What causes heart disease?

I have been somewhat silent on this blog for a while. Mainly because I have been putting together ten thousand words on the true cause of heart disease. Of course, by heart disease I mean the thickenings and narrowings in the larger arteries in the body (atherosclerotic plaques). I am also focussing almost entirely on the arteries supplying blood to the heart (coronary arteries), and the main arteries that supply blood to the brain (carotid arteries).

Whilst atherosclerotic plaques can develop in other arteries that supply, for example, the kidneys, or the bowels, problems here are generally less common, and less severe – although not always. In general, however, the main killers in ‘heart disease’ are heart attacks and strokes (not all strokes, only the most common form of stroke, an ischaemic stroke). So, at the risk of becoming over-pedantic, and simultaneously sloppily inaccurate, I am calling heart disease Cardiovascular Disease (CVD), and looking at heart attacks and strokes.

With that out of the way, what causes cardiovascular disease (CVD)? Whilst it took me only a few days of research, many years ago, to realise that the diet-heart/cholesterol hypothesis was clearly nonsense. It has taken over thirty years to work out what is actually going on. In truth I could not truly progress until it suddenly dawned on me that I should not be looking for causes. For that is a mugs game.

Once you start looking for causes, you find that there is almost nothing that a human can ingest, or do, that has not been claimed to be a cause of CVD, or a cure for CVD. In many cases both… simultaneously. In 1981 a paper was published in the journal Atherosclerosis which outlined several hundred possible ‘factors’ involved in causing or preventing CVD. Today, if you hit Google, or Pubmed, I can guarantee that you could find several thousand different factors. If, that is, you could be bothered.

If you could be bothered, what could you possibly make of ten thousand different things involved in CVD in one way or another? Can they all be true risk factors? Some of them are certainly only associations, not causes. A few are simply statistical aberrations, found in one study and contradicted in another. Even removing them, there are so many, so very very many. Pick your favourite and trumpet it to the world. Vitamin K, Vitamin D, coffee, leafy green vegetables, omega 3 fatty acids, intermediate chain monounsaturated fats, HDL raising agents, selenium, lowering homocysteine…. on and on it goes.

Is there any other hypothesis where you have to fit in ten thousand different factors? No, there is not. Yet no one has been put off identifying more and more things. This is why, I believe, we have such a terrible mess. I amuse myself sometimes looking at the knots the cholesterol hypothesis ties itself into to.

Just to give one example. We have had ‘good’ cholesterol and ‘bad’ cholesterol for some time now. More recently we have ‘bad good’ cholesterol (raised HDL increasing CVD risk during the menopause), and ‘good bad’ cholesterol (light and fluffy LDL that protects against CVD). Now, that’s what I call a non-disprovable hypothesis. A risk factor that can be good, or bad. Or ‘Good bad’ and ‘bad good’.

Whilst contemplating such nonsense it came to me, in a moment of the blindingly obvious, that in order to understand CVD I had to move away from trying to fit ten thousand factors into the biggest intellectual jigsaw known to man, and move on. I had to know what the actual process is. What is actually happening in the arteries.

Once you start to look at CVD through this window, you suddenly realise that very little is ever written on this topic. The world famous cardiology bible ‘Braunwald’s Heart Disease’ is virtually silent on the matter. Or at least it was when I looked through it a few years ago.

In a massive book on heart disease, the process of CVD development is covered in less than half a page. The cholesterol hypothesis itself is usually left completely unexplained. Or there are gaping holes, and bits that you just have to take on faith. Raised LDL leaks/travels/gets into the artery wall where it creates inflammation and plaques develop. The end.

Then you start to ask, so why do plaques never develop in veins? Same structure as arteries, same level of LDL. Why do plaques never develop in the blood vessels in the lungs (pulmonary arteries and veins?). What has oxidised LDL got to do with it? Where does oxidation occur? How does LDL leak into coronary arteries, and carotid arteries, but cannot leak into arteries within the brain itself?

Questions, questions, questions and almost no decent answers. There is a kind of collective brouhaha noise with a lot of ‘well it just does’ thrown in when you start to ask. ‘Explain again, how does LDL get into the arterial wall. Each step please?’. You are usually met with perfect anti-Popparin logic. We know that raised cholesterol causes heart disease, so it must get into the arterial wall using some mechanism or other. And look, there is cholesterol in atherosclerotic plaques. So it must get through.

Of course, it is true you can find cholesterol in atherosclerotic plaques. No-one is going to deny that. But you can also find, for example, red blood cells (RBCs). Now, you might be able to explain how LDL can pass through endothelial cells (the cells that line the arteries) in some fashion. Although I would argue that, if so, why does LDL not pass through endothelial cells in veins. And why cannot it pass through, or between, endothelial cells in the arteries with the brain?

LDL molecules, after all, are minute in comparison to an endothelial cell. However, RBCs and endothelial cells are pretty much the same size. So, please try to explain to me how a RBC finds itself within the artery wall, underneath the endothelium? Try getting one cell, virtually the same size as another, to pass through it. A very clever trick indeed.

Then, if you start exploring further, you find that the cholesterol you find in atherosclerotic plaques almost certainly comes from the cholesterol rich membranes of RBCs.

The view that apoptotic macrophages (dead macrophages) are the predominant source of cholesterol in progressive (atherosclerotic) lesions is being challenged as new lines of evidence suggest erythrocyte membranes contribute to a significant amount of free cholesterol in plaques.’1

Oh look, it seems that the cholesterol does not come from LDL. Anyway, I am jumping ahead of myself here, and getting dragged back into explaining why the cholesterol hypothesis is nonsense. Which is playing the game on the opponents’ pitch, under their rules.

The simple fact is that, to replace the Cholesterol hypothesis, there is a need to come up with something better, which actually fits all the facts. That, of course, is rather trickier as – boy – there are a lot of facts. Also, some of them may seem utterly disconnected.

My simple credo is that, if your hypothesis cannot explain everything about CVD you cannot explain anything. Attempting to do otherwise means that you are left suggesting that there are many different causes, and many different processes, all of which end up causing CVD through non-connected mechanisms. Well if that is true, then we just have to give up. Smoking causes CVD like this, LDL causes it like that, diabetes in a completely different way.

This is why I get so frustrated when people simply shrug their shoulders in a debate on CVD, and retreat to the position of inarguable logic when they tell me that CVD is ‘mutifactorial.’ To which I agree that of course it is bleeding mutlfactorial (as are all diseases). But that the statement itself is meaningless, unless you can then tell me how all the ‘multi’ factors fit together within a single, unified process.

In short, with CVD, if you are going to explain it, you need to be able to explain how, for example, the following factors increase risk, and through what single mechanism, or process. [This is not an exhaustive list by any means, but these are all definite, and potent, causes]:

  • Rheumatoid arthritis
  • Steroid use
  • Systemic Lupus Erythematosus
  • Smoking
  • Kawasaki’s disease
  • Use of Non-steroidal anti-inflammatory drugs e.g. ibuprofen, naproxen and suchlike.
  • Being a deep coal miner – especially in Russia
  • Using cocaine
  • Getting older
  • Getting up in the morning – especially on Mondays
  • Type II diabetes
  • Raised fibrinogen level
  • Cushing’s disease
  • Air pollution
  • Acute physical or psychological stress
  • Chronic kidney disease
  • Avastin – a cancer drug

Looking at one of these risk factors, System Lupus Erythematosus. Young women with this condition have, in some studies, an increased risk of CVD of 5,500%. Compare that with, for example, raised LDL. Even if you believe that it raises the risk of CVD, which is debatable, the increase in risk (as defined by mainstream research) is 66% for a 3mmol/l increase in the LDL level2. Changing the LDL level by this much takes you from low risk, to Familial Hypercholesterolaemia (FH).

If we accept that the 66% figure is, indeed, correct, we can see that SLE increases the risk 83 times more than having a very high LDL level. Or, to frame this differently. SLE increases the risk of CVD 8,300% more. Clearly, therefore, SLE has far more to tell us about what really causes CVD than raised LDL ever could. Deep coal miners in Russia have their final, fatal, heart attack aged 42, on average. Children with Kawasaki’s disease can die of a heart attack aged 3.

Here, therefore, are the real causes of CVD. Super accelerated CVD with death at a young age. No need for statistical games. This is the where the answers truly lie. Now comes the difficult bit. How can you fit them all together within a single disease process, without finding anything contradictory?

Ladies and gentlemen, it took me thirty years.

References
1: https://www.researchgate.net/publication/5958670_Free_cholesterol_in_atherosclerotic_plaques_Where_does_it_come_from

2: http://www.jbs3risk.com/pages/impact_intervention.htm

346 thoughts on “What causes heart disease?

  1. Edward Hutchinson

    Before anyone totally writes off Vitamin D3 insufficiency as a driving force underlying most (if not all) Dr Kendrick’s list above it may help to understand that ALL vitamin D research to date has been based on the myth that from the time it is created near the skin surface until through a series of hydroxylations through calcidiol (storage form 25(OH)D) to finally the hormonal form calcitriol it is inert.
    We now know in it’s basic natural form previously assumed inactive sterol, vitamin D3, is a potent and general mediator of endothelial stability at physiologically relevant levels. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607301/
    Dietary Vitamin D and Its Metabolites Non-Genomically Stabilize the Endothelium
    It’s only when people take effective amounts of Vitamin D3 (cholecalciferol) on a DAILY basis (half life in this form =19-25hrs) that cholecalciferol is available to maintain endothelial function. Hollis was nearly there in his paper http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849670/
    The role of the parent compound vitamin D with respect to metabolism and function: Why clinical dose intervals can affect clinical outcomes. But still we see most UK doctors are not using effective vitamin d3 dosing protocols.
    Daily Vitamin D3 supplementation has been shown to improve Lupus markers http://www.ncbi.nlm.nih.gov/pubmed/26351776 however it’s worth knowing indigenous peoples naturally attain 25(OH)D equilibrium around the 50ng/ml (125nm ol/l) level not the 32ng/ml (80nmol/l) level used in this trial.
    If we can have 100 years of vitamin D3 research without noticing cholecalciferol is active from the moment it’s created in the skin or absorbed from supplements it not surprising we are at present unable to come up with a rational cause for heart disease.

    Reply
    1. mikecawdery

      Dr Hutchinson.

      Many thanks for the links. There are others that are in support ( Holick- a leading Vit D researcher eg [Dermato-Endocrinology 1:1, 4-6; January/February 2009]; ©2009 Landes Bioscience). At this point I would point out that the CMO wrote to GPs recommending their considering this. I questioned my GP about this. There is a restriction on this test in the local NHS because so many are using it. Interestingly the vast majority of tests are showing deficiency and that is using the conventional range which is way below the 125 mmol/L that you mention. Unfortunately the VitD3 that is prescribable under NHS rules is very expensive, while I get VitD3 5,000IU for a year for circa £20. When tested my VitD ( 25(OH)D) level was around 125 nmM/L
      A useful website on this subject is http://www.vitamindcouncil.org

      While I agree that Vit D3 is generally a good health factor, I do not believe that it is use will significantly improve cardiac health unless one uses group sizes as large as those used in statin studies (5,000 to 10,000+) where they might well show a good or better efficacy than statins. But Big Pharma and its shills ain’t going to spend multimillions$/£ to test it!

      Reply
      1. Edward Hutchinson

        I am not a doctor. Retired teacher.
        Had to learn about Vitamin D3 to resolve problems associated with late effects of polio.
        Fortunately I came across papers linking Post Polio Syndrome to axonal injury and so I was able to reverse some of the recent damage and slow ongoing deterioration so no greater than normal ageing.
        High 25(OH)D levels are associated with decreased axonal injury in MS.
        http://www.ncbi.nlm.nih.gov/pubmed/26462862
        I guessed the same happens in PPS.
        Vitamin D prevents axonal degeneration.

    2. mr Chris

      This is very interesting. I note that you speak of daily supplementation. Does this mean that there is a difference between daily supplementation and massive monthly doses, which I was told let the body do the regulating through taking the Vitamin D out of fat storage as needed?

      Reply
      1. mikecawdery

        Mr Chris,

        Yes, cost!

        The “approved” prescription drugs (ie passed by the FDA, EMA et al) are very costly and manufactured by pharmaceutical companies. As Dr Hollick proposes 10-20 minutes in good, midday sun (before applying sunscreen) can result in up to 10,000 IU for free. After that the process automatically shuts down. Or one can take a daily supplement.

        Unfortunately, it seems that the the “official” view is that VitD is only involved with calcium and rickets – a sort of step function; one has rickets – deficiency – no rickets – no deficiency. Since every cell in the body requires VitD (and has receptors) it is important to maintain a healthy level around 100-125 mmol/L

      2. Kevin O'Connell

        Mr Chris (& Mike Cawdery et al)

        Yes! Vitamin D half life is only ca 24 hrs. True, much goes to the liver and 25(OH)D, with its half life of ca 3 weeks and thence to Calcitriol [1,25(OH)2D] but the direct effect of D on cells looks to be of great importance.
        See Hollis: Dr. Bruce Hollis – Vitamin D Dosing Interval

        The relevant (and, I think, very important) slide is “Vitamin D and Tissue Homeostasis.”

