provided cheap, healthful and effective nutrition and energy for billions of people. The key to eating a carbohydrate rich diet and being healthy, like most Blue Zone cultures around the world eat (cultures that live into their 90s and 100s without chronic disease), is to try and eat carbohydrates in their whole state as possible (i.e. whole grains, beans, peas, lentils, yams, sweet potatoes, whole potatoes, squash, with as little added oils and animal foods as possible. If you eat a high meat-fat diet along with processed carbohydrates that have added sugars and oils in them (muffins, cakes, crackers, chips, most breads, pastries, etc.) you are getting a ton of sugar and fat along with your carbohydrate source which can lead to insulin resistance, diabetes, obesity and poor health. So keep it simple. Eat the carbohydrate in its whole state as possible, with minimal added oils, sugars and animal foods, if any, and add tons of vegetables or combine good carbs like beans and rice. White rice did not lead to obesity in cultures until those cultures started eating more meat (animal foods), fat and added sugars. White rice and vegetables doesn’t make you fat. Meats, oil, dairy foods and white rice make you fat!

Enjoy and save money! Rice and beans are cheap!

Mexican Style Bean and Rice Casserole

Ethopian Wild Rice

Green Chile Rice with Black Beans

Burritos with Spanish Rice and Black Beans

Costa Rican Rice and Beans (Gallo Pinto)

Rice Bowls with Kidney Beans, Spinach, and Mixed Veggies

Mexican Rice Soup

Enjoy. Keep it simple, healthy and cheap!

Be and Stay Well,

Kirk

You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday   916-489-4400    KwikerMedical.com     StayingHealthyToday.com      
Kirk's FREE "21 Day Healthy Living Program"  Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs"

Enhance Your Memory and Prevent Alzheimer's Disease Now!

I was preparing my handout for my “Alzheimer’s Disease and Cognitive Decline Prevention and Reversal” talk at LABIOMED this Wednesday (6:00 p.m., 1124 West Carson, Torrance, CA – 310-803-5657 RSVP) and wanted to make it available to everyone. Here is the 10 page PDF of resources from my 3 favorite books and author/researchers on the subject (“Diet for the Mind”, Martha Morris, PhD; “The Alzheimer’s Solution” Dean and Ayesha Shirzai, MDs; and “The End of Alzheimer’s Disease”, Dale Bredesen, MD).

This handout is incredibly extensive. Use it in combination with my website where there is links to books, research papers, podcasts and websites on the subject of prevention and reversal of cognitive decline and Alzheimer’s disease made for easy access (just click on the links).

There is much hope in the prevention of Alzheimer’s and cognitive decline. While it seems like there is no effective drug treatments, that does not mean this condition cannot be prevented and in some cases reversed. If you read the handout; resources on this page; read these 3 books you will know that we can turn back this epidemic of cognitive decline. But you must act.

If I had to pick out 1 thing to tell people to do for their mind/memory…… it would be to exercise vigorously for 1 hour daily….

If I could only get you to do one dietary habit….eat no processed carbohydrates – only whole carbohydrates. (2nd would be to decrease saturated fat intake – meat…)

If I could get you to follow one lifestyle plan – Follow the NEURO Plan in the “Alzheimer’s Solution” and join: Team Sherzai

If a loved one had Alzheimer’s – but had the right team (physician, family support, insurance/or economic where-with-all, health coach, in home assistance, etc.) then I would do the Bredesen Protocol (The End of Alzheimer’s).

Unlike the all other chronic diseases – heart/cardiovascular disease, diabetes, bone loss, eye disorders, obesity, arthritis, etc. you can “buy time” with medical interventions (i.e. drugs, surgeries,etc.) to extend life, maybe not the quality, but you can extend life. And if a person said “OK I am going to reverse my heart disease now and do the diet you told me to do” it can be done at a very late stage and be successful. Same with diabetes. But in Alzheimer’s and cognitive decline there is no grace period. There is no medical therapy that extends the window of when you can try. Once a person slides to a certain point of cognitive decline you can know all the biochemistry and environment that is imbalanced, and the lifestyle (diet and exercise) that is off, but then it is up to the family/support people to do EVERYTHING for the patient (right foods, exercise, take supplements, hormones, medications, correct toxic environment etc.) and it gets too overwhelming and it doesn’t even get attempted and the patient has to have extensive home care or goes into a facility for “whare-housing”. Sound brutal it is! I have experienced this personally on several occasions from the practitioner end.

