Millions of people have undergone CT heart scans that provide a heart scan or coronary calcium score. Unfortunately, people are then advised by doctors to take a statin drug, aspirin, a beta blocker or other combination of drugs that do NOT stop the 25-30% year-over-year rise in score. This eventually leads to heart attack or needing heart procedures like bypass surgery, angioplasty, or stent implantation, even death.
Doctors say that there is nothing you can do to stop this rise in heart scan score. What they are really saying is that there are no DRUGS or PROCEDURES that they can provide beyond the useless ones they prescribed. They did NOT tell you that there are a number of crucial non-drug and non-procedural ways to reduce your heart scan score and reduce, even eliminate, risk.
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Let’s talk about how to reduce your heart scan score. First of all, is that even possible? Yes, it is very possible. I’ve done it many times. I’ve helped people reduce their heart scan scores, for instance, from a high score of like 900 down to 300 or 400. It’s not that difficult.
The conventional answer is that you cannot do that, and the reason why a lot of my colleagues say that, is because what they’re saying is:
there’s no drug that does that;
there’s no procedure that does that.
What they don’t recognize is that there are non-drug, non-procedural tools that you can draw from, that you can get on your own, and reduce your heart scan score, in the majority of people.
What is a heart scan score? That’s a coronary calcium score. It’s a scan of your heart obtained by a very rapid CAT scan device. It quantifies, it measures, how much calcium you have in your arteries. Calcium occupies about 20% of plaque volume, of atherosclerotic plaque volume. So if you have 20 cubic millimeters of calcium, you have about 100 mm3 of total plaque volume .What it doesn’t tell you is percent blockage. People often ask “what percent blockage do I have?” Well the heart scan doesn’t give that kind of information. And remember these are mostly people who have no symptoms of heart disease, and thereby typically do not have blockages, that is blockages that impede coronary blood flow.
So it’s like quantifying the rust in a pipe. If I had a foot long length of pipe, a heart catheterization where I inject dye, would say something like: there’s rust in the center of the pipe and it impedes 20% of flow. That’s what a heart catheterization tells you, something like that. A heart scan would tell you something like this: in this one foot segment of pipe there are 298.2 cm3 of rust. That’s the kind of information a heart scan yields; not in pipes of course, in your coronary arteries.
It’s a wonderful tool; very easy and inexpensive tool to track whether there’s plaque growth. If you do nothing, your heart scan score increases on average about 25-30% per year. It’s horrifying how fast that score will go up. A score of 100 will be 130, 180, and onward — goes up very quickly, if you don’t do anything.
What if you take a very high dose of a statin drug, aspirin, a beta blocker, maybe an ACE inhibitor? That’s what my colleagues do, and they call that heart disease prevention. It has virtually no impact. That’s a fact. We helped publish those data many years ago. You put people on the conventional answer, and heart scan stores are hardly touched at all. They still continue to progress, at about 25% per year. About 20 years ago I started from scratch. We were scanning all these people, and had to devise new means of putting a stop to these scores. It led to a very simple menu of strategies — but they’re not drugs, and they’re not procedures.
Eliminate all grains and sugars
The first strategy is the diet that I’ve articulated in the Wheat Belly books and now the Undoctored book, and that is absolute elimination of all grains and sugars. Grains of course: wheat, rye, barley, millet, corn, oats, triticale, sorghum … all grains, all seeds of grasses, and all sugars. Why is that? Well, because the most common abnormality that leads to having a positive heart scan score, and heart attacks, is an excess of small LDL particles (not high LDL cholesterol; not a high cholesterol — that’s what I call the kindergarten version).
The real measure is something you obtain through testing called lipoprotein analysis or advanced lipoprotein analysis such as NMR the Liposcience Lab method. That’s what I did for many years. It quantifies how many small LDL particles you have. There’s only two common components of diet that cause formation of small LDL particles: grains and sugars. So take grains and sugars out of the diet, and measures of small LDL plummet. A very typical experience would be 2000 nmol/L (particle count per volume) at the start, and zero within a few weeks to months after taking all grains and sugars out of the diet, or other very low numbers.
