Wednesday, July 29, 2009

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All of us physicians need to stop referring to the medicines we use for cholesterol control as 'cholesterol lowering medications.' This is just not so and another example of the ignorance of physicians. For most people, even those with cholesterols over 200; we need to raise their cholesterol, not lower it. By this I mean we need to raise their HDL or heart protective cholesterol.

So what's all this cholesterol lowering mumbo jumbo. We learned in an earlier blog that lowering the total cholesterol number has not had an effect on lowering the prevelence of heart disease. This is because total cholesterol is an irrelevent number. It means nothing. All it is is the summation of all the carrier molecules of cholesterol, one of these being the HDL. When one's HDL is greater than 59, it will almost always drive up the total just based on the fact total cholesterol depends on how high (or low) the HDL is.

What we are really doing by using the so-called 'cholesterol lowering medications' is causing an effect known as plaque stabilization. You see, it is the buildup of plaque with the subsequent breaking off of a piece of that plaque that creates the problems. Once a plaque ruptures, the body will attempt to heal this by accumulating platelets at the rupture site. If we accumulate too many platelets at a plaque site, this will prevent the flow off blood past this site. Since blood cannot flow past this area, a heart attack or stroke can occur. The medications like Lipitor, Crestor and Zocor etc. stabilize plaques making it less likely to rupture and hence lower one's risk for heart attacks or strokes. This is obviously a good thing.

Again, cholesterol lowering is not what we should be focused on when using these meds. We need to change our thinking and stop saying cholesterol lowering and start focusing on plaque stabilization. Once this happens we will be in a better position to prevent heart disease.

Dr Jim


Tuesday, July 28, 2009

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A New Look at Autism

I spent the weekend reviewing some very interesting videos and data on the treatment of autism, a major problem in our society. This treatment paradigm was very unique as it treated autism with radiofrequency waves introduced into the brain via a patch as well as ultrasound treatments to the brain. The researchers have reported very positive results and I had the pleasure to sit and speak with these brilliant key researchers last evening.

Before anyone goes and thinks this is a bunch of malarkey or pseudoscience I submit the following; we know as physicians that the brain emits electromagentic waves as we can record these via an EEG (electroencephalogram). On top of this, each of our organs emits an electrical impulse. The greatest example of this is the heart measured through the EKG (electrocardiogram). We also know that we can shock the heart back into its regular rhythm by using a defribrillator--hence, we can control what the heart does internally,externally with the use of the paddles.

Why cannot the same be done to the brain?

It was interesting to note that the brain's gamma waves were absent when the subjects were not interactive with their environment and before treatment (as measured by the EEG), only to return after the subjects received the radiofrequency and ultrasound stimulation. Concomitant with the gamma waves reappearance after treatment was an increased interactivity with the environment in a more appropriate fashion. This included increased interaction with the subject's parents as well as increased vocal/speach patterns.

As I've been reading alot about our conscious state recently (the current book I'm reading is Julian Jaynes' "The Emergence of Consciousness in the Breakdown of the Bicameral Mind")
I immediately wondered 'Do gamma waves need to be present in order for consciousness to exist?' Which led to my next thought, "If gamma waves need to be present, does their absence create the unconscious autistic mind?'

Now when I say unconscious, I don't mean passed out on the floor unconscious. I am referring to being in a state that is simply reactionary to the environment, with no ability to think of oneself as oneself. That person would also lack the ability to be introspective. This is exactly how we were only 3000 years ago. It was around 3000 years ago that we became 'conscious' as a species, developing the ability to think about our reactions before we reacted, and also to reflect upon our thoughts without being active. This is the conscious state.

Is this unique and groundbreaking methodology for the treatment of autism awakening these patients to the concsious state? I think it may well be.

So what is my involvment, you may be wondering? Well, it will come as no shock to anyone that I will be placing the subjects on a restrictive carb intake, along with the other treatments, to see if we can increase the cognitive functioning even further. As you might imagine, these patients are eating an overabundance of carbs, and not enough fat,cholesterol and protein.

Now using a low carb approach in children is not unique. Dr John Freeman from John's Hopkins has used what he calls the Ketogenic Diet-which is a low carb, higher fat, and more cholesterol and protein approach. He treats mainly children with severe recalcitrant epilepsy and has treated some who were autistic who were experiencing seizures with excellent results. (His book is "The Ketogenic Diet".)

It must be emphasized our brains are mainly fat and need fat to function properly. If we are underconsuming fat we will probably not be getting enough essential fatty acids-these are fats which we cannot manufacture on our own-into the brain. I propose that one not eating enough fat will not be giving the brain what it needs to function properly.