That is why I really plead with you DON’T WAIT. Start at least the NEURO Plan Now! It is all at your fingertips! One click away!

Website Resources: Alzheimer’s Prevention and Reversal Resource Page

Handout: Alzheimer’s Disease and Cognitive Decline Prevention and Reversal Handout

You are in charge with most of your disease and longevity...." Just Do It!":-)!

Be and Stay Well,

Kirk

You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday   916-489-4400    KwikerMedical.com     StayingHealthyToday.com     Kirk's Healthy Living Tips  Kirk's FREE "21 Day Healthy Living Program"  Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs"

Finding Your Ikigai - The Key to a Long, Happy and Healthful Life!

One of my deepest passions ("Ikigai" see below) is to share with people simple, proven ways to not only extend the length of their lives, but to increase the quality, purpose, function and disease-free periods in their lives. You know I am a "Blue Zones" fan because...while I love nutrition and prevention research, and spend a great deal of my life looking through it, I give more credence to learning from people who live long functional lives, which is what the "Blue Zone" populations are all about.

While I recommend in my practice "plant-slanted" diets, exercise, stress management, nutraceuticals, hormones, environmental clean-up and do lots of sophisticated nutritional testing - what is more important is paying attention to how the longest, happiest, most functional people live and incorporating those principles in our busy modern lives. That is why studying one of the Blues Zones, Loma Linda, CA, is so important. This is 60 miles from downtown LA... in the "heart of the beast" so-to-speak. So you don't have to travel to a far away Blue Zones isolated from the rest of the world to find examples of long living people.

So just read these short "Blue Zone" pearls...The "Low Tech" way to health and longevity.

Watch this excellent short 4 minute video on Longevity by Dan Buettener, creator of the Blue Zones.  Video

Sign up for the Blue Zone health letter....great and simple health pearls....(at the bottom of the page)

When you add a strong sense of daily purpose to a healthy lifestyle now you have the recipe for a really long and wonderful life. In Okinawa, Japan they call this... (Ikigai - "the reason for being - the thing that gets you up in the morning")

This two minute video on "Ikigai" "the reason for being; the thing that gets you up in the mornging" in Japan is wonderful!...pretty funny though ends up being a Nescafe ad.... good for them! Spreading some good message!

The 10 Laws of Ikigai (3 minutes)

You are in charge with most of your disease and longevity...." Just Do It!":-)!

Be and Stay Well,

Kirk

You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday   916-489-4400    KwikerMedical.com     StayingHealthyToday.com     Kirk's Healthy Living Tips
Kirk's FREE "21 Day Healthy Living Program"  Kirk's FREE "Alzheimer's, Heart Disease, Diabetes Living to 100 and Obesity 'Reversal' Programs"

Is Coronary Calcium Testing The Best Way to Discover Heart Disease? An Interview with Matthew J. Budoff, MD

Kirk’s video summary of his interview with cardiologist Dr. Matthew J. Budoff (10:05 min)
Kirk's interview/podcast with Dr. Budoff Listen Here (31:08 min)

Why Assess for Coronary Calcium?
The value of coronary calcium scoring is that is allows the practitioner to look inside the heart to know who to treat for coronary artery disease. External physical presentations can be deceptive for actual coronary artery disease presence. With knowledge of the actual extent of the coronary artery disease then tailored lifestyle, diet, exercise, nutrient and drug interventions can be implemented to more effectively reduce the risk of disease progression or expression of a coronary event.

What is Atherosclerosis and What Happens to the Artery?
Atherosclerosis means hardening of the arteries. It is the exact same process as bone formation. The coronary arteries are like hoses. You turn on the water and some of the water is absorbed by the hose, and then it stretches or dilates. Then water eventually squirts out of the end of the hose. But it doesn’t right away. With calcification or stiffening of our arteries  (atherosclerosis) the blood shoots through the arteries at a greater pressure which causes damage to the blood vessel and causes plaques to rupture. A hard stiff artery is not a healthy artery.

How Does Plaque Get Created? What is the Difference Between Microvascular and Macrovascular Plaque Rupture?
Microvascular ruptures of plaque occur (not “macrovascular” plaque rupture which can lead to a heart attack or stroke) and the body tries to protect itself by walling off the plaque (lipid rich core) with calcification, so it can’t communicate with the blood vessel so you won’t get a macrovascular plaque rupture. Over time these small microvascular ruptures result in a significant amount of  calcium being laid down and stiffening of the artery (atherosclerosis). The “macrovascular” plaque ruptures, which penetrate the endothelium and cause a clot, can result in a heart attack or stroke occurs after a significant  number of these microvascular plaque ruptures occur. So preventing further microvascular ruptures, leading to coronary calcification, reduces the risk of a large plaque rupture.