      3. Edward Hutchinson

        Sorry I missed this reply earlier.
        There is a huge difference between daily and monthly cholecalciferol supplementation.
        If you read the paper I linked to in my first comment in this thread
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607301/
        Dietary Vitamin D and Its Metabolites Non-Genomically Stabilize the Endothelium.
        and understand that cholecalciferol, in that form has a half life of just 19-25hrs you should be able to work out how many days cholecalciferol once monthly provides.
        I know of no research showing that once cholecalciferol has been converted to calcidiol it’s possible for it to be converted back to the cholecalciferol form. When humans evolved naked in the equatorial sun DAILY CHOLECACIFEROL formation was the norm and there would have been no reason to have evolved a feedback loop to restore cholecalciferol to it’s original form. Now we know that cholecalciferol has an important role in that form we have to adjust our supplementation and UVB exposure policies to more nearly match what would have occurred throughout the human evolutionary process.

    3. ellifeld

      I used to work in a health food store; many times customers would come in to purchase vit D based on having been tested by their physician. Unfortunately in almost all cases that I remember the doctor never made a numeric recommendation. The patient was on their own despite being tested for their levels. In the few cases that a doctor would make a recommendation it was always extremely low, between 400 and 1000 IUs. It’s possible that the patients asked for the test and the doctors are unfamilar with appropriate levels but one would think that the doctor should try to educate themselves on levels if patients are asking.

      Reply
      1. mikecawdery

        The “official” daily intake is, I believe, 400 IU for adults, and this is raised to 600IU for geriatrics like myself with an upper limit of 1000IU. However, the EMA has recently raised the upper tolerable limit to 4000IU. Many studies use the official daily dose, and, unsurprisingly find little effect. One suspects that there is a bit of astroturfing in this including the dire warnings of adverse reactions and toxicity. However, in the US they have a registry of adverse reactions and vitamins have not been involved with any deaths in at least two decades. More agnotology! .

        Big Pharma and their poodles, the FDA and the WHO (JEFCA) are doing their best to convert nutritional supplements, such as VitD3, to pharmaceutical products so that they can get their paws on them

      2. mikecawdery

        Stephen T

        5 μg = 200IU. Not a commonly supported dose rate – usually 10 μg

        From the NHS website:
        People should also take a daily supplement containing 10 micrograms (0.01mg) of vitamin D if they:

        are aged 65 years or over
        aren’t exposed to much sun – for example, those who cover up their skin for cultural reasons, who are housebound or confined indoors for long periods

        and
        What happens if I take too much vitamin D?

        If you take vitamin D supplements, do not take more than 25 micrograms (0.025mg) a day, as it could be harmful. However, taking less than this is unlikely to cause any harm. I would love to see any references that substantiate this statement. The EMA has recently increased their upper limit of tolerability to 4000IU (100 μg)/day.

        Some useful refs on the subject by Holick:
        n engl j med 357;3 http://www.nejm.268 org july 19, 2007 – an excellent review.
        Am J Clin Nutr 2008;87(suppl):1080S– 6
        Dermato-Endocrinology 1:1, 4-6; January/February 2009]
        And http://www.vitamindcouncil.org (Dr Cannell)

        I like to compare the medical establishment’s treatment of adverse reactions to VitD with those of statins. In the case of all vitamins (incl. VitD) in the US there have been no reports of associated deaths in the last few decades. The MHRA has some 200 reports of death associated with simvastatin and atorvastatin and QoF does not pay for adverse reaction reporting! I would suggest bias against a nutritional supplement as against patented, allopathic drugs! It is certainly reflected in the dermatology clinic at my local Trust hospital where all the notice boards are smothered with advice and adverts for sunscreens without a word about the importance of Vit D!

        Is it not remarkable that statins “are well tolerated” with little warning of adverse reactions (despite the fact that the AR rate approaches 20%) but vitD is credited with “danger” at 1000 IU but the medical therapy may be as high as 50,000 -100,000 IUin a single dose each week for up to 18 weeks? Do you not see certain discrepancies in the “official” advice?

    4. Soul

      Dr. Davis’s, author of WheatBelly has mentioned in his experience preventing cardiacs events in patients with vitamin D3, as one of his main tools. I’ve often thought if that is the case, which D3 helps the most, pill form or being out in the sun? I would imagine the sun, with the different nutrients and compounds that are made that way would be best. It reminded me too of another doctor reportedly helping “cure” many diabetic and heart disease patients, Walter Kempner of Duke university. He had this crazy rice diet, would give a few supplements to patients, such as vitamin A, but also made his patients walk outside for 30 minutes or greater each day in the often hot southern sun – if I remember correctly. I think it was 30 minutes or greater. Oh, I thought, they are outside soaking up the sun, raising vitamin D levels.

      Anyway, hard to say. Will be interesting to read the up and coming book it sounds like. Looking forward to it.

      Reply
      1. Stephen T

        Mike the daily recommended amount of vitamin d in the UK is 5ug and that’s 200 International Units (IU). To avoid calcium and vitamin d being deposited in our soft tissues, and to properly and usually use it in teeth and bones, I’ve read that we need to take vitamin K2, MK7. 180 mcg of K2 for every 1,000 units of vitamin d. Simple? Maybe not.

    5. Dr Robert Proietto

      Some advice I give my patients, it is important that anyone taking high dose D3 also take Vitamin A (as retinol palmitate) and Vitamin K2. The three work together to balance calcium, especially in the bone, and help prevent toxicity from Vitamin D. I have seen patients turn their arteries to bone with unopposed, high dose D3. It is also important to take Mg2+ with your D3, such as Magnesium aspartate or gluconate. Magnesium is a cofactor for vitamin D biosynthesis, transport, and activation. It also helps properly manage calcium in the tissues. Unfortunately, most people seem to be deficient in magnesium based on dietary history and symptoms.

      Reply
      1. Angela Staniford

        Thanks for that. I read Chris Masterjohn recently who stated Vit A was esential with D3. Without the corresponding vit A the D3 would quickly be at an overdose level. With the Vit A it was hard to reach overdose levels.

      2. Edward Hutchinson

        But have you any evidence Masterjohn is aware of the research showing CHOLECALCIFEROL is active BEFORE it is hydroxylated to calcidiol or further hydroxylated to calcitriol?
        http://www.ncbi.nlm.nih.gov/pubmed/26469335
        As everyone has assumed in it’s basic form it’s inert there is no peer reviewed work looking at the role of CHOLECALCIFEROL either on it’s own or in relation to Vitamin A.
        It may be that Masterjohn is overstating his concerns.
        In the UK we have a long way to go before we get the general population up to the natural levels found in indigenous peoples. 125nmol/l is just about a third of the level above which hypercalcemia may be found in people who are consuming excess calcium. (generally from supplements or fortified foods) dietary sourced calcium is much better used.
        What matters is what actually happens in practice.
        Here we see Dr Coimbra using up to 60,000iu daily vitamin D3 to reverse/control MS.
        http://vitamindprotocol.blogspot.co.uk/p/dr-cicero-galli-coimbra.html
        No reported cases of vitamin D toxicity because his protocol states
        * While on the protocol it is important that patients drink a minimum of 2.5 liters [almost 85 ounces] of fluids [preferably water, total fluids] per day to guarantee the elimination of calcium through the urine.

        * Patients must exclude all foods rich in calcium during the treatment. Basically milk, dairy, and all of it’s sub products. Including calcium fortified foods, oat milk, rice milk, soy milk and etc.
        There is no mention of vitamin A in Coimbra’s protocol.
        If it really was necessary to prevent hypercalcemia then I suspect he would have found that out by now.

  2. jerryblackett@gmail.com

    I am being thick. Does final sentence mean more to come or was answer in preceding paragraph? I am not a doctor- simply someone diagnosed with mild heart disease who is grumpily on a low staton because your book reluctantly acknowledged it might reduce risk of inflammation for reasons we don’t understand

    >

    Reply
    1. BobM

      I think if you read his book again, he suggests that statins have very little overall benefit. If you’re concerned with inflammation, you could try increasing your omega-3 fatty acid intake (in fish and/or fish oil), which also has an anti-inflammation aspect.

      Reply
    2. Lynne

      Or does it mean, look it up research for yourself – find the cause of heart disease in the list of diseases Dr Kendick has given us. Dr Kendrick does not like to spoon feed or draw conclusions for us!
      However I hope that there is a follow up post with yet more information or dare I say conclusions

      Reply
    3. Joe

      Or you could read this study:

      Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms
      http://www.tandfonline.com/doi/full/10.1586/17512433.2015.1011125

      “Pharmacological evidence and clinical trial results support the interpretation that statins stimulate atherogenesis by suppressing vitamin K2 synthesis and thereby enhancing artery calcification. Statins cause heart failure by depleting the myocardium of CoQ10, ‘heme A’ and selenoproteins, thereby impairing mitochondrial ATP production. In summary, statins are not only ineffective in preventing CHD events but instead are capable of increasing CHD and heart failure.

      “Physicians who are involved in prescribing cholesterol-lowering medications cannot ignore the moral responsibility of ‘informed consent’. Patients must be informed of all statin adverse effects, including the ability to cause CHD and heart failure, onset of diabetes mellitus, carcinogenicity, teratogenicity and central and peripheral nervous disorders besides the well-known rhabdomyolysis and hepatic injury. Most of these adverse effects of statins become apparent after 6 or more years of statin therapy. Chronic administration could ultimately lead to these statin adverse effects as pharmaceutical and biochemical research has now demonstrated.”

      How’s that, for giving you even more to think about?

      Reply
  3. Ash Simmonds

    Interesting discussion just tonight – my gf is new to all this and so still super enthusiastic (I’m sitting there at dinner hoping nobody notices I’m eating only the meat), she can explain much of the mainstream stuff about “LCHF” vs “SAD” etc, but then her friend asked “if saturated fat and cholesterol doesn’t cause heart attacks, what does?”.

    Such a difficult issue to cover over dinner, but so much of what is in this post is basically what the theme of my “elevator pitch” on heart disease is.

    Basically, nobody knows how it starts, just that at some stage *something* happens. Much like an accident a mile down the freeway that turns into a pile-up, or a sore on your thigh that you start scratching. Was it caused by a mosquito or did you accidentally sit on something small or do you scratch it in your sleep or was it just random inflammation?

    Who knows what started it – but we know how to not make it worse. DON’T SCRATCH IT too much and do other stuff to mess with the body’s healing systems.

    We don’t know what STARTS problems in an artery, but we sure as hell know what contributes to further inflammation and deposits and such.

    Reply
    1. Mat

      @Ash
      ” “if saturated fat and cholesterol doesn’t cause heart attacks, what does?”. ”

      Turn it around – make *them* prove what does! Sat Fat / Cholesterol have never been proved to cause CVD!

      Reply
  4. Dr. Göran Sjöberg

    Interesting blog – especially for me personally!

    I guess I must believe in what I have doing to my body on a broad scale to address the life style factors as an ‘anecdote’ during 16 years now and all the time having refused all medical treatments.

    Slowly digesting Platos collected works, now on my eternal vacation, I realise that the present day common belief that medical doctors know what they are prescribing is nothing new. On every other page in these works this belief is used as the strongest reference point of logic in the Socratic dialogues.

    Reply
  5. David Mallett

    After labouring through all this, I was left with the feeling that you are leaning against an open door. I read your blog anyway and believe it all. My son recommended it and as a result I gave up drinking (no I do not believe the glass of wine a day theory) and, more important, Simvastatin. I gave Kawasakis up years ago after my three-potter 500 raised the front wheel on every gear. You also give poor Peter Cushing bad press here – he only made rotten films and didn’t kill many people with those.
    Try another blog entry that tells me what you think will help to keep us alive a bit. I live in a pretty clean air environment but cannot help getting older. Anybody can tell me how to die.

    Reply
    1. Old fogey

      Of course Pauling was on to something – that’s why his vitamin C research was never replicated properly by the medical establishment, who – instead of providing the vitamin C directly in the vein, gave it by mouth, and then declared that nothing worked.

      Reply
      1. mikecawdery

        Old Fogey,

        Pauling indeed has shown the value of VitC but has been called a quack by Big Pharma shills. However A Dr Klenner (thru’ 1940-70s) has published several clinical reports on the clinical efficacy of VitC in flu and other conditions. There is a huge data base of research that is simply ignored by the medical establishment to protect allopathic drugs.

        Incidentally, unlike most mammals, man cannot make VitC (along with guinea pigs). Dogs, when stressed or sick, can increase massively the production of VitC. One can only assume that this increase has a beneficial effect and is not just for fun. But VitC is a nutritional supplement and is not currently patentable and not (yet) a pharmaceutical drug.

      2. Kevin O'Connell

        Looks like oral C is fine. Note that Cameron (& Pauling) were largely delivering 10g orally. Lots more on this – Klenner, Hoffer, Saul, Hickey, …

  6. dphil2014

    I’m confused about FHC and my cholesterol profile. You say that increasing LDL by 3 mmol increases risk by 66% and put me into the FHC group. My total chol is 9.5, and LDL is 7, which is 4 mmol above Heart UK’s recommended level. But I’ve managed 79 years of healthy life so far, with nothing more serious than a very slight calcification of a heart valve. True, my HDL and triglyceride levels are good, 2.16 and 0.9 respectively, but why am I not affected by such a high level of the wrong cholesterol?

    Reply
      1. Flyinthesky

        Mike, re the waking times video. everyone on here has come to the same conclusion, in this narrow focus of interest we are generally in agreement.
        What is a continuous source of dismay to me is how people cannot cross refer this reality, it has no matter what the base area of interest is, it really does all work the same.
        The political parties, the UN, the eu, the WHO….. dare I say climate change, they’re all on the same bus and the destination is deceit, for their own interests.

    1. mikecawdery

      May I suggest that your problem is that you have a lot of “good, bad cholesterol” and very little of the “bad, good cholesterol” as described by Dr Kendrick. But the DIRECTIVES require your poor GP to put you on statins on pain of serious consequences (GMC???). I am not sure how much QoF payments are involved.