I feel very privileged to be a part of what I feel will be a major step forward in the treatment of this debilitating disease.

Tomorrow I'll talk about plaque stabilization and how doctors should not be using the phrase "cholesterol lowering medication", but should be telling their patients the med (the statins such as Crestor, Lipitor etc...) is being used for plaque stabilization.

Dr Jim

Thursday, July 23, 2009

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Total Cholesterol Means NOTHING!!!!

A question I get asked on a daily basis after someone has bloodwork drawn is "What was my total cholesterol?" Only problem is, total cholesterol means nothing. Nothing at all. The total cholesterol is simply the summation of all the 'carrier' molecules of cholesterol. That is,
Total Cholesterol=HDL+LDL+VLDL+IDL.

Now most of us have heard of the HDL and LDL, but most of us have never heard of the VLDL and the IDL. HDL is referred to as the 'good cholesterol' and the LDL is mistakenly referred to as the 'bad' cholesterol. The VLDL is a function of the triglycerides or fats in the blood and the IDL is a transient thing so it doesn't hang out in the blood too long to be an issue so we can simply ignore its value.

Now back to Total Cholesterol. So the total cholesterol number is derived by adding all those carrier molecules of cholesterol together. One can see that if the HDL goes up, it will most likely raise the total. I often tell my patients that they do not want to 'lower' their cholesterol, they want to raise it. I will get very strange looks from people when I say this, especially if their total cholesterols are above 200. Their immediate response is usually "But I thought my total cholesterol should be below 200" which prompts me down memory lane and the ever so changing incorrect recommendations of what the total cholesterol (and LDL) should be.

When I was growing up in medicine, we were told by the powers to be to try and get the total cholesterol below 250. If we did that, the reasoning went, we would see less heart disease. We were also told to try and get the LDL below 150. This didn't work; we still saw alot of heart disease.

Then we were told to try and get the Total below 220 and the LDL below 120. This didn't work either, we still saw alot of heart disease.

Next came the advice from the 'experts' to get the total below 200 and the LDL below 100 and we should really see a lowering of heart disease. Nope, this didn't work either. We are currently being told to try to get the total below 200 and the LDL below 70. This will not work to lower heart disease cases. Not at all.

You see, total cholesterol means nothing. Nothing at all. It is an irrelevant number. When people ask me what their total cholesterol is I tell them I just bought a goldfish and a kite for my kids and stored the kite in the garage and placed the goldfish on my kitchen table. I then get this puzzled look, as if to say "Er, I don't care what you bought and where you placed it, I just want to know my total cholesterol number."

Just like it was irrelevant what I bought and where I placed it, so too, is the total cholesterol. Again it means nothing. Yet we want to know it. We yearn to know it. We talk about it at cocktail parties, read about it in the paper, worry about it when we are eating. But it means nothing.

Absolutely zilch.

What we need to be focused on is the HDL and the triglycerides. Tomorrow I will tell you why the term 'cholesterol lowering medications' is a misnomer, and why the medical profession and pharmaceutical companies need to stop using that phrase and should focus more on a concept referred to as plaque stabilization.

Dr Jim


Wednesday, July 22, 2009

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Houston: We Have a Problem!

Ok, so an object the size of Earth collided with Jupiter destroying its atmosphere as a result of the collision. An amateur astronomer from Australia reported this event to American 'Professional' astronomers.

Does this not frighten anyone? Shouldn't the professional astronomers, from any country for that matter, shouldn't they have picked this up? If an object the size of Earth could be missed by all the telescopes and satellites we have monitoring space, well, what else are we not seeing?

This is a perfect example of how easily things are missed, especially when they are right in front of us. Take, for example, eating low carbs. We have all the data right in front of us. We have the successes of the prior clinical trials all pointing to the effectiveness of following a low carb life-style, yet the vast majority of doctor's still do not 'believe' and certainly do not understand the importance of placing patients on a low carb eating style.

Heck, I was blind for at least six years after I had graduated my residency to the importance of low carbs. Having been on both sides of the fence, that is, using low fat/low cholesterol and now using a low carb approach; I have witnessed the effectiveness of low carbs firsthand in thousands upon thousands of patients. Why is the medical profession still blind?

The amatuer asronomer from Australia represents the lay public who understands the importance of low carbs; and the professional astronomers represents the medical profession who continues to 'miss' the fact that low carb lifestyle changes are very beneficial in many different disease processes. Let's face it, more laypersons than physicians understand the importance of low carbs; why is this so?