Coronary Calcium is the “Tip of the Iceberg” of Coronary Artery Disease
If you have a lot of coronary calcification you have a lot of soft and fibrous plaque and a lot of atherosclerosis in the arteries.

The coronary calcium score is usually only assessed over the age of 35-40  because until then the individual may only have a significant amount of soft plaque but it hasn’t calcified yet. The calcified plaque seen with the coronary artery calcium scoring (CAC) usually represents about 20% of the total plaque burden (or “tip of the iceberg”) with the latter 80% being the three forms  of soft plaque that are more likely to rupture which is not seen with the CAC testing. Soft plaque is only seen with CT angiography which is essentially the same test as the CAC testing with the same machine but you just get an iodine containing contrast dye which allows for the soft plaques to be seen as well.

The patient that has more “microvascular” plaque ruptures is more at risk to have a “macrovascular” plaque rupture which can lead to a heart attack, stroke or death.

Why Do CT Angiography?
In the preventive world you want to stay with CAC testing to determine who is  at risk of a stroke, heart attack or sudden death from multiple microvascular ruptures that could lead to a macrovascular rupture. A CT (computerized tomography) angiogram (CTA) is used in a patient who is having symptoms to determine if they have coronary artery disease or not, and is excellent at diagnosing “stenosis” or tightening of  the coronary artery. CTA is excellent at determining whether it is coronary or non-cardiac chest pain. CTA is a diagnostic tool for coronary artery stenosis while CAC is a prognostic test for coronary artery disease. You can have significant coronary calcification without stenosis in possibly an exerciser and someone who had been living a good lifestyle. If the person is without coronary symptoms do CAC testing, if symptomatic do a CT angiogram to determine if the cause is cardiac or not.

Types of Soft Plaque (non-calcified plaque)

There are 3 types of soft plaque:

1) Low attenuation plaque, the necrotic core, is pure lipid. It is the most inflamed, pathological and most likely to rupture plaque. It is probably the most dangerous type of plaque.

2) Fibro – fatty plaque – has more fibrous tissue. It is more stable and less likely to rupture.

3) Fibrous plaque – may be protective. It walls off the top of the plaque from the artery. This thin layer walls off the soft plaque from the wall of the artery. This fibrous wall can thicken, and protect against plaque rupture.

These three types of plaque can be seen with CT angiography. It is not clear yet whether a stent might be put in if someone has too much of the low attenuation plaque.

Inflammation Markers – Lipoprotein-associated phospholipase A2 (Lp-PLA2) and Myeloperoxidase (MPO) Dr. Budoff has more experience with Lp-PLA2 and there has been more studies done with this inflammatory marker compared to MPO. The timing of their use may be of significant value in indicating short-term increased risk, and the reduction of imminent risk either by  chance or some type of medical or lifestyle intervention. These two markers may be  very valuable in following increasing and decreasing risk in the short-term but needs  more study. They may be valuable in following a new therapeutic intervention over several months instead of waiting a year or so to repeat a coronary calcium score (CAC).

Vascular Function Testing
Another way to follow a therapy to see if the intervention is having a positive short-term effect is endothelial function testing (brachial reactivity testing) which can measure the effects of a meal on arterial reactivity within hours.

Artery Stiffening (Thickening) as a Cardiac Risk Factor
Artery stiffening is a negative risk factor for cardiac health. An stiffened artery increases the speed that blood flows through the arteries and it is a marker of end organ disease. A more rapid speed of blood flow can be measured and is a negative with regards to cardiac  health.

Is Carotid Intimal Media Thickness (CIMT) Testing of Value for Coronary Risk?
Carotid Intimal Media Thickness (CIMT) testing is not the optimal test for evaluating atherosclerosis. It is mostly measuring the media thickness. The media is much thicker than the intima. The intima is where the atherosclerosis occurs. So the CIMT misses most of this. 80% of what it is measuring is the normal wall of the carotid artery. CAC scoring is a much more accurate assessment of coronary artery risk. CIMT really is outdated for this evaluation.

Stroke Risk Assessment?
For evaluating the carotid arteries Doppler ultrasound is valuable looking for plaque and stenosis and may be a better tool than CAC scoring for evaluating stroke risk.