      Reply
  7. Nigella Pressland

    Another insightful & stimulating blog post Dr Kendrick. I can’t wait to hear what you do think causes CVD.

    Reply
  8. Sylvia Brooke

    I loved this Doctor McKendrick. In the past I have not understood the medical terminology you use, actually I still don’t. However, this was explained in such a way that I was able to understand it all pretty much. I had three stents in my LAD in November 1914, and since then I have made myself unpopular at my Surgery by refusing various tablets to reduce cholestrol. Statins just about reduced me to a zombie, not to mention the muscle and joint pain which they caused. Just reading the side effects is enough to give you a heart attack.

    On my last visit to the Surgery my Doctor stressed the fact that I had high cholestrol by raising both arms and drawing huge circles in the air and saying “you have blocked arteries all over your body”. Scare tactics don’t begin to describe it.

    I actually stopped taking statins after discovering your blog and speaking to some wonderfully helpful people about their experiences whilst taking them. I will always be grateful to you all.

    From this posting I have decided that the reason for my CVD is having Rheumatic Fever as a child, plus the dreaded Old Age and hating getting up in the morning – especially Monday!

    This post made me laugh out loud. Now that can’t be bad for a miserable Monday morning. Now I am going shopping and intend to buy a medical dictionary. Have a lovely day Doctor McKendrick. I hope your relative has made a full recovery.

    Reply
  9. linda connaughton

    Thank you for the info I was diagnosed with type 3 hyperlipidemia in 2011 aged 42 I am quite healthy apart from this . I cannot take statins and have had lots of dissagreements with docs over this ,I take plant sterols and opti omega 3 now as statins I think have caused problems with my arm and legs . in 2015 I had an angina attack now on waiting list to have a triple bypass ,they say with the angiogram I have one artery that is on its own this is completely blocked and the other 2 arteries are partially blocked ,could I right this myself without the operation ?as im feeling a lot better in myself with my own herbal treatment and diet ;my cholesterol was 12.1 in 2011 and have lipids ,now I have my cholesterol down to 5.3 . my triglycerides where very high .
    Linda

    Reply
    1. Andrew Ward

      Linda, I read your post and could not, in clear conscience, avoid replying. I myself have had three angiograms and three angioplasties. I have five stents in my coronary arteries, two of which were placed because the very first one had already blocked-up again. A friend had triple bypass and still, several years later, has severe pain in his chest because of how the operation is performed (it is called invasive surgery for a reason!) and he had a heart attack after the bypass. If I could go back to the beginning when I first had angina, I would do things a lot differently. Before you agree to this operation, read all you can about Linus Pauling’s protocol (vitamin C, Lysine, Proline), and a website called k-vitamins.com. Also, read up on the benefits of ground flaxseed. I am writing this because you are at a point that I was once, and I hope that you can avoid this surgery if at all possible. (you can, but you have to be prepared to say no to the doctors, and that takes courage). After my second heart attack and last angiogram the doctor literally told me that if I didn’t take Plavix and Crestor I’d be dead within a year…well, that was 2011 and I’m still here 🙂

      Reply
      1. Dr. Göran Sjöberg

        I am also still here after 16 years of refusal.

        When I asked my last (?) cardiologist, who frankly told me that he was not the least interested in what I had been up to during the years since he considered it to be ‘almost criminal’, if he didn’t think i was worth a deep thought when I was sitting in front of him in a pretty good shape without surgery or any medicine, he went silent for a short while but then composed himself and blurted: “You have only been lucky!”

        Tomorrow I will bring out my chain saw for the first time this year and cut down a couple of large trees which I will chop into firewood for the next winter. Great exercise for a VERY clogged anecdotical man.

      2. Anna

        My understanding, for what it’s worth, is that high triglycerides are not good, and that the best way to lower them is to cut carbs, sugar, maybe wheat.

      3. joelouisconnaughtonlinda

        Hi Andrew and all who have given me the info ,I started taking lysine and vitamin C on Tuesday this week . I’m hopeful that this will work ; since 2011 when taking statins my right arm I have trouble with and my legs are not the same my muscles drop making my legs really thin (due to statin usage I think )
        I will post on here as and when there is improvement I haven’t got a date yet for the triple by pass so hopefully by then I will see a change with my angina and the small lipomas I have all over ,I had the raised yellow ones on my knees and elbows ,but they went when my cholesterol came down from 12.1 to 6.3 . I still have the lumps under my skin which are not changing with my diet and plant sterols ,so will be great to see if they go now as I have been trying to find something since 2011
        when my post says joe this is also my link

      4. Andrew Ward

        Thank you, Linda 🙂 I have never felt better despite the cardiologist’s attempt to the contrary! I wish you good health. Cheers.

    2. Barry

      Linda,
      I’ll back up Andrew’s advice. There’s plenty of evidence that bypasses do not work in the long run plus what is to stop exactly the thing (partial or complete blockage) recurring? No change in diet or lifestyle means the same thing will happen again.
      Here is a link to Linus Pauling http://www.paulingtherapy.com/ where you can read about vitamin C, lysine and proline. Obviously it is for you to decide if you wish to follow his advice – if I was in your position I certainly would. According to Pauling following his advice should resolve part of the plaque problem.
      With respect to calcium in plaque I strongly recommend that you read Vitamin K2 and the Calcium Paradox by Dr. Kate Rhéaume-Bleue http://doctorkatend.com/ to understand the link between calcium in the diet and vitamins A, D and K2. Without sufficient K2 in your diet (which is highly likely given modern food production techniques) calcium may deposit in tissue including your cardiovascular system. She provides ample evidence of the beneficial effects of vitamin K2 supplementation. K2 is not toxic so no harm in trying it.
      So, if you believe Linus Pauling and Kate Rhéaume-Bleue simple dietary additions can result in impressive CVS improvements in weeks/months.
      If you are not already following a LCHF diet (high triglycerides suggest that you are not) then please do some research regarding the LCHF diet.
      Wishing you success!

      Reply
      1. joelouisconnaughton

        Thank you Barry I am off to Holland and Barrett tomorrow to stock up I would rather try anything than have the operation . I don’t smoke or drink I’m 5 feet weighing nearly 8 stone and very energetic .i have the genetic problems so I am told

    3. Galina Lebedev

      I am not an expert, but I guess vitamins D3 and K2 supplementation, regular blood donations and scheduled exercising could be helpful or at least not harmful. Also, sitting for hours could be harmful even for an exerciser.

      Reply
    4. Barry

      Linda,
      May I suggest that you check out some other vendors as well as H&B. K2 appears to becoming the “new kid on the block” and it is worth looking around to get the best value. I just had a look at the H&B website and could only see 50 mcg K2 at, in my opinion, silly money. You need at least 100 mcg of K2 as MK7 per day and much more if you take K2 in the synthetic form of MK4 (something like 10 times as much which means that you need to consider dose/cost) to meet basic requirements and, given your issues, I’d go for 200 mcg per day plus. Dr. Kate’s book provides details.
      There are numerous alternatives to H&B one of which is Oxford Vitality (UK based firm that sells direct and also via Amazon). They have 100 and 500 mcg tablets of K2 as MK7 at a fair price. I have no connection to Oxford Vitality, other than as a satisfied customer.
      For lysine and vitamin C try sports/body building websites where you’ll find both available as a powders. Many of these sites say take lysine with fruit juice but Linus Pauling recommends that lysine (which is tasteless) is best taken without any sugar when being used for plaque reduction. Check the Pauling website for dosage but, from memory, I think he recommends 2 grams per day for those at risk. You can take as much vitamin C as you like (up to bowel tolerance – which will vary depending upon your body’s need for vitamin C) but you’ll need at least 3 grams per day and quite possibly 10 grams or more. Spread vitamin C dosage over the day to minimise loss in urine.

      Reply
      1. linda

        thank you barry for all the info I have just got the vitamin powder and the lysine .lets see if I can stop the operation and help repair my body .I will keep you up to date

      2. Anne

        I get Life Extension Super K from Amazon – 200 mcg of K2 as MK-7 which has a much longer half life (a few days) than MK-4 which is just a couple of hours. The Super K also contains 1000 mcg of MK-4 but even that is pointless unless you’re taking them several times a day. I take one Super K one day and two the next day, alternating like that so that I get an average of 300 mcg of MK-7. I highly recommend Dr Kate Rheamue-Bleue’s book ‘Vitamin K2 and the calcium Paradox’ – lots in there too about vitamin D3 and vitamin A – the three are synergistic.

      3. Carol A.

        Barry and Linda, What about non pharmaceutical Vit K supplements!

        According to Professor Cees Vermeer, one of the world’s top vitamin K2 researchers, Vitamin K2 and vitamin D work together to increase MGP, (Matrix Gamma Protein) which, in healthy arteries, congregates around the elastic fibers of your tunica media (arterial lining), guarding them against calcium crystal formation
        “The only mechanism for arteries to protect themselves from calcification is via the vitamin K-dependent protein MGP. MPG is the most powerful inhibitor of soft tissue calcification presently known, but non-supplemented healthy adults are insufficient in vitamin K to a level that 30 percent of their MGP is synthesized in an inactive form.
        So, protection against cardiovascular calcification is only 70 percent in the young, healthy population, and this figure decreases at increasing age.”

        Now going back to the food supplement, In an article I read recently, Dr Kate Rheaume-Bleue suggests ..
        ”There are several different forms of vitamin K2. MK-8 and MK-9 come primarily from fermented dairy products, like cheese. MK-4 and MK-7 are the two most significant forms of K2 and act very differently in your body. MK-7, is a newer agent with more practical applications because it stays in your body longer; its half-life is three days, meaning you have a much better chance of building up a consistent blood level, compared to MK-4 or vitamin K1″.

        As a food supplement Dr Kate, suggests Natto (being the highest content), however, natto is generally not appealing to a Westerner’s palate, so you can also find vitamin K2, including MK-7, in other fermented foods, including fermented vegetables made with the proper starter culture (a starter culture of vitamin K2-producing bacteria). Gouda and Brie cheeses each contain about 75 mcg of vitamin K2 per ounce, while scientists have also found high levels of MK-7 in a type of cheese called Edam.
        Dr. Vermeer recommends between 45 mcg and 185 mcg daily for adults. You must use caution on the higher doses if you take anticoagulants. However in healthy adults research has shown you can’t overdose on Vit K, the gut uses what it needs and extracts the excess!

        In the UK and Europe (unsure about the USA) these cheeses are easily obtainable in most supermarket chains and reasonably inexpensive. Perhaps, worth a look at Dr Kate’s articles and perhaps researching cost of these products v supplements!

        But don’t forget to take your Vit D as well, I hope this is helpful!

      4. Richard

        Hi Barry, My name is Richard and I actually work for Oxford Vitality. I have a Google Alert set up to inform us when people mention our company so that we can monitor feedback and help in any way we can. I just wanted to thank you for your recommendation and I’m glad you find our products to be of a high standard and at a fair price point. Being able to help people with well engineered, high end supplements whilst maintaining we are accessible to all budgets is our main aim as a company. Thanks again, it’s much appreciated. It’s clear your advice in this thread is too 🙂

      5. joelouisconnaughton

        Sorry been away for a while had triple by pass done 2nd Feb . Feeling great at the moment back jogging ,just got to keep my arteries clear now . Refused any statins and blood thinners except aspirin taking one a day , l-lysine 5 daily ,vitamin k2 -m7 ,opti – omega 3 1,000mg ,vitamin d and vitamin c these I take daily will keep you up to date on my full blood count the latest in Feb was 6.2 down from 12.1 in 20011 my triglyceride is the biggest problem

  10. lynne garwood

    Don’t know if you get his postsHaven’t read yet = oh dear! But thought you may be interested as re cause of heart disease – his perception can be trusted,  I believe, having read both of his books xx

    Reply
  11. Soul

    Allright, about time! Well, if you are going to go, go big as we say in America. I have bets on the electrical system and H3O2 water being involved. If that is the case at least one large part of the religious order will be backing the theory. And if not the case at leas the theory can help explain why my electric car performs much worse when it comes to holding energy in cool weather. Rather a bummer with that right now.

    Reply
  12. PeggySue

    Lovely to have you back Dr Kendrick!
    You’ve given us all a treat for “Blue Monday” but one that has left me really confused. So sorry – I feel as though I should have had a eureka moment but it just won’t come, no matter how often I read and re-read the post.
    I don’t seem to be alone in my confusion (thank goodness) – is it a case of nobody knows the “what” exactly but the answer lies in conditions such as lupus in young women? Or is it a case of “To be continued ……” or, erm …..

    Reply
  13. Danny Evatt

    I think it’s very sad that governments, Universities, etc. are no longer looking for the “cause” of CVD – evidently because they think they have already found it! It’s as if all scientific discovery, curiosity and investigation have stopped (true also for cancer and climate change).

    So yes, please Dr. McKendrick – let us know more!

    Reply
  14. Ola

    What a cliffhanger! Someone mentioned vitamin D in the comments. Lack of sun exposure seems to be a piece of the puzzle. Maybe vitamin D is important but only because it suppresses hepcidin levels? I’ve been intrigued by the iron-heart disease hypothesis for quite a while now, and I’m wondering if Dr Kendrick is going in a similar direction. Can’t wait for the next installment!

    Reply
  15. Paweł

    Phew, that was a long wait. Good blog though, one of two I actually bother to read alongside Petro’s Hyperlipid.

    Reply
  16. Sylvia

    What a puzzler. Just love a whodunnit. Read somewhere, might be your blog that we have lost the ability to manufacture our own vit D through some mutation. Also women have less CVD until after menopause. Winter brings its own problems with the elderly. Think I have had my goes now, await some interesting ideas.