Oh well, I guess I should be happy that Earth sized thing didn't collide with us :-)

Tuesday, July 21, 2009

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Weight Loss Pills

We are forever trying to find the cure to obesity. Instead of realizing that a cure is available, right here, right now; we, as a society, focus on the simple fix. That simple fix comes in pill form.

First we had the stimulant methamphetamine, which, while people would lose weight; thay also became highly addicted to it and then this became illegal for doctors to prescribe. Many doctors wound up in jail for the prescribing of this drug for weight loss purposes.

Then came the Phen-fen, or was it Fen-Phen combination of pills docs started prescribing for weight loss. I remember giving a lecture while I was a resident about the success people were having using this combination of pills. Only trouble was that this combo of drugs was causing a condition the literature referred to as primary pulmonary hypertension; an irreversible side-effect of taking this combination of pills.

Primary pulmonary hypertension is a condtion which affects the pulmonary arteries, increasing the pressure within these vessels and subsequently causing right sided heart failure. This eventually leads to death. Is this the price our society will pay to lose a few pounds?

When phen-fen was removed from the market a new drug Meridia appeared on the scene. We ocassionally see it being used, but it, too, fell by the wayside.

So I wake up this morning to the morning news espousing now a new drug to treat obesity. I forgot what they called it, but it is a combo of a drug we use to treat anxiety, bupropion; along with naltrexone, a drug used to treat alcohol addiction. The medical doctor commentating on this as yet to be released pill, was extolling the virtues of yet another pill to treat obesity.

The thing that frustrated me the most was that the studies reported that a weight loss of up to 17 poinds was seen in the first year of using this new pill.

17 pounds!!?? Are you kidding me!!??

Starting a low carb lifestyle can easily take 17 pounds off of someone, sometimes in as little as one month. I have seen this happen time and time again. Oh yeah, the story from the people who refuse to accept that a low carb lifestyle is for everyone will claim that's just water weight.

Well, while I'll agree that some of it is indeed water weight as starting low carbs does have a natural diuretic effect; when you've lost 50-60-100+ pounds on low carbs-come on-will you stop with the water weight malarkey already!

We are a lazy society. We want a quick fix. The drug companies create the fix, and unfortunately we doctor's keep the drug companies in business due to our continued ignorance of the biochemistry of nutrition.

The obesity epidemic is not because we are eating too much in the way of saturated fat and cholesterol containing foods. This epidemic is continuing due to our ignorance that we need to eat MORE staurated fat and cholesterol containing foods---not less.

What to do; what to do.

I know what I'm doing. I am just going to continue to tell everyone the correct way to eat. I have to stop this blog, I am getting myself all worked up....Time for my afternoon burger :-)

Dr Jim

Read the first ten chapters of my book for free at

Monday, July 20, 2009

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Still Buying Into the Low fat Myth

So I am online at the Deli getting my Chef salad with blue cheese dressing and the 2 people ahead of me have ordered what they believe to be healthy food. Notice how I ordered low carb :-)

I saw salads galore-not a bad thing until you consider the bagels, Thousand Island salad dressing, the regular juices (which contain alot of sugar) and the cookies for a snack. This was what the kids were eating and, of course, it is way too much sugar. Absent was the fat, cholesterol and protein from this lunch that a growing child's body needs to grow and be healthy.

The gentleman in the white coat (doctor?) ordered a bagel with light creamcheese (that is, low fat creamcheese) and was very specific that he only wanted the creamcheese to be spread lightly.

It is an absolute tragedy that these people are eating this way, having not a clue they are increasing their (and their children's risk) for heart disease, obesity, diabetes, and many other disease processes. When will we get it? That is, when will we doctor's finally get it.

Imagine if everyone knew how dangerous following a low fat/low cholesterol diet was. I can guarantee the Government would slap a tax on high carb containing foods, just like they tax alcohol and cigarettes. Let's face it, carbs are just as addictive as alcohol and cigarettes-even more so. We actually go through withdrawal when we lower the amount of carbs we eat; and this withdrawal is similar to what one experiences withdrawing from alcohol or cigarettes.

I just hope the day comes soon when everyone understands the dangers inherent in the overconsumption of carbs.

Dr Jim

Tip of the day: Cantaloupe is actually pretty low in carbs, containing about 6-7 grams of carbs per half a cup.


Wednesday, July 15, 2009

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Living Into Our Hundreds and Beyond...

A few questions today before I get to our main topic. My first question is, if it's evaporated milk, why is it still there? My next question arose as I was shopping one day. I'm walking down the diary aile and I came across fat free half and half. Well, isn't that just half?