What is the CAC Radiation Exposure?
It is the same as a mammogram about .5 millisievert. Background radiation in Los Angeles for a year is 2.5 millisievert. If you are a 50 year-old person and you get a CAC test you now have the exposure of 50 years plus 3 months which is trivial compared to the overall things we do. A stress nuclear test for the heart is much higher, 16 millisieverts which is high (32 x the exposure compared to CAC testing). A CT for the spine is 17 times the radiation dose of CAC testing.

CT Angiography (3 Dimensional) Versus Traditional Invasive Angiography (2 Dimensional)
In a comparison of the two procedures there was a study done which showed if you need to have clarifying angiography for chest pain, a positive treadmill or other findings, the invasive angiogram resulted in 80% more invasive procedures, twice as much money spent, and more radiation with no better diagnostic value. There was no added value going to the invasive angiogram versus the CT angiogram. If you need to put in a stent then use the traditional 2 dimensional angiogram and go to the cath lab. If just for diagnostic purposes the CT angiogram would be of greater value with less expense and risk.

Coronary Calcium Classification Scoring – What Does it Mean?
0 plaque burden is the goal and about 1/2 of individuals tested have no calcification. A score of 100 is moderate plaque burden. A score of 400 is severe plaque burden but scores can go up into the 1000s.

Think of a calcium score as a lifetime picture of atherosclerosis. You could be stable with a high score if this was from the past and you had changed your lifestyle such as changing your diet, getting exercise and you did not get any more plaque. As of right now you usually don’t see coronary calcification regression. But no more progression is a good thing. You may have  a stiff artery but with exercise and lifestyle it could be functioning better than it was, or, it could be progressing if the score continued to go up significantly.

Soft plaque can be reversed by statin drugs, a garlic extract and possibly by some diet approaches. Calcified plaque is like scar tissue and probably isn’t regressing any significant amount. The only way you can see regression of atherosclerosis is to do CT angiography which could show regression of soft plaque which could mean the artery is getting softer and it could have a bigger lumen. If the calcium score isn’t going up that is a good sign. But some patients may want CT angiography to show they are reversing their soft plaque.

Is the CAC Test Paid For?
Medicare in most states will pay for the CAC testing if there are more three or more risk factors: high blood pressure, high cholesterol, family history, history of smoking and low HDL cholesterol. Most private insurances won’t pay for the test.

How Significant is Blood Cholesterol in the Atherosclerotic Process and Plaque Deposition?
LDL cholesterol is a significant player in creating these lipid cores. Triglycerides play a significant role as well. Triglycerides may play a role in inflammation and metabolic syndrome and this inflammation may increase the enzymes myeloperoxidase and LpPla2. Dr. Budoff thinks LDL cholesterol is a very bad player and triglycerides a somewhat bad player in the atherosclerotic process. Total cholesterol is not of value to assess. A naturally high HDL is protective but raising it with therapies has not been proven to be of benefit and remains to be proven. Dr. Budoff believes the number of LDL particles is significant. Like more cars on the freeway is bad, but the size of the LDL particles isn’t as important (i.e. it’s the number of cars not the size of the cars that is important for overall traffic burden)

Does the Benefit of Statins Outweigh the Risk?
Dr. Budoff believes the side effects to statin drugs is small, maybe 5-8% but the good news is they are reversible, side effects. The other point is that the evidence is clear that those who take statins live longer. They have reduced mortality. So he likes his patients to think they will be in the 92% plus of individuals who will benefit from statins. In patients with statin related side effects such as myalgias he will recommend CoQ10 but he has only seen some improvement in symptoms but not always. These side effects are believed to be due to statins effects on lowering CoQ10 levels thereby reducing mitochondrial energy production in the  muscle cell or other cells.

Integrative physicians, he believes, feel they may be able to extend mortality in heart disease patients in other ways than using statins so they are more cautious with their use of statins.

Dr. Budoff’s A,B,Cs of Preventing Heart Attacks and Established Coronary Artery Disease
A – Aspirin – 81 mg low dose
B – Blood pressure control – lowering
C – Cholesterol lowering
D – Diet – Mediterranean style diet with fish consumption. Different diets for different scenarios weight reduction, diabetes control, etc.
E – Exercise is very important. It does everything. Reduces diabetes risk. Reduces blood sugar and improves glycemic control. It reduces cholesterol and improves HDL cholesterol. Lowers blood pressure. People live longer who are exercisers.
F – Fish consumption or fish oil (a study of a more concentrated EPA only supplement (Vascepa) – 980 mg of EPA per 1000 mg capsule. 4 grams daily of Vascepa in The REDUCE-IT (Reduction of Cardiovascular Events Outcomes) Trial he believes will show benefit). In the United States we are very poor at eating fish so supplementation may be the best way to go. G – Maybe garlic will be of benefit. It is part of the Mediterranean diet He has shown results in  a trial of aged garlic extract in reversing soft plaque.