    Reply
  17. Stephen Blackbourn

    The fact that atherosclerotic plaque tends to form mostly in the arteries leading to the heart and brain is puzzling.

    Maybe its there by design rather than by accident?

    Reply
  18. dearieme

    I hope you’re not leading us to the great anti-climax of “it’s all due to stress”, doc. Until there are independent measures of stress, how could one avoid circular reasoning? I do hope that whatever you propose makes sense of the rise and fall of heart attack rates over the last century.

    Reply
  19. Jennifer

    Once again, Dr Kendrick many thanks for being so generous in sharing your logical thoughts.
    Your dissection of the way we cling onto theoretical explanations, shows how few irrefutable facts we truly know about many bodily functions. Yes, researchers accurately describe what plaque is, where it is found etc…..but to actually explain the process of its formation, beyond the hypothetical stage, seems a world away to me.
    In the mean time, physicians and pharmacologists are doing their darndest to mitigate the nasty effects of plaque, and I do see why, in order to effectively counteract it, they need to understand everything about its formation process.
    I lost any religious faith many years ago, after much thought about the illogicality of the power of prayer etc etc. Quite simply, I am a great believer in the scientific explanations of everything around us. I hope I live long enough to read a paper which can conclusively define the mechanism(s) underlying CVD.
    Two things for sure though,
    1) cholesterol levels in our blood are not to blame for CVD, and
    2) Statins are not of any help once plaque has formed.

    Reply
    1. Dr. Göran Sjöberg

      Jennifer,

      I am also a strong believer in science and therefore disgusted by the evident proliferating abuse of science in the medical research in the hands of Big Pharma.

      My firm stand on the theory of science is that knowledge is possible.

      Reply
      1. Jennifer

        Goran, I am sure that the science will be forthcoming at some point.
        I note that a number of responders to Dr Kendrick’s paper are still being tempted to put forward their particular theory as to what specific substance may cause CVD…..rather missing the point of today’s blog, in which Dr Kendrick seems to be asking:-
        “by what process is plaque deposited?”
        I understand that plaque has been shown to be present in the large arteries of children as young as 3 years of age…..which rather negates the practice of theorising about any specific foodstuff or chemical or lifestyle being causative. The very young are not likely to have been exposed to measurable quantities of any of the suggested offending agents, so…..I am beginning to think that genetics may hold the answer; however, that is not a lucrative line of investigation.

      2. Dr. Göran Sjöberg

        Jennifer,

        I noted that as well!

        Now you and me just happen to ask the same question why many miss the very point of this blog but without exception (?) it is within all (?) living species the ability of constantly connect phenomena with causes. This must also be fundamental for survival in a Darwinian sense. What makes Homo Sapiens exceptional in this respect is our more elaborate ability to do this. We may even explicitly ask us the question WHY.

        Talking genetics there is today a revival of the disputable field of epigenetics, but today based on the molecular biology of the cell ,which might bring deeper understanding of the fundamental processes involved. But as always abuse of science is close at hand not least in the epigenetic field as history clearly tells us.

      3. The Informed Consumer

        “My firm stand on the theory of science is that knowledge is possible.”

        Whilst I agree with that statement, I suspect it should be qualified with ‘limited’ i.e. that limited knowledge is possible.

        I have been reading Dr. Kendricks blog for a while now and the more I read, the less I realise we know.

        Over the history of medical science we have been persuaded certain facts are irrefutable until they are refuted e.g. cancer is a death sentence, period. Oh! we just discovered there is benign cancer, OK, some cancer is a death sentence. Oh! we discovered chemotherapy, except you could die from the treatment, as with radiotherapy. So we’re now defeating cancer (I believe) 80% of the time providing it’s diagnosed early enough. Ok, so now cures are qualified to make the massive amounts of money spent on research seem worthwhile. So on and so on.

        And I will state here that we need research, unfortunately often funded by big pharma who produce the most disgusting array of harmful cures we can ever imagine. But research is necessary.

        However, I used to work in marketing for the largest animal pharmaceutical company in the world and their range of ‘pour on’, ‘injectable’ and oral anti-parasite products were the global norm, providing farmers believed the route to prosperity was through fat cattle. What few of the population realise is that there are residues from these anti-parasitic compounds floating around in the carcasses butchered to provide us our daily protein intake. I guess antibiotics fall into the same category. And of course, the same goes for fruit and vegetables and their associated pesticides but we have barely a clue as to what they do, for all we know, they might be good for us. When was the last time any of us saw a worm in our poo? I very well remember mine, 48 years ago at Scripture Union camp (I had no idea it was a religious organisation, it was a seaside camp as far as I was concerned) when we were given several things in our tea to (amongst others) purge us of parasitic worms and suppress sexual urges. I still have no idea if either worked other than I have never seen a pooworm since, and my first marriage was at the end of a shotgun.

        My belief is that we know as much about the human body as we do about the universe and, indeed, our own planet. It therefore interest’s me to note there are a variety of claims about vitamins presented on this blog, in this particular case, vitamins K, D and C, assuming I have interpreted everything correctly. And whilst I have no doubt the relative benefits of each are ‘understood’ (barely) I make this simple analogy. Imagine trying to pot a ball on a full sized snooker table, not easy for most of us, but possible. Call that ball vitamin C. Now add in another ball, call it vitamin K and try to pot them both with a single shot. Perhaps possible by an expert and other than by blind luck, impossible otherwise. Then add in a vitamin D ball and try to pot it along with C and K in a single shot. Virtually impossible, even for an expert.

        Now make the table three dimensional, as the human body is, and chuck in multiple other Vitamin balls than can block, deflect or interfere with the trajectory of our three target balls C, K and D, or indeed combine with them to make them too big/too small to progress to the pocket or even fit in it.

        Now I’ll contribute another variable. There is much talk here about Vitamin D and it’s health promoting benefits. My question is, does a black African Zulu need more or less Vitamin D than a white English Coal Miner to be healthy. Probably well researched, but has anyone ever rolled in the other two Vitamin balls and executed a study, far less refined them down to the consequent interaction with statins/artery calcification/strokes/CVD etc. etc. I doubt it as the variables in a three-dimensional space are mind-boggling, never mind all the other contributing entities.

        Thankfully, knowledge is limitless, as far as we know, or we would all live forever on a planet never destined for destruction in a few billion years. Sadly, however, the indefinable enjoyment we derive from procreation would vanish and you and I would be having this conversation for the rest of eternity, which would drive one of us to suicide, thereby revealing the opportunity for procreation. Happy days, the human race is kickstarted.

        Seriously. We all need to step off the treadmill of desire for extended life and accept we are all mortal. Eat what the human race has eaten for thousands of years, what it can get, and accept the consequences. Exercise when we are young and accept it’s a declining ability. Pass on one’s knowledge of everything to one’s children. If you don’t like polluted cities, move to the country. If you want money, suffer the pollution. But always remember, doing a job is more important than going to work.

        What on earth does this have to do with Dr. Malcolm Kendrick?

        Simply that he delivers an extraordinarily complex question in an equally, extraordinarily simple way……….not that I can understand a word, but I kind of get the context. Perhaps we aren’t, after all, victims of our own excess, although excessive habits produce their own problems, but most of us are creatures of moderate habit yet we exhibit immoderate health (particularly heart) problems. Which would seem to suggest it’s not us that’s the problem, it’s the medical profession’s perception of us that’s the problem.

    1. Ola

      Both vitamins are involved in hepcidin regulation. =) I look at Dr Kendrick’s list and I see connections to iron regulation everywhere. I’ve been suffering from some major confirmation bias, I must admit.

      Reply
  20. Sean Parker

    Malcolm
    All you have to do is bring out another book about it all so as to blow the ‘closed minds’ out of cholesterol bog they dwell in.
    Sean

    Reply
      1. Lynne

        Ha, ha! How wonderful to be able to laugh at the medical establishment. I will forever see my GP as a limpet clinging on. And my ex Rheumatologist. He won’t see me any more because I refuse to take medication – he says his job is to manage people on drugs – well that is an epitaph in the making. Thank you Dr Kendrick – laughter really is the best medicine. I had the best holiday ever giggling through both of your books.

  21. belle

    Brilliant, so looking forward to the next post!
    Adrenal dysfunction (therefore can’t quench inflammation/deal with allergies, pollution, stress etc,) and lack of connective tissue integrity(causing leaky blood vessels) are my guesses! And there’s a vit C link with both…

    Reply
      1. Brian Wadsworth

        Bravo. Bravo.

        May the scientific method prevail. Hmm, has anybody tracked the progress of heart disease at the micro level in animals yet? I suppose not given your post.

  22. Gary Ogden

    Kawasaki disease is clearly related to mercury poisoning, so you can scratch that off the list. Also, isn’t the development of arterial plaques a normal process related to aging in most people? Seems I’ve read of autopsies done of elderly people (including the Maasai) showing asymptomatic atherosclerosis. Thanks for a great read. I seems clear to me that the answer to the puzzle lies largely in environmental factors, as it does for most of what ails us. I would guess that nutrient deficiencies and toxins are at the root of such. Very interesting about the RBC’s.

    Reply
      1. Gary Ogden

        I simply meant that, being a rare condition in which mercury poisoning clearly plays a causal role, it has little relevance to the overall incidence of heart disease. Environmental mercury has increased dramatically over the past two or three decades from coal burning in Asia and the tripling of the vaccine schedule, and mercury was widely used in medicine, particularly since the early sixteenth century, yet the rise of heart disease as a major killer didn’t begin, at least in the U.S., until around the 1920’s, and mercury wasn’t used in vaccines until the 1930’s, so there doesn’t seem to be any clear correlation.

  23. TS

    1.Why do we all still say ‘Vitamin D’ when the substance is now known not to be a vitamin but acts as a hormone?
    2. If people read your books, particularly the Great Cholesterol Con, they would be less confused and less confusing themselves. Sometimes we need to reread books to fully grasp points. This is meant to be helpful rather than critical.

    Reply
    1. mikecawdery

      TS
      True but what is the hormone called? Call it convention I suppose. One might also ask about CoQ10, (ubiquinon(e)???) a vital intracellular anti-oxidant for which Merck has a patent combining it with simvastatin but has kept very quiet about it for 25 years

      Reply
  24. Anne

    Re coronary arteries – the way the blood flows in them, the blood flow is more turbulent than elswhere ? Where there’s turbulence it can lead to inflammation ? Which can lead to atherosclerosis ?

    I had a biscuspid aortic valve (birth defect) which calcified, as they sometimes do, because of the turbulent blood flow through – that’s why I wonder if a similar process happens in the coronary arteries ?

    Reply
  25. Sharon Caswell

    I am a big fan but am puzzled at why you haven’t gone over to the “dark’ side – that being functional medicine – it’s clear that a paradigm shift in thinking is needed – it might be there
    People break at their weakest link – many causes for seemingly the same result –

    Reply
  26. Robert Pfalzgraf, MD

    As an autopsy pathologist, I have seen atheromatous plaques in only arteries of the systemic circulation. Two exceptions are pulmonary arteries of those with long standing pulmonary hypertension and saphenous veins that have been used to bypass blockages in coronary arteries. I always thought that blood pressure affected the rate of atherosclerosis formation. Something I was taught and have seen again and again over the past 30 years and almost 8000 autopsies.

    Reply
      1. Lucy

        Maybe that explains why people with sleep apnea get more heart problems. The lack of sleep and oxygen makes them get high blood pressure.

      2. izzy

        I mean sleep apnea is a symptom. I cured my husband’s SA with a magnesium supplement one year ago. He took the supplement for about a month and the SA hasn’t come back. And I don’t need ear plugs at night anymore!

  27. Gilles Mongeau

    Dr Kendrick,

    Please don’t go when Hollywood comes knocking with a full time job giving advice on how to set-up a story for a sequel 🙂

    Great post!

    Reply
  28. ellifeld

    I don’t agree with Dr. Greger’s remedy for essentially all disease (complete plant based diet) but his latest video he blames the cholesterol levels of the pregnant woman for the later heart disease of the future adult, http://nutritionfacts.org/video/heart-disease-may-start-in-the-womb/?utm_source=rss&utm_medium=rss&utm_campaign=heart-disease-may-start-in-the-womb&utm_source=NutritionFacts.org&utm_campaign=22300e9200-RSS_VIDEO_DAILY&utm_medium=email&utm_term=0_40f9e497d1-22300e9200-23345465. He thinks we should start treatment as soon a 2 yr old for CVD but at least he is saying it should be treated by diet not statins. Having read enough information like yours, Dr. Kendrick, I don’t believe in the cholesterol theory but still he mentioned something occurring in pregnancy that will later cause heart disease, Thought it might be interesting.

    Reply
    1. BobM

      I haven’t seen the video, but how can one remove genetics from that equation? The only way to do that would be to have two identical twins, let one eat whatever the “normal” diet is and one eat a “plant based” (whatever that is) diet, and follow them for 50+ years.

      It seems women who have children are also being for causing their children to have obesity beginning in the womb:

      http://news.harvard.edu/gazette/2006/08.24/99-obesity.html

      It’s difficult for me to believe any of these studies, especially since many other factors could explain this. Plus, anyone who thinks we should be treating 2 year olds for CVD is crazy. The pediatricians for my 8 year old are going to be giving her a cholesterol test. That’s freaking insane. I just hope they send me the results, so I can send a copy of Dr. Kendrick’s book to them.