Now, on with the show, er, I mean blog.

As a species and due to medical breakthrough after medical breakthrough, we have been living longer and longer. The current life expectancy is around 72-75 years of age. I am thoroughly convinced that as medicine continues to advance, we will easily live into our hundreds healthier and with more vitality.

Even though there are many causes of death, we will find cures. We will figure out everything which causes us to age and halt or reverse the process. We will be able to let cells continue to divide indefinitely. One of the things which contributes to the aging process is the fact that a cell can only divide so many times before it can no longer divide, and dies. This is referred to as apoptosis and now it is not reversible. Someday it will be.

We will learn how to prevent apoptosis when we finally understand why a cancer cell can divide indefinitely. When we fully understand cancer, and we will; this will provide us with the knowlege to increase our life expectancy into the hundreds of years.

Another thing which contributes to aging is cumulative DNA damage. We will learn how to fix and prevent this. And we will halt or reverse the aging process.

We will be able to take a single cheek cell, place it in a petri dish, add all the proper nutrients and growth factors and grow any organ we may need. The transplanted organ into our body will be our own, so there will be no need for a histocompatability check.

With this cheek cell we will be able to clone a new us. Cheek cells will be placed in storage just in case we are hit be a car, or die traumatically; so a trustee can grow a new you. Will the clone have the same conscious awareness as the donor of the parent cheek cell is a discussion for another day.

None of this will happen so long the Government continues to regulate Health Care. This will definitely not happen with a National Healthcare System. The fact that the powers to be now are even considering such a sweeping change is a testament to the profound ignorance of what has happened in other countries with a National Healthcare System in place. One only needs to look at Canada and Great Britian as but two examples of failed health care.

To my opponents who think Canada's health care is good, why are so many Canadians coming over the border to receive healthcare in our great country.

We need less regulation of medicine, not more. Look at the computer industry which runs largely unregulated. Look at the advances that have occurred only within the last 10 years. We have smaller and smaller personal computers, which do more and cost less. This is only possible due to the absence of regulation of this industry.

I have been a physician about 16-17 years. Most of my collegues are honest, caring people. They deeply care about their patients, stay awake at night worrying about them, always wondering if they provided the right care. I say 'most' of my collegues because I am a realist. There are some doctors who are not like that. But they are the exception, not the rule.

We do not need more regulation of the health care industry. We need less. Interestingly enough, what will drive down medical errors in hospitals and offices will be the appearance and utilization of computers at all hospitals and offices. What will help medicine achieve its goal of zero error will be when the unregulated computer industry becomes an intimate part of the medical field.

Without the de-regulation of medicine, my vision of the future of our lives, a gift which can never be had back, will never be attained.

Dr Jim


Tuesday, July 14, 2009

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Another look at Vitamin D

One thing I've been doing lately is checking Vitamin D levels. I am amazed at how Vitamin D deficiency is non-gender specific. I am seeing low Vitamin D levels in both men and women, with some men having lower Vitamin D levels than women.

What most of my patients will say when I check their labs and tell them their Vitamin D levels are low is that they really aren't in the sun that much. Well, think about it. We doctor's tell you to stay out of the sun or you'll get skin cancer; now we're turning around and telling everyone they have low Vitamin D levels and to get back in the sun! Arrghhh. Did we physicians mess up again?

All kidding aside, I had a Eureka! moment a few weeks ago where I leaped (or is it lept) up from my bed at about 2 am with some interesting thoughts. My first thought was why was I awake at this hour and my next thought was where was my 17 month old Lab named Princess. When I glanced to my right I saw her tail wagging and the remnants of my cell phone charger, luckily not plugged in as the phone was charged. She looked so proud of her accomplishment! "Hey, at least she didn't eat my phone this time," I thought.

My final thought was a look into why I may be seeing so many low Vitamin D levels. First off, Vitamin D is a hormone and it is made from cholesterol. That's right, cholesterol. Also, we need fat to absorb it properly as it is a fat-soluble vitamin. Could the reason why we are seeing so many people deficient in Vitamin D be because we have turned into a fat and cholesterol phobic nation. I think that is a good thought. I also think it is because we are not in the sun all that much anymore.

The current reccomendations (is it 1 c and 2 m's or the other way around) are if your Vitamin D level is below 32 is to take 2000 units a day and to re-check the level in 2-3 months. Some Endocrinologists are giving 50,000 units a week for those with very low levels and of course are rechecking levels in a few months.