What Is The Price Range for the CAC Testing?
It should be below $150 per test. The Diagnostic and Wellness Center charges $129. A 64 slice scanner is minimum that should be used to get the best picture. Less than that and the machine is probably greater than 10 years old. The scanner at the Diagnostic and Wellness Center is a 256 slice scanner (~$1,000,000,000 machine). The picture can be read by a technologist. The equipment is more important than the expertise in reading the CAC scan.

Matthew J. Budoff, M.D. is a Professor of Medicine, David Geffen School of Medicine at UCLA; he is Director, Cardiac CT and Director, Fellowship Program, Division of Cardiology; Director of the Diagnostic and Wellness Center at Harbor-UCLA Medical Center, 1124 W. Carson Street, RB-2, Torrance,  California 90502, email: Budoff@ucla.edu. Office (310)  222-4107; FAX (310) 787-0448; (310) 222-5101; CT Laboratory (310) 222-2773

You can make a complementary Wellness Consultation with Kirk Hamilton PA-C on Wednesdays at the Diagnostic and Wellness Center by making an appointment here.

Be and Stay Well,

Kirk

You can call for "brief" medical questions 8-9 a.m. PST Monday-Friday   916-489-4400    KwikerMedical.com     StayingHealthyToday.com     Kirk's Healthy Living Tips
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Is It Sunshine or Vitamin D That Reduces Your Risk To Chronic Diseases? An Interview with Karl J. Neeser, PhD

Kirk’s video overview of his interview with Dr. Neeser (4:50 min)
Kirk's interview/podcast with Dr. Neeser   Listen Here (23:00 min)

Dr. Karl J. Neeser is the co-author of the book, “The Key to Health and Longevity” (with Ratana Somrongthong, PhD). During his research of the book he became aware of the inverse association between vitamin D and many non-communicable (non-transmissible, chronic, lifestyle) diseases. Vitamin D is really a hormone with receptors on virtually every tissue in the body. Since we have evolved as a species being exposed to the sun, the dramatic reduction in sun exposure from fear of sun, in addition to greater amounts of time indoors due to one’s occupation and general living conditions has put us at risk for vitamin D deficiency and deficiency of whatever physiologic benefits come from sun exposure.

Risk factors to these non-transmissible diseases include reduced physical activity, vitamin D insufficiency, reduce quality of sleep and poor diet.

Vitamin D absorption from the diet is reduced as we age. Fifteen to 20 minutes in the mid-day sun is optimal for manufacturing adequate vitamin D levels. This is “non-burn” tanning of the skin. As soon as there is a slight reddening or “pinking” of the skin one should cover up and get out of the sun.

Vitamin D in the blood should be at least 50 ng/ml. Oral doses of vitamin D3 may be needed to get above 50 ng/ml.  Several thousand IU of vitamin D may be needed to achieve this level. It is probably better to get the vitamin D from the sunshine than a pill. There appears to be additional benefits to sunlight exposure that go beyond the increase in vitamin D levels.

Supplementing with high doses of vitamin D may suppress endogenous production of this hormone which may have adverse consequences.

The central nervous system (CNS), eyes and cardiovascular system all have vitamin D receptors. While sun exposure has been associated with certain skin cancers it is protective against “black” melanoma, the most malignant form.

It is noted that some Asians have a preference for light skin and avoid the sun intentionally. Intravenous vitamin C and glutathione have been used to lighten their skin.

There are many diverse dietary beliefs for longevity and optimal health. General recommendations are to not eat sugar; eat good fats; fast for at least fourteen hours daily; eat an early dinner (5-5:30); eat vegetables, fruit and fish.

Reducing EMFs, getting sunlight, exercise and get good sleep are longevity fundamentals. Self-responsibility is a must for a healthful lifestyle and longevity.

Karl J Neeser, PhD is a professor at Chulalongkorn University College of Public Health Sciences in Thailand and has been a Professor for many years at Lausanne University in Switzerland. He has been involved with, and lecturing on Anti-Aging Medicine for more than 20 years.  His areas of expertise are exercise, sport science, physiology and an anti-aging lifestyle. karl.neeser@gmail.com

Be and Stay Well,

Kirk

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