      Reply
      1. ellifeld

        It’s only a 4 minute video if you’re interested. Hey if the are looking at cholesterol levels in dogs and cats, well I’m surprised they don’t check out the cholesterol levels of new borns. Maybe that’s next.

  29. Alan

    I was thinking about the most obvious answer, “response to injury”, however if it is multiple injuries at one site, wouldn’t you get layers, ie plaque, damaged epethelium, plaque, more damaged epethial cells, etc.
    I’m thinking the cells will probably not live very long squeezed between two plaques and you could end up with one undiferenciated plaque, but wouldn’t they show up as dead cells in the plaque, or can we even detect this?

    Reply
      1. Doug

        So you start with a high velocity turbulent flow, close to the pump therefor largest pressure in the system and most violent, turbulent flows. Add to this some initial injury, inflammation, and then continue to irritate the area as the flow velocity increases with each subsequent narrowing of the pipe, layer by layer, like sand blasting the rust off metal thru a narrowing high pressure hose, with the bloods own particles as grit. The body continues to try to heal but only causes a continued increase in pressure and turbulence thru the narrowing pipe until ……..

        So in order to allow healing you need to reduce the pressure, reduce the grit and allow the body to finish the healing,

  30. Mark Dionne

    Using the source you quote in Reference 2: If I reduce my LDL from 150 to 75, (which converts to about 2 mmol/L) then my risk of CVD will go down by 44%. This seems like a worthwhile thing to do.

    Reply
  31. mikecawdery

    Dr. Kendrick,

    Once again you have presented us with an excellent article. Like everyone else, I look forward to further revelations, though I suspect that there are i***s out there that would prefer that you would shut up – you are challenging their status as “experts??”

    Reply
    1. mikecawdery

      Dr Kendrick

      I suspect that there are i***s out there that would prefer that you would shut up – you are challenging their status as “experts??
      Judging by the down click someone does not like me or supports the i***s

      Reply
  32. Martin

    What are the clues do far? – response to injury, (inflammation) blood pressure (why is blood pressure too high or low – is it also inflammation? Vit C reduces inflammation and because our bodies do not make it we need to get it from our food choices – as they used to say – let food be your medicine.

    Reply
  33. Stephen T

    Dr Kendrick, can you give us your opinion of Linus Pauling’s ‘cure’ for CVD? It certainly wouldn’t please the heart bypass surgeons. And I remember from your book that you’re not impressed by this operation.

    Reply
  34. Jonathan Christie

    The disease process is weak collagen rent by turbulence at junctions in arteries, high blood pressure, high insulin levels, inflammatory process such as are likely in that list of diseases.

    Why is the collagen weak? Insufficient vitamin C since we lost the ability to synthesize the stuff from glucose. Torn collagen exposes lysine residues, lipoprotein(a) has receptors, bridges the tear with, er, plaque. Repeat.

    This is Pauling and Rath’s theory of course. I believe in it because I’m a 35-year Type I diabetic with a calcium score of zero, i.e. no plaque, and I’ve taken grams of C daily for 32 of those 35 years because Cathcart’s bowel tolerance scheme cured my CFS and I was terrified of a relapse.

    This is unlikely to be a placebo effect because Pauling and Rath published years after I started taking C 🙂

    Reply
    1. Dr. Göran Sjöberg

      I am also a ‘believer’ i Pauling and vitamine C and am just now slowly sipping on my daily 8 grams of ascorbic acid dissolved in a large glass of water. Doesn’t hurt anyway although you have to be careful in the beginning so you must not visit the restroom too frequently.

      At 69, when daylight arrives, I am soon to go for my chain saw and the big trees in my garden.

      Reply
  35. Gert van der Hoek

    The central process seems to be inflammation, chronic inflammation. Inflammation can cause damage to the arteries, you may want to compare arteries to bicycle tires, you don’t want little holes in them. So you have to fix the holes: with stickers, aka plaques? Inflammation can have all kinds of causes, resulting in overstressed or damaged mitochondria, excessive “free radicals”?

    Reply
  36. Henry Fabian

    As a layman diagnosed with substantial calcification of one of my arteries I’ve read as much as I can find about the topic of CVD, which is also the reason why I follow this blog. I’ve looked at videos on the web showing a blocked artery that was supplying adequate blood flow to the heart muscle through collateral vessels. I’ve read about the myogenic theory of heart disease as well as the role of the Sympathetic/Parasympathetic Nervous System in creating a cardio events and I have read several books that Dr. Thomas Levy wrote about coronary heart disease being a form of arterial scurvy (which caused me to adopt the Linus Pauling protocol several years ago.). I have also watched a relative expire of a cardiac event in the midst of severe stress.

    I am not a believer in the Statin or Roto Rooter approach to preventing or dealing with CVD as there appears to be too much evidence to the contrary. I am certainly keen to hear from Dr. Kendrick but my current belief is that stress in all its myriad forms is the killer and that to hold the killer at bay (at least for a while) requires certain diet, nutrition and lifestyle commitments.

    So far this approach seems to be working for me. After being on the Pauling protocol for more than a year my Dr had me take a nuclear stress test; it showed full profusion in all arteries and when I mentioned my C and Lysine regimen my Dr immediately discounted that of course.

    Fighting the good fight me hopes.

    Reply
  37. robert lipp

    Appreciate a knowledgable reader confirming (this is as I am understanding it from this and other sources):
    1. Vit D reduces cvd risk – which supplement form is best (calciferol)?
    2. Regular daily dose, say 5000 iu, is better than a massive weekly dose?
    3. Measurement (UK) of 30 is normally good, but higher at 50 is better and still not potentially toxic?
    Thanks

    Reply
    1. Edward Hutchinson

      i)Colecalciferol. Vitamin D3 DAILY is best.
      See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607301/
      Dietary Vitamin D and Its Metabolites Non-Genomically Stabilize the Endothelium.
      While it has a half-life of only 19-25hrs It direct action on endothelium in this form is more than the combined action of Calcidiol (storage from) or calcitriol (hormonal form)
      2) It is misleading to suggest a one size fits all daily amount for vitamin D3. The range of responses ranges over 100ng/ml 250nmol/l for any specific daily intake.
      See chart that downloads from this link
      http://grassrootshealth.net/media/download/serum-level-rise-chart_2015.pdf
      Aim to get 25(OH)D to 50-60ng/ml or 125nmol/l-150nmol/l as only at that level can significant amounts of CHOLECALCIFEROL (as distinct from 25(OH)D or 1.25 dihydroxyvitamin d) be measured in tissue.
      3) 50nmol/l is not good It’s barely adequate.
      It’s only at 125-150nmol/l that vitamin d3 is best able to resolve inflammation. Luxwolda reported 115nmol/l was normally found in indigenous peoples but this rose during pregnancy and lactation at which human milk is vitamin D3 replete.(See Hollis/Wagner)
      Betteryou Vitamin D3 Testing service handles the postal test service for the Cityassays (Birmingham NHS) path lab. £21 each if you by a 6 pack. It usually takes 3 months of effective strength supplementation. for levels to plateau, Grassrootshealth have a set of charts that provide evidence based information on how to work out what would be an effective intake for your weight.

      Reply
      1. mikecawdery

        Dr Hutchinson,

        Thanks for the links. The grassroots graph says it all. Should be on Every practice notice board.

      2. robert lipp

        Thanks Edward. I did not understand some of the above, maybe more than some. I will check the references and study it all again and again. So my reading is, take calciferol daily to get adequate tissue levels, plus take presumably a few other things like omega 3, all to reduce inflammation.

  38. Kathy S

    I’ve been ordering extra copies of both of Dr. Kendrick’s books along with one on Vit K2 and have been giving them away to those I think should read them. I gave The Great Cholesterol Con to my Cardiologist several weeks ago and when seeing him last week, asked him what he thought. He said that he thought it was interesting. I didn’t push him on the subject – figured it might make him uncomfortable – but he also doesn’t push me or judge me on my decision (even before reading the book) on my decision not to take statins or the beta blockers. Am on the blood thinners, reluctantly but at least they make a bit more sense to me. Three stents now and hoping I’m over all of this mess. Who the hell knows. Have been taking K2/mk7, Vit D, C and Lysine for good measure. We’ll see. Keep up the good work Dr. K and would love to see you out in the public eye on this subject.

    Reply
  39. Gilles Mongeau

    Dr Kendrick,

    Re-reading your post, I assume you meant ‘anti-Popperian’ instead of ‘anit-Popparin’ logic?

    Reply
  40. Tony Gaskell

    Is it feasable that basic physics could explain the initial development of arterial obstructions, and that a persons lifestyle / environment further complicate or advance the development of plaques or vice versa?

    Basically blood flow is a liquid being pumped through a pipe.

    The Brain instructs the heart as to the required pressure needed to maintain body function and physical activity.

    The flow rate required is dependant on pump (blood) pressure and the diameter of the pipe (artery)

    Blood pressure x diameter of artery = blood flow rate.

    So far so good.

    When we are young, arteries (& veins) are smaller, flexible and smooth inside, allowing easy flow of blood at low (ish) pressures.

    As we age, arteries become wider and stiffer (wear & tear, higher blood pressure, trans fats etc)
    which initially slow’s down blood flow. This slower flow then allows deposits, (that would normally stay in the blood stream) to be deposited on the artery walls (this does not happen to veins, because the generally stay ‘small bore’ though some veins in legs do enlarge and display plaque development.

    This now starts a chain of events where the heart has to increase blood pressure to maintain the required flow over the initial deposits in the arteries. Any liquid that is carrying substances, sterols etc (like muddy water) has to now pass over these deposits (the pipe/artery is no longer smooth inside) causing a further increase of deposits, so a vicious circle, or chain of events is occurring.

    Remember; Liquid flow rate is dependant on pipe diameter (and smoothness of internal pipe) and pressue applied, any restriction to interior diameter, be it deposits or blockage, will seriously affect flow rate (more deposits) or pump problem (heart attack)

    Then into this mix we have diet, lifestyle and environment………..which is cause, and which is effect?

    Reply
    1. Gert van der Hoek

      You say: “initial development of arterial obstructions” . I am not sure these are “initial” or even the cause of a heart attack. There is some interesting research concluding aterial blockage is secundary, is happening after a heart attack.

      Reply
  41. Tony Gaskell

    I should have added………

    It could be argued that this theory may confirm the value of exercise and physical activity as opposed to a sedentary lifestyle: When regularly exercising, blood is pumped through arteries at a higher pressure, thus removing any temporary deposits inside the artery walls, maintaining a relatively ‘smooth’ inner wall.

    A sedentary lifestyle, with it’s associated lower blood pressure will allow arterial deposits to remain longer, where they then become a fixture within the artery wall, possibly an on-going process.

    Reply
      1. izzy

        I am sorry I am unaware of high iron problems other than hemochromatosis (genetic) and NAFLD (dietary)…

      2. Diana

        “I am sorry I am unaware of high iron problems other than hemochromatosis (genetic) and NAFLD (dietary)…”

        Look it up. Iron overload is a real problem, many physicians are unaware.
        Microbes need iron to multiply. They try to get it and are very skilled in doing that. The body puts iron to the storage during inflammation, to keep it away from them. You get iron overload. Genetics plays no (main) role here.

  42. Diana

    Dr. Kendrick

    does your hypothesis consider this?

    Fungal rDNA signatures in coronary atherosclerotic plaques. (Ott, 2007)

    “Bacterial DNA has been found in coronary plaques and it has therefore been concluded that bacteria may play a role as trigger factors in the chronic inflammatory process underlying coronary atherosclerosis. However, the microbial spectrum is complex and it is not known whether microorganisms other than bacteria are involved in coronary disease. Fungal 18S rDNA signatures were systematically investigated in atherosclerotic tissue obtained through catheter-based atherectomy of 38 patients and controls (unaffected coronary arteries) using clone libraries, denaturating gradient gel analysis (DGGE), in situ hybridization and fluorescence in situ hybridization (FISH). Fungal DNA was found in 35 of 38 (92.11%) coronary heart disease patients by either polymerase chain reaction (PCR) with universal primers or in situ hybridization analysis (n = 5), but not in any control sample. In a clone library with more than 350 sequenced clones from pooled patient DNA, an overall richness of 19 different fungal phylotypes could be observed. Fungal profiles of coronary heart disease patients obtained by DGGE analysis showed a median richness of fungal species of 5 (range from 2 to 9) with a high interindividual variability (mean similarity 18.83%). For the first time, the presence of fungal components in atherosclerotic plaques has been demonstrated. Coronary atheromatous plaques harbour diverse and variable fungal communities suggesting a polymicrobial contribution to the chronic inflammatory aetiology.”

    Reply
    1. Gert van der Hoek

      That is interesting. There were more reports on a bacteria or virus linked to a cancer or chronic diseases. We probably all have heard of Papillomavirus linked to cancer.
      It may well be that in the end every chronic ailment is linked to a certain bacteria, fungus or virus.
      Now it is interesting to look carefully at a certain virus or bacteria, but maybe it is more productive to look at it from another angle: immunity, or compromised immunity of the host.

      Reply
      1. Diana

        Gert

        regarding fungi: they are so tightly connected to the well-being of their host that they can compromise the host immune system when threatened, or when provoked into the growth mode (nutrient availability, quorum sensing signals etc.).

        I could address many points mentioned in this post and comments but I do not wish to hijack the comment section. Just try to answer a simple question for yourself: what are statins, where are they originally from?

        It is imperative of these days that host microbiome is considered in almost every disease state.
        Did Dr. Kendrick need 30 years to realize this? Better late than never.

  43. DBM

    At its heart CVD is a structural disease of the coronary arteries. So if you want to understand its development you need to understand the structure and make up of the coronary vessels and what causes this structure and its function to fail.

    The coronary arteries are a crown (corona) of arteries that wrap around the heart and supply the myocardium with all its nutrients and oxygen etc . Not only are the vessels are under a fairly high pressure system intra-luminally( as opposed to veins which are exposed to low intra-lumial pressures) but they are also exposed to extra-luminal pressure; shearing and compression forces as the myocardium contracts beat to beat. No other arterial system is exposed to this constant, relentless movement second in, second out, day after day.

    There are certain weak spots with in the corona that are exposed to more pressure than others and these are the areas that need further bolstering and thickening to withstand these structural forces. It is at theses areas that most pathogenic atheroma lie. Pathology slices of fetal coronary vessels show a smooth consistant thickness of the intima (lining) of the artery walls with no signs of thickening . However, pathology slices of coronary vessels of neonates already begin to show thickening of the intimata of coronary vessels. This is not pathology but a natural adaptive response to structural forces.

    So what are coronary vessels mostly made of ? Collagen. What is college made of? In large part , vitamin C. Vitamin C plays a huge role in the synthesis of collagen and is also one of the main antioxidants in the body. Most animals can produce their own vitamin C but by quirk of evolutionary fate Humans are one of the only animals not able to do this and so are vulnerable to the consequences of vitamin C deficiency. Not enough Vitamin C means not enough collagen which the leads to poor repair when the structure of the coronary vessels are damaged. Instead of collagen being laid down in response to damage of the vessel wall atheromatous plaque develops, the less collagen is present the more unstable these plaques become. So in situations where there is a defect or reduction in vitamin C there will be an increased risk of CVD.

    SLE and Rheumatoid arthritis are both connective tissue diseases so by definition there is a defect in collagen and increased risk of CVD. Kawasaki disease, with its coronary artery micro aneurysms has been postulated as a form of tissue scurvy (i.e. severe Vit C deficiency).

    Hyper-insulinaemia and hyper glycaemia can increase renal excretion of Vitamin C, which could explain the increased risk of CVD in Cushings, Type diabetes, steroid use stress etc.

    Vitamin C is also used as an antioxidant so if if it is being consumed in its antioxidant activity there is less left over for college synthesis. Smoking, air pollution , coal mining all require large amounts of antioxidants to mitigate their effects. Exposure to all these environmental factors can deplete vitamin C and so impair the the ability to repair damage appropriately.

    Damage to coronary arteries is inevitable, a by product of living, and can not be prevented. What is at fault is the bodies attempts to repair this damage; if the basic tools and nutrients are not available or are being used up for other more pressing needs then the structure and function of the arteries will be compromised.

    Reply
    1. Dr. Malcolm Kendrick Post author

      Interesting ideas indeed. There are many who would agree with much/most of what you say. I do like the Rath Pauling hypothesis about vitamin C, and it is certain that if you interfere with the healing process, you will compromise arterial structure and function.

      Reply
      1. DBM

        Thanks,

        This also fits in with the ‘Triage Theory of ageing’ that was put forward by Prof Bruce Ames several years ago. http://www.pnas.org/content/103/47/17589.full

        This basically sates that all the diseases of ageing have their root cause in a specific vitamin or mineral deficiency. If there is a surplus or adequate supply of all the essential vitamins and minerals , health is maintained. However , where there is a deficiency of one particular vitamin the body makes a decision, triages ,the nutrients to the area of most need; i.e it will prioritise short term health over long term maintenance.

        Here http://ajcn.nutrition.org/content/90/4/889.short he raises the case of Vit K deficiency; when levels of Vit K are low the body will redirect this to preserve coagulation function at the expense of its role to prevent arterial calcification in the long term. This theory can also be applied to Magnesium, Vitamin D and most probably to vitamin C. If you dig deep enough most disease states and for that matter side effects of most drugs will be due to mineral / vitamin depletion.

        One things for certain CVD aint cause by a statin deficiency

    2. PeggySue

      Thank you for taking the time to share these thoughts with everyone – completely fascinating. You hear collagen and vitamin c mentioned in the same sentence on face creams but it hadn’t occurred to me how the principle would apply in other, less superficial, ways!

      A question though – it seems that many, many things in nature are no coincidence and are there by “design”, not accident. So how come us humans missed out on something so vital as being able to make our own vitamin c? Calling it a quirk of evolutionary fate doesn’t seem to cover it.

      Reply
    3. BobM

      All of the information on Vitamin C also helps to explain (at least partially) why Type 2 diabetes and heart disease are correlated, as Type 2 diabetes is a condition where too many carbohydrates are consumed, and carbohydrates cause the body to need more Vitamin C, which likely isn’t enough in most high-carb diets.

      I note the Inuit had very little carb intake and little Vitamin C, too, but this article implies they got enough:

      http://discovermagazine.com/2004/oct/inuit-paradox/

      Reply
      1. Ari

        This is partly true, but the other way around. Body does not need more vitamin C, but less glucose. Vitamin C and glucose (blood sugar) are structurally similar:
        http://orthomolecular.org/library/ivccancerpt.shtml
        and
        http://www.naturalnews.com/034185_glucose_vitamin_C.html
        “Glucose and vitamin C (ascorbate) have a very similar chemical makeup. This theory proposes that elevated glucose levels compete and effectively restrict vitamin C from entering cells. Both glucose and vitamin C depend upon the pancreatic hormone insulin and its signaling effects in order to get into cells.”
        This is why too high blood sugar replaces/competes vit.C in some organs and cells: collagen and macrophages (those killer cells that fight viruses and germs). The functions of those entities is thus eroded, arteries weakened and immunity against diseases collapsed, respectively.
        This is one more reason to quit sugar and reduce carbohydrates in your diet.

    4. Ari

      Don’t forget sulfur! Collagen needs both vit. C and sulfur. MSM is a good source, if you can’t ingest sufficient amounts of broccoli. D helps in controlling (over)inflammatory reactions of persons, who are genetically prone to rheumatoid diseases (HLA-B27 positive for instance).

      Reply
  44. Gert van der Hoek

    “Damage to coronary arteries is inevitable, a by product of living, and can not be prevented”.

    Mmm, damage to (coronary and other) arteries is inevitable, fact of life, the result of human evolution during hundreds of thousands of years? May be not.

    Reply
  45. Sylvia Brooke

    As the discussion has become more and more difficult to understand, due to so much medical terminology, I must abandon it before it muddles my thinking on these matters. Before doing so, however, I would like to pass on a very simple but invaluable piece of advice which was given to me by Steve Gold on this blog some time ago.

    We had been discussing the dreadful side effects that I had been experiencing whilst taking statins to lower cholestrol. The discussion which followed between a number of people who had already stopped taking statins convinced me to stop taking them too, and I have never regretted that decision. I began to feel better quite quickly afterwards.

    Steve suggested that I try Epsom Salts in my bath as it is a source of magnesium. He also suggested that I should consider taking Q10 supplement (?) too. As I have great difficulty getting in and out of the bath I now soak my feet in epsom salts two or three times a week, and the results are nothing short of amazing. Such a simple thing to do with such amazing results, and I will always be grateful to Steve for this advice.

    I have yet to source the Q10 but will work on that.

    Reply
      1. Sylvia Brooke

        Thank you for that information Mike. Very interesting and proves my point I think. I will certainly keep on with the foot baths and also seek out some Ubiquinol as advised by Frederica too. Thank you both, much appreciated.
        Sylvia (Brooke).

    1. Frederica Huxley

      Co enzyme Q10 is easily sourced. It is usually in the form of Ubiquinone, but a number of companies will supply the more effective Ubiquinol form.

      Reply
      1. Frederica Huxley

        If I’m not mistaken, the supermarket Co enzyme Q10 tends to be the less effective Ubiquinone. If you can’t find which formula is in the bottle, it is safe to assume it is not Ubiquinol!

    2. gilbert78

      I too gave up after trying all five manufactures products in increasing order of price, the GP always starts with the cheapest. The last had side affects but nothing like the ones I started with. My physio’ read a heap of books on the subject and recommended Dr. M.K’s book & another from an astronaut flying doctor , I was convinced and gave up and did follow the advice on Vit supplements and Q10 , I obtain mine from Boots but my physio advised the Active Form of Co-Q10

      Reply
    3. Steve Gold

      You’re welcome Sylvia!

      I’m glad I was able to help you in such a simple way and I’m equally glad that you came back to say it worked. I remember the exchange we had last year. Everyone should realise that NO-ONE is ill because of a lack of simvastatin, atorvastatin, furosemide, amiloride hydrochloride or whatever other “med” your big pharma shill (GP!) pushes at you to, “reduce your numbers”. It’s total and utter bollocks and nonsense.

      I believe that ill health (is generally) because of our environment. Some things we can control (eg eating a good diet but not the “good diet” that the government would have us eat). Also, have a drink a two – whatever you enjoy. Ignore the recent bollocks the UK government came out with. In fact, in general you won’t go far wrong by doing the exact opposite of whatever the government suggests when it comes to health.

      So, going back to the magnesium, it’s a simple deficiency in lots of people and easily fixed. Supplementing generally can’t do any harm. Supplementing with other minerals such as potassium (simply buy some potassium chloride and use as table salt) will also yield dividends as well as vitamins D and K2 because most of us are likely to be deficient. Your doctor should know all of this. It ain’t difficult.

      I really would strongly encourage you to take the CoQ10 supplements.
      I’m not really sure whether the ubiquinol rather than the ubiquinone version is worth the extra expense or if it’s just a marketing exercise by the manufacturers. I think all of the research has been done with ubiquinone but it does appear that ubiquinol will more quickly build up your body’s reserves.

      Amazon sell ubiquinol at a decent price. I’d suggest 100mg twice a day.

      If you’re really wanting to go for it(!) I’d also suggest buying a bag of D-Ribose and putting a teaspoon in your tea twice a day. The magnesium, CoQ10 and ribose is part of the “Sinatra Protocol”, created by Dr an American cardiologist Stephen Sinatra who’s been mentioned on here by Mike Cawdery.

      But nothing can substitute for eating real food! And yes, your granny did know best and certainly better than most doctors’ these days so eat that liver at least once a week with at least one or two fresh eggs daily, lots of good quality butter and take everything your GP says with the large pinch of salt you can also quite safely consume!

      Reply
  46. belle

    some have mentioned iron, and this needs vit C for optimal absorption. Low iron lowers glutathione production which means more free radicals and injury to blood vessels. Could be a factor too…

    Reply
  47. Gretchen

    I don’t understand why we need a single cause for heart disease. If I cut my finger with a knife, I will bleed. If I get Ebola, I will also bleed. Two very different causes of bleeding.

    Reply
  48. Paweł

    Interesting ideas regarding vitamin c supplementation and I do take a lot of it when unwell but I have reservations on taking large doses of vitamin c on daily basis. My main concern is that there might be an adverse effect on the effects of excersise.

    Reply
      1. Mr Chris

        Frederica,
        I live in Belgium and the milk you buy from supermarkets is vile.
        After much searching I have found a farm that sells milk direct from the cow.
        Great

  49. John Collis

    Could there be an epigenetic component as well affecting the arterial walls? What makes the epithelium lining the arteries different to the epithelium elsewhere? There is a suggestion that vitamin D deficiency is involved in the development of MS.

    Reply
  50. Barry

    Carol A (Jan 19).
    I have Dr. Kate’s book and have recommended it numerous times on this blog. I’m also familiar with the research in the Netherlands which I believe is pretty much at the leading edge of K2 research.
    I’m very much in favour of obtaining everything from non-pharmaceutical sources. The problem is how can you be sure that the food that you think contains whatever actually does and in sufficient quantity? I try to eat the foods that should contain the nutrients I wish to consume but I also back up with additional supplements (being careful with vitamins and minerals that can be toxic in high dose). With respect to vitamin K2 there should be adequate amounts in cheese such as Brie and Gouda but can I be sure? I live in Belgium so access to high quality cheese (at a price) is not an issue but, personally, I buy decent cheese from the supermarket and take K2 (as MK7) supplements which, overall, is significantly cheaper plus I know that I am getting sufficient K2 (assuming that manufacturer of the supplement is not corrupt).

    Reply
    1. Sylvia

      The lack of nutrients in our soil must play a part. Margaret Roberts and her wonderful little book ” cell salts for healthy living” is worth a read. When I was young my Dad and all our neighbours grew there own veg and kept chickens, but my parents died young. Dad smoked and developed COPD and Mum had a very impoverished upbringing. I think our children are subject to a great deal more stress in the fast pace of life now, so social conditions do matter.

      Reply
      1. Gary Ogden

        Sylvia: The lack of nutrients in our soils absolutely plays a part in what ails us. A 2015 apple has only 5% of the nutrients of a 1914 apple. Decades ago Dr. Carey Reams developed a method of gauging nutrients in fruits and vegetables by the analog of sucrose percent, called Brix (after Adolf Brix). I recently purchased a refractometer, and downloaded Dr. Reams Brix chart, and have been testing everything. Results? Produce from my garden, and one of the organic farmers at the market test good to excellent; grocery store organic test average to good. I suspect most conventional would test low. I also suspect that missing nutrients are part of the reason so many people are overeating and fat; their bodies are telling them they are starving for nutrients, so keep shoving it in.

  51. Andrew Shouler

    Hi Dr. Kendrick. Thought you might find this of interest! ☺ https://medium.com/@rnikoley/did-food-enrichment-cause-the-obesity-epidemic-c9d083eb49bf#.hae7aoyql With warm regards, Andrew.

    On Mon, Jan 18, 2016 at 9:22 AM, Dr. Malcolm Kendrick wrote:

    > Dr. Malcolm Kendrick posted: “I have been somewhat silent on this blog for > a while. Mainly because I have been putting together ten thousand words on > the true cause of heart disease. Of course, by heart disease I mean the > thickenings and narrowings in the larger arteries in the body (” >

    Reply
  52. Ari

    One could argue, that insulin is to blame. That is what I thought a moment ago. But now it seems, we are back in the inflammation theory. The clues offered by Dr. M.Kendrick hint so much in that direction. I googled LUPUS and INSULIN. They are so intertwined, that it is difficult to judge, which is first – inflammation or insulin (+insulin resistance)? However, the hits from Google point to a solution in which both need to be addressed. If you have Lupus or Rheumatoid Arthritis or any other inflammatory condition, it must be taken care of. You also need to limit everything, that might worsen your condition: sugar and bad carbs to keep insulin down and milk proteins, that increase insulin, too. Don’t fear saturated fat in dairy products, as they mitigate the insulogenic effect. Avoid vegetable oils (omega-6) as they are inflammatory and make you fat (just like excess carbs), which further increases inflammation. To keep inflammation in control, use effective amounts of omega-3, vit. D3, C and other substances, that are known to curb inflammation, like ginger for instance. Boron and sulfur-rich compounds such as MSM or taurine could help, too. Or eat only foods, that do not have a label on them!

    Reply
  53. Barry

    What causes heart disease? We, Homo sapiens, cause heart disease by living and eating in a manner that is alien to our history. By ignorance or choice many of us consume foods that are a poor source of the nutrients we need to provide health and typically promote ill health. Don’t get me started on the rash of TV programs that promote the consumption of energy dense and nutrient deficient food. We seem to think that we can out-smart nature and make the world work the way we want it to but nature bites back – and hard. Even those that genuinely try to make a healthy choice are waylaid by the food industry in that many foods are nutritionally deficient as a direct result of modern production techniques where profit is the priority.

    Perhaps the best place to start is to consider who does not suffer from CVD. Any research on this will quickly lead to Weston A. Price who discovered that those that ate traditional foods were healthy and free from the issues that plague western cultures. He also found that as soon as the western diet was adopted these previously healthy people began to suffer the typical western issues. He also noted the existence of what he termed activator X which we now know is vitamin K2. Today such research would, I suspect, be very difficult if not impossible due to the spread of western dietary habits.

    To maintain the body in good condition throughout life requires that an abundance of all necessary nutrients are available. If they are not available then the body will make the most of what is available to support short term survival rather than long term health. No point is saving for a rainy day if you’re not going to survive to see it.

    So, if we accept Dr. Price’s research the next question is what do we do in the west that screws up our health so much? I think there are two major factors:

    1) Excessive carbohydrate consumption with an emphasis on refined carbohydrate and especially sugar (with HFCS being a particularly bad type). We quite simply have not adapted to process a carbohydrate dense diet. Carbohydrate consumption results in high level of insulin and I think there is a lot of evidence that it is insulin, in excess, that is truly damaging. John Yudkin recognised the role that sugar played in CVD and showed that CVD could be directly related to sugar consumption and not saturated fat. Dr. Joseph Kraft clearly understands the role insulin plays and stresses the current approach to determining T2D is wrong in so far as doctors look at A1c and blood glucose but ignore the underlying insulin level. T2D’s do not have a shortage of insulin – they are swimming in it up to the point where their beta cells give the unequal struggle. His view is that those with CVD not identified with diabetes are simply undiagnosed. Equally we all know that diabetics have a much higher risk of CVD by current diagnosis techniques. Hyperinsulinemia is massively underdiagnosed. No system is immune to the effects of chronically evaluated blood glucose or insulin.

    2) A shortage of vital vitamins and minerals which can be traced back to the beginning of industrialized farming and food production (let’s not forget the adverse effect of many medications). Remember that CVD is very much a condition of the modern world. Today vital vitamins and minerals which are required for biochemical processes are either very low or missing in a vast majority of the population. The body gets by as best it can but damage will accumulate and eventually surface as illness. Time to perhaps mention the vitamin de jour – K2. Most people are deficient and those that are will almost certainly have calcium based plaque in their CVS. The other vital vitamin which we cannot make ourselves is vitamin C and Linus Pauling showed how vital it is.

    On a final note we should not think of CVD as something that affects people only as they grow older – bad diet hits from the word go but, usually, only manifests as a major issue later in life (excluding those with medical conditions).
    I’ll now wait for Dr. Kendrick to tell me what the real problem is!

    Reply
    1. Dr. Göran Sjöberg

      If anyone, as evidently you and me, should be seriously concerned about the connection between your overall health and what you put into your mouth Weston Price book “Nutrition and Physical Degeneration: A Comparison of Primitive and Modern Diets and Their Effects” will for sure shake any belief that it doesn’t matter much.

      This is solid research although carried out more than 80 years ago.

      Reply
  54. Anna

    The mention of lupus and rheumatoid as well as steroid use is puzzling to sort out, as those sufferers are given steroids, so which is the cause?

    As to Cushing’s and diabetes, I recall a book by a doctor 30 years ago, whose idea has unfortunately never taken off, but he described a few body types that humanity has, and the one he called adrenal is certainly more Cushingoid, at least when unbalanced, and more prone to diabetes and heart trouble. These body types are based on the endocrine system and which organs are strongest. The adrenal body type is stockier, heavier set, has a larger upper body, muscular legs, narrow hips and not much of a rear, both men and women. They gain weight in the upper body and frontal belly region.

    I also do see a stress component here, both physical and emotional. I suspect we are heading into hormonal or endocrine territory. I can certainly suspect a link with vitamin D and C, as well as inflammation. But these are causes. As to the how of it, I’ve nothing.

    The NSAIDS are bad for the kidney and heart because they mess with the prostaglandins, fine for eliminating pain, but needed in those other areas of the body.

    Is it only Avastin? I’ve heard chemo in general can damage the heart.

    As to getting older, well, it is a very bad habit.

    Reply
    1. PeggySue

      Anna, re. your first paragraph, my immediate thought was Lupus and RA are disorders of the immune system and steroids suppress the immune system.

      Vitamin c’s main popular claim to fame is boosting the immune system.

      Someone earlier mentioned the importance of keeping a “healthy biome” (apologies if that is incorrect terminology) and my train of thought has moved to the fascinating research being done on the link between extreme allergies in babies (such as eczema) and the quality of their little biomes in the womb. Giving the children pre and probiotics has produced some amazing results I believe.

      Reply
  55. mjean

    How about chronic constipation, the valsalva technique of holding breath and pushing to evacuate the bowels, and the high pressure wave when the breath is released. That would provide the initial damage to the arteries near the heart, that wouldn’t damage the arteries in the extremities.

    Reply
  56. Anna

    If vitamin C, higher pressures in arteries, and injury are all clues, it reminds me of something I read years ago, that plaque gets set down at sites of injury somewhat like a scab. And vitamin C would be important because it is vitamin C which gives springiness and resilience to tissues, meaning the higher pressures won’t injure. Since I have somewhat high blood pressure, that is the main reason I take vitamin C.
    But where I’m confused is that Dr. K has said research doesn’t really show a great result from treating blood pressure. So that doesn’t fit.

    Reply
    1. Edward Hutchinson

      There is a difference between the medical drugs used to treat blood pressure and taking action to reduce the cause of high blood pressure.
      In Dr K’s Potassium Your Invisible Friend the importance of raising potassium intake nearer to the optimal 4.7g rda inevitably has the effect of lowering blood pressure.
      The role of dietary potassium in hypertension
      https://drive.google.com/file/d/0B_1-13ATOOVDbWQ4QkFiV1dpMnc/view?usp=sharing
      There is a big difference between removing or reducing the cause of a problem and giving a medication that masks the symptoms of that underlying problem.
      If someone is potassium deficient we have a choice to correct the deficiency status or provide a drug that spares the limited inadequate amount of potassium in the body.
      It’s similar to doctors prescribing expensive, potentially dangerous drugs that mimic the actions of vitamin D3, rather than correcting the underlying vitamin D deficiency state with DAILY effective strength CHOLECALCIFEROL.

      Reply
      1. Mr chris

        Hello
        Interested to know what you come up with as a decent dose of Vitamine D3?
        One comment on this blog talked of a doctor having patients who had transformed their arteries into bones because of calcification following on excessive supplementation.
        The NYT wellness blog had a bit of a rant the other day on supplementation “not proven, no demonstrable effects etc”
        I find that sort of article very irritating. My lipids specialist says the same about CQ10 I reply if it is placebo effect it sounds great, all the benefits and no side effects.

      2. Edward Hutchinson

        Indeed people who recommend calcium supplements to those who also get adequate dietary calcium are responsible for
        “Death By Calcium” please watch

        and

        The Calcium Story Jason Fung
        Dr Coimbra regularly prescribes up to 60,000iu/daily D3 http://vitamindprotocol.blogspot.co.uk/p/dr-cicero-galli-coimbra.html
        As it is possible to use these amounts without inducing hypercalcemia, we must ask why some people experience problems at lower doses and supplemental intakes that are below the amount of cholecalciferol produced in skin following short non-burning UVB exposure?
        If we know raising 25(OH)D from 20ng/ml to 40ng/ml triples the amount of calcium absorbed from diet, why do doctors regularly prescribe tiny amounts of vitamin D3 and mega amounts of calcium?
        Surely common sense would suggest sufficient Vitamin D to match the 25(OH)D’s levels found in indigenous peoples where no calcium supplements are available.
        Here in the UK the calcium RDA is 700mg/d and most people can get that from diet alone.
        1000iu DAILY vitamin D3 for each 25lbs a body weighs is generally sufficient but testing 25(OH)D after 3 months will show if more/less is required to attain/maintain 125nmol/l at which level vitamin D is best able to resolve inflammation and surplus cholecalciferol is found in tissue in measurable amounts.

      3. Anna

        Hi Edward,

        Well, I do understand that drugs only mask problems. But if the actual problem that causes injury is high pressure, it would actually stand to reason that lowering the pressure would alleviate that, even if it did not address other aspects of the problem.

        On the other hand, I’ve tried various things and never been able to affect my pressure. Except about a year ago I went low carb and it seemed to help quite a bit but not entirely. Lately, I’ve been eating more carbs although I am still sticking to the intermittent fasting wherein I go about 16 hours between dinner and breakfast, and really only eat 2 meals a day.
        As to the potassium, I did see once where Dr. K recommends it, but here in the US all the pills are 99mg, so there must be a law or something. I think he recommended 1 or 2 grams daily, and this would mean 10 or 20 pills a day. So, I got discouraged.

  57. Paweł

    Just a question regarding vitamin c supplementation. These two studies show adverse effects of mega doses of vitamin c on the effects of exercise. I only take mega doses ~2-3g of vit C when unwell otherwise whatever comes from offal and broccoli on LCHF.
    Thanks dr Kendrick for a very informative blog, it certainly helped me to convince my mother to chuck those statins in a bucket.

    Reply
      1. mikecawdery

        Thanks for the links – most interesting and suggests that the anti-oxidant effect may influence oxygen availability in exercise. However, that same anti-oxidant effect would seem to be of value in disease as Klenner and others have shown.

  58. MattH

    Love the let’s think this through approach, Dr. Kendrick. Caused me to re-read Cholesterol Con and wonder how your thinking on process & cause of CHD has evolved since that book.

    (And, side benefit — when I looked for / didn’t see diabetes in list of CholCon’s statin side effects, Tom Naughton & his commenters pointed me this pile o’ evidence –> http://www.tandfonline.com/doi/full/10.1586/17512433.2015.1011125 and http://jcbmr.com/index.php/jcbmr/article/view/11/26 (the latter a nifty delve into post-2006 RCTs)

    Reply
    1. mikecawdery

      You will enjoy de Lorgeril’s book – real blistering revelation on statins

      de Lorgeril, Michel (2014-03-05). Cholesterol and statins: Sham science and bad medicine

      Reply
  59. Nate

    Dr. Kendrick,

    First time poster here. I’m a physician. I find the pathophysiology of atherosclerosis and coronary artery disease one of the most fascinating aspects of medicine. It is all very confusing. I have read the Great Cholesterol Con-and a many other sources as possible.

    I’m also a lecturer at a small medical school. I’m scheduled to give a lecture on atherosclerosis to the medical students on Jan 26. If you post your thoughts on this issue before then, I will probably work them into the lecture.

    Thanks,

    Nate

    Reply
  60. Anna

    I believe it was Weston Price who said that K2 can be gotten from grass fed butter. Might have to be nonpasteurized, though.

    Reply
    1. Gary Ogden

      Correct. Highest levels of K2 from rapidly-growing green grass, primarily during Spring. All dairy products from cows (and possibly other ruminants) on pasture contain K2, converted in their marvelous digestive systems from K1 in the grasses and forbs they eat.

      Reply
  61. Stephen T

    Professor Tim Noakes says the following: “The evidence suggests that high blood glucose concentrations are the single most important factor predicting risk that arterial damage causing heart disease will develop. It seems that glucose damages arteries directly through the glycosylation effect on key proteins and also by promoting oxidation of the small dense LDL cholesterol particles.” (Page 284 of ‘The Real Meal Revolution.)

    So, the western high-carb diet raises blood glucose and insulin leading to type 2 diabetes, raised triglycerides and lower HDL. The western diet at the root of western heart disease.

    Reply
    1. Barry

      Stephan,
      I don’t think anyone can question that the western diet is the primarily driver of many diseases including CVD. Wherever it (the western diet) goes major health issues follow in short order and perhaps none more so than CVD and diabetes. It’s the precise mechanism by which it causes the problem(s) that requires refinement.

      I think it is clear that a lack of essential vitamins and minerals are involved. There are many books and hundreds/thousands of websites that detail the importance of various vitamins and minerals. They are all important – some more so than others. If you have an adequate supply of vitamins and minerals calcium based deposits in the CVS shouldn’t be an issue. According to Pauling and others vitamin C (in amounts far higher than the RDA) should help to keep fatty based deposits under control in a healthy person. However it would appear that the typical low intake of vitamin C, coupled with excessive insulin resulting from excessive carbohydrate consumption overwhelms the ability of vitamin C (plus other vitamins and minerals) to keep the CVS clear and the result is fatty deposits form. Whether these deposits also contain calcium depends upon vitamin and mineral status.

      If you haven’t got the book you may find Good Calories, Bad Calories by Gary Taubes of interest. I think the title is misleading (implies a diet book to me) but it contains a wealth of information including the role of insulin. More information here http://www.cell.com/action/showFullTextImages?pii=S1550-4131%2804%2900007-5 and https://www.ncbi.nlm.nih.gov/pubmed/11158035/ not forgetting Amy Berger who wrote a series of articles about insulin http://www.tuitnutrition.com/2015/09/its-the-insulin-1.html which includes many very useful links.

      On to Dr. Kendrick’s very valid question as to why deposits form in arteries and not veins. I have Gods knows how many books but not one explains this. However a Google search produced this http://jonbarron.org/anti-aging/arteries-and-veins . Assuming this is correct it slots right in with the western diet – it tends to move the body away from an ideal pH towards a more acidic pH (which is associated with a raft of issues including cancer).

      Reply
      1. BobM

        Barry, I can argue against “I don’t think anyone can question that the western diet is the primarily driver of many diseases including CVD.” For one, I have no idea what a “western diet” is; it’s like a Mediterranean diet — it’s amorphous. You make it be whatever fits your hypothesis.

        Also, what about the studies of the Japanese who emigrated to the US? If they kept their traditions, but ate a “western diet”, they also kept their low rates of heart disease.

        Further, this does not explain why people within a country have widely varying rates of heart disease while eating basically the same.

        I won’t say that the “western diet” is blameless, but it’s difficult to place the blame solely or primarily on the “western diet”.

      2. Stephen T

        Barry, I take an interest in Gary Taubes’ work and appreciate it, but I prefer to listen to him speak. Thank you for your detailed, thoughtful and helpful contributions.

        The exact mechanism that causes heart disease is clearly something like a holy grail for the medical profession. I just try to be healthy and do the right thing.

        As for cancer, the lack of progress in treatments makes me wonder and I found this documentary compelling with its alternative view and the seemingly successful treatments it describes. I had no idea of the battles that have taken place in the US to suppress alternative treatments. Quackery says the establishment, but I no longer trust them as I once did. There are good people in the documentary who just want to do the right thing and the medical establishment has wanted to shut them up or buy them. I would not accept standard treatment until I’d made an informed decision.

  62. maitski

    I think the cause will eventually end up having to do something with iron. Wouldn’t that be special? Government mandated fortification being the cause of so much disease and death.

    Reply
  63. Ken

    First, thank you for the blog postings. This is a great site and it is a great source of information on statins and diabetes for me.

    When I looked at the list, I assumed that the too much cortisol was the common element. Unfortunately, that does not explain the non-steroidal anti-inflammatory drugs, and there is nothing like a fact to destroy great hypothesis. That led me to a slightly different answer – I believe that all of the items are COX-2 inhibitors. Most of them have excess cortisol as the COX-2 inhibitor, but the NSAID’s have a different mechanism. Still, they are known COX-2 inhibitors.

    So, my guess is that the cause of CVD is COX-2 inhibitors. That fits all of the scenarios described. Unfortunately for humanity, there is no money to be made in avoiding a cause of disease and you can’t treat this with a pill.

    Reply
      1. David Bailey

        Could it be that there is much less oxygen in that environment? Is this all about free radical damage?

      2. Ken

        Dr. Kendrick – a little background. In real life, I am an accountant and treasurer who likes a good mental challenge. I never gave human biology a second thought since graduating from college, until I had a cascade of problems last year – high blood sugars, high A1C, metabolic syndrome, and memory problems on top of all of that! Researching atorvastatin and its side effects is what started all of this for me. I have fixed those problems, but this challenge of yours is a fun way to keep my researching skills sharp.

        Okay, it looks like I was wrong on the COX-2 inhibitors. That fit your examples but I was able to find the cases of fetal and infant atherosclerosis where the hypothesis failed. Have to hate having a perfectly good hypothesis destroyed by a pesky fact. Elevated homocysteine levels seems to fit all of the cases, but that only appears to be an association, not a cause. Probably a better diagnostic tool than cholesterol, though.

        I (with no medical school background) can only come up with one reason for the whole artery/vein problem. In an artery, you are going to get pressure on the vasa vasorum. If a particle, like a macrophage, gets embedded in the artery wall, the additional pressure at the point of penetration could feasibly stop the flow of blood to the artery wall at that point, causing the tissue in that area to die off. This appears to reduce CVD to an infection, such as you might get from a splinter in your finger.

        Where I am coming up short is figuring out what causes the initial infection. Maybe there are multiple sources and it doesn’t really matter what they are, much as our skin has many sources of infection but it only matters when our immune system does not take care of the problem.

      3. Dr. Malcolm Kendrick Post author

        You’ve been speaking to Uffe Ravnskov? When you use a vein as a coronary artery bypass graft, the vasa vasorum are usually damaged/missing, and plaques develop at high speed.

  64. TS

    My thoughts:
    Stressors of any kind – emotional or physical – can affect the autonomic nervous system and put one in the fight or flight mode through hormones. This can cause arterial damage which is repaired by the body (with the help of Vitamin C) if the stress is not continuous. If the stressful periods are too long, repair is constantly interfered with and serious damage arises. Short bursts of stress with periods of calm between them are probably pretty harmless – we evolved to cope with them.

    Reply
  65. bill

    My partner, a lymphedema specialist, says that
    arterial blood carries proteins, but since the protein
    molecules won’t fit through capillaries, the
    protein either goes into cells, or into the lymph system
    before the blood goes through the capillaries, coming
    out into the veins. Therefore, venous blood
    doesn’t carry protein. Could this be part of the
    issue?

    Reply
  66. Craig

    Going through a few more items on that list, NSAIDS suppress eicosanoids including inflammatory prostaglandins which in turn lowers collagen production, a case of inflammation being coupled to a repair process but they also lower thromboxane which you might think is a protective effect; Avastin is primarily a vascular endothelial growth factor inhibitor; Cushing’s disease characterised by hypercortisolism and problems in the HPA. I can hardly wait for the next 8317 words tying all this together!

    Reply
  67. TS

    Further thoughts – fun, eh?

    Why do we consider Inflammation to be a bad thing! It is an important part of the repair process. Therefore anti-inflammatory drugs must have the reverse effect.
    Steroids are anti-inflammatory.
    Cushing’s – too much cortisol.
    Anti-inflammatory drugs are used in Rheumatoid Arthritis, SLE, Kawasaki’s disease…..

    Chronic illness or chronic adverse states or conditions are more threatening to arteries and arterial repair than short-lived ones. (Chain smoking, deep coal mining, air pollution…The adverse states might include poor Vitamin C levels, etc.)

    Hell on Earth!

    Reply
      1. TS

        Do you think then, Dr Kendrick, that anti-inflammatory drugs could be disrupting the repair to damaged arteries?

      2. Dr. Göran Sjöberg

        Your view is also my own fundamental view on all these metabolic diseases if I don’t misread what you are saying.

        In my present world view much of the inflammatory state can be related to high carb diets/insulin resistance and the notorious omega-6 fat hurting the immune system. Compromised mitochondria function may be at the bottom.

      3. David Bailey

        I actually wonder how certain we can really be that NSAIDS are responsible for extra CVD. I mean, people who use NSAIDS aren’t the same as those that don’t – they have more arthritis, or other painful problems.

        Also, I can’t help feeling that big Pharma wants to blacken these compounds in order to make way for new patentable drugs!

        I guess I have just become incredibly cynical about medical evidence of all forms!

      4. Craig

        Inflammation is the cause of behaviours, remedial and protective, which is why I will stop banging my head on the wall eventually. Anti-inflammatories encourage you to exacerbate the original problem.

  68. Garry Lee

    I think that heart disease is caused by unhealthy endothelium from any of multiple mechanisms. These include trauma from position and blood pressure, toxic effects of insulin. Blood glucose, insulin etc etc

    Reply
    1. izzy

      From personal experience I saw that just a tiny amount of coconut oil (1 tsp) daily has the power to lower homocysteine to healthy levels in a couple of months. I don’t recommed guzzling on it though.

      Reply
      1. Barry

        Izzy,
        Why not? It’s one of the very best oils you can consume and one of the safest, if not the safest, oil to use for cooking. It was used in vast quantities by the food industry before it was vilified in order to promote alternative and very unhealthy oils by producers of processed oils in the US. It is only in recent years that coconut oil has staged a partial recovery (partly due to the FDA’s long over due ruling on reducing transfats). It is still considered by many as unhealthy due to the dreaded saturated fat content. Recommend that you read The Big Fat Surprise by Nina Teicholz – she has done a excellent job of covering the history of fats, food industry and even the acclaimed Mediterranean Diet – which isn’t quite what many think it is.

      2. izzy

        Taking a lot of a good thing doesn’t make it a better thing – there is even bad good cholesterol as we read above. My story is overweight => weight loss with no processed foods + whole grain diet + olive oil only => reactive DVT to a shoulder injury (thoracic outlet syndrome) => found out about Hashimoto’s => Paleo diet + coconut oil => LC diet + too much coconut oil => metabolic acidosis => back to Paleo without coconut oil because I do not tolerate it anymore (the mucosa inside my mouth peels). Things that really helped were a tiny bit of coconut oil daily when I first tried it, magnesium oxide for acidosis, silica+glutamine for endothelium repair (now I replaced glutamine for whey protein powder which is high in lysine and contains glutamine) and proper thyroid support.

      3. Stephen T

        Izzy, I add three table spoons of coconut oil to my full-fat yoghurt every morning and I have no reluctance to use it. The only problem with guzzling the stuff would be the expense. I think the price of anything goes up 50% when it gets a reputation as ‘healthy’. It seems to be good brain food because of its unusual structure (medium chain triglycerides).

  69. Anne Michna

    Great blog, as always. Adding to the ‘vitamin mix’ does vitamin E have any part to play? I quote from old article in Journal of Orthomolecular Medicine “Vitamin E is a powerful antioxidant in the body’s lipid phase. It can prevent LDL lipid per oxidation caused by free radical reactions. It’s ability to protect cell membranes from oxidation is of crucial importance in preventing and reversing many degenerative diseases. In addition Vitamin E inhibits blood clotting (platelet aggregation and adhesion) and prevents plaque enlargement and rupture”. On the other hand I have read that cardiologists do not recommend supplementing with Vit E?

    Reply
    1. Dr. Göran Sjöberg

      My meeting with an arrogant cardiologist two years ago made me look for a solution to my unstable angina on my own and over Linus Pauling’s writings I arrived at 1600 IU/day of natural vitamin E might solve my angina problem.

      Anyway and for whatever reason I don’t suffer from this problem anymore. Big Pharma is today though doing what they can to stop this obvious ‘abuse’ of vitamins. I guess they want me.

      Reply
    2. Andrew Ward

      Anne, why I no longer have a GP (but a naturopath): Doctor: “why aren’t you taking daily aspirin?” Me: “I take vitamin E” Doctor: “where did you hear that? on Oprah?”!

      Reply
  70. John Scott

    If veins do not have plaques and arteries do, then what is different?
    Oxygenated blood, pressure and veins have valves. Veins are also fighting gravity.
    Are veins thinner in structure as thet are not under pressure?

    Reply
  71. Stipetic

    Does it remotely have to do with disruption in VEGF-A activity or its pathway, leading to a slower response thereby allowing more time for RBCs, and the like, to enter the endothelium, etc.

    Reply
      1. Ken Strain

        NO?

        this little molecule is implicated. Then so are mitochondria too (as is so frequent in chronic disease).

      2. Ken Strain

        NO?
        Are you thinking about this small molecule? If so mitochondria should play a part, as usual in chronic disease.
        Ken

  72. Garry Lee

    You are thinking weakened matrix under endothelium due to vitc vitd lack etc…it’s certainly a good thought

    Reply
  73. John Scott

    I guess also that if the veins do not get plaques, it may be because all the baddies in the oxygenated blood have been delivered throughout the body and the veins perhaps are returning the filtered blood.

    Reply
  74. B

    That’s good to hear, just finished your book which I could not put down… reading the last bit again as I’m really interested in the “stress” process….. And can’t wait to hear what more you have to say about this…

    Reply
  75. caldem99

    To be clear, there must be an initial inciting event, or injury for an atheroma to form in the first place. An inflammatory response results and the process leads to healing (scar formation). Recurrence leads to plaque formation and thickening. A weak or incompletely healed atheroma can rupture and lead to blockage. Blockage leads to ischemia and infarct. MI or stroke results. Terribly oversimplified I know, but these basic mechanisms have never been fully elucidated.

    Reply
    1. Sylvia

      So what might the initial event be, infection, actual physical occurence, stress, bad diet.
      A number of things together. Talk about kept in suspenders D Kendrick.

      Reply
  76. JDPatten