Checking levels is important as Vitamin D,as a fat soluble vitamin, can increase to toxic levels if one takes too much. Same is true for Vitamin A. As an interesting side note, never,ever, eat polar bear liver. The amount of Vitamin A is so high it will probably kill you. Of course, if you got that close to a polar bear, it would probably be eating your liver. Polar bears are one of the few animals which actually hunt humans as prey. But then again, if you are about to eat its liver, it probably isn't much of a threat.

Back to Vitamin D. Remember it was a hormone and it is a hormone important in calcium regulation. In fact, calcium cannot be absorbed from the intestine or kidney without Vitamin D's presence. Since calcium is very important to bone health, and since our bones produce what are known as the formed elements of the blood (white and red blood cells and platelets); Vitamin D is a very important thing to have enough of.

One last note; why were so many people wearing orange shirts today?

Dr Jim

Monday, July 13, 2009

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The Word of the Day is Gustatory

I found myself using the word gustatory alot today. Dont know why, the word kept coming out and left a bad taste in my mouth.

Gustatory refers to our sense of taste.Hence the bad pun above :-) It is one of our five senses-sight,smell,hearing and touch are the other four. After I had spoken this word back to some of my patients today, I wondered how many times a day a doctor will use words their patients have no idea what it means. So in essence, by using words a patient does not understand, lessens the value of the visit for the patient.

I constantly strive to not explain medical terms with medical terms. If this is done, the patient will have no idea what the doctor is talking about and the visit is a waste of time for the patient. Here's an example; I've overheard a surgeon explaining what a small bowel obstruction is by stating "Your jejunum and distal illeum are constricted by a volvulus which needs to be reduced via a NG tube to facilitate convalesence."


I couldn't believe what I was hearing and obviously felt bad for the patient who thank goodness was mine so I re-explained that what the doctor should have said was "Certain parts of your small intestine are narrowed to a point where food cannot pass. We need to place a tube in your stomach to help relieve this narrowing and this will help yopu get better. (Yes, I know, the first sentence was a run on; just dont tell my english teachers:-)

You may now be wondering who Yopu is. Actually, he is a creation of mine as I mistyped the word and I immediately thought of a Star Wars character and I went with it. I meant to say you, not yopu....

Do doctor's use these fancy words to make them look smarter? Possibly. Or do doctor's just not even realize that they are speaking in ways the patient just does not understand? This is more likely.

Gustatory sensation is very important in the low carb lifestyle as we have to like the taste of the foods we eat. If we dont, we will not eat them. The good news is that there is a low carb world out there just waiting for all of us to uncover.

Friday, July 10, 2009

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Do You "Believe it' or is it a Fact?

Let the blogging begin! I will attempt to share with everyone my thoughts of the day or week, as often as possible through this blog. I think, no wait, I know, we're gonna have fun with this :-)

Most of you know me as a low carb doctor. If someone has stumbled upon this blog by accident and has no idea who I am, first off, welcome and second, well now you know I am a low carb doctor.

To arrive at the correct conclusion that eating low carbs and more saturated fat, cholesterol and protein is the safe and preferred way to eat, is a journey. More like an understanding. You see, I did not always know the correct way to eat. For many years I was placing my patients on low fat, low cholesterol diets, and even though these diets did not work to any degree to help my patients; I remained blind and did not 'understand' the correct way to eat for years to come.

This understanding came to me when I started reading Protein Power, by Dr.'s Michael and Mary Eades. It was the proverbial Eureka! that began my understanding of the correct way to eat. The journey, with myself and my wonderful patients, has lasted now a little over 11 years.

I wish to emphasize a point I like to make to my patients when they ask me, after I explain the correct way to eat, if what I just told them is my belief or opinion. I immediately define the difference between a belief and a fact.

A belief can be true or not. A fact is just that, a fact. It is neither right nor wrong, a fact simply is. I used to believe in Santa Claus growing up, this belief, unfortunately, has been shown to be false (bummer).

Now beliefs can, as shown above, be true or false. I like to use the question of "Is the world round or flat?' Ask yourself this question. You'll answer, I hope, that the world is round. Now ask yourself if you 'believe' the world is round. When asked this question directly most people will answer, "Yes, I do believe the earth is round." I immediately counter that no, you do not believe the earth is round, you 'know' the earth is round.

The fact the earth is round is not a belief, it is a fact. It just is. Same is true with the correct way to eat. It is not my belief (theory, supposition..etc), it just is.

By understanding the corect way to eat, most patients will have very little to no need for medications, will live a longer, healthier life, and will not be giving drug companies their hard-earned cash. As an added bonus they wont have to see my face as often either :-)

Have a great weekend everyone!

Dr. Jim