In other words, it’s not just a slight improvement it’s a dramatic improvement, often obliteration, absolute elimination of expression of small LDL particles. That’s a huge advantage. Small LDL particles last much longer in the bloodstream, are much more adherent to arterial tissue, they’re much more inflammatory. They only come from consumption of grains and sugars.
Now other benefits come from elimination of grains and sugars: loss of visceral fat, because visceral fat’s inflammatory. Inflammatory markers drop like crazy. Blood pressure drops. You lose weight. Triglycerides come way down. HDL cholesterol goes way up. In other words, the elimination of grains and sugars is not just a means of reducing small LDL particles; it generates a whole landscape, a broad landscape of improvements in health that all lead to better control over that heart scan score.
Vitamin D: 25-OH vitamin D 60-70- ng/mL
Next is vitamin D. When I added in vitamin D about 10 so years ago, it was the first time I watched heart scan scores plummet — dramatic reductions. Before I added vitamin D, we were lucky to get a 0% year-over-year (lack of increase in a heart scan score) or slowed it down maybe 9% per year increase, or maybe a very modest, maybe 3% reduction, from one year to the next. When I added vitamin D, that’s what we started seeing 24% reduction, 36% reduction, 48% reduction, 72 — incredible amounts of regression, of reduction in the heart scan score. So Vitamin D is crucial.
Refer to the Undoctored and Wheat Belly Total Health books on exactly how to do that, but we aim for a 25-hydroxy vitamin D blood level of 60-70 ng/mL. typical dosing is 6000 units of an oil-based gelcap per day — typical not, for everybody; that’s why we use blood tests. Because vitamin D is a powerful anti-inflammatory agent. It has other beneficial effects that allow you to reduce your score. Vitamin D also normalizes calcium metabolism; the thing we’re measuring in your arteries by the heart scan score.
Fish oil: 3600 mg/day EPA + DHA
Fish oil: we use a true therapeutic dose, which is 3600 milligrams of EPA and DHA (not of fish oil, but of EPA and DHA). That’s why you can’t use krill oil; it’s too trivial a dose. That’s why you can’t use flaxseed oil or other sources of linolenic acid. You want the EPA and DHA of fish oil, 3600 mg, broken into two different doses: 1800 mg morning, 1800 mg in the evening.
Iodine and ideal thyroid status
Iodine and thyroid normalization are very important. Even marginal degrees of hypothyroidism, even with a TSH in the high “normal” range, is enough to make your heart scan score, and thereby your heart attack risk, go sky-high. Saw it happen many times, because thyroid disease is very very common. We start with iodine, 400-500 micrograms (µg, mcg) per day and we get ideal thyroid measures. How to identify ideal thyroid function you’ll find discussed in the Undoctored and Wheat Belly books. You want ideal thyroid status; not “okay”, not “acceptable”, not your doctor saying “oh I think your TSH is okay”. Don’t accept that. You want ideal thyroid function, including a normal or ideal free T3 thyroid hormone.
Well, it’s not a big effect, we supplement magnesium, because that helps correct such things as high blood sugars, high blood pressures, and all the things that contribute to heart scan scores. We either use the malate or the bicarbonate salts, and once again to detail how to do that, even how to make your own magnesium water to supply magnesium bicarbonate, the most absorbable form magnesium available, that’s all in the Undoctored book and Wheat Belly Total Health.
Cultivate healthy bowel flora
Lastly, cultivate bowel flora, with a combination of a high potency multi-species probiotic (with occasional fermented foods; fermented veggies: kefir, yogurts that you make yourself) and prebiotic fibers. That’s a whole conversation of its own. Find lots of videos and conversations in the Wheat Belly Blog and Undoctored Blog, and we explore this even further than in the Undoctored Inner Circle, website — the community of people who are deeply involved the Undoctored community.
So that’s it. Follow those basic six basic strategies and the majority of people can put a stop to any further increase in the heart scan score, and most drop their score. There are exceptions. There are some genetic variants that I won’t discuss today, but we discuss further in the Undoctored Inner Circle. We take a deep dive in these kinds of things. There are genetic variants such as the apoprotein E gene (ApoE) and also lipoprotein(a), and some others, but those are a little bit exceptional. Most people, just by following these six basic strategies, can stop their heart score or reduce it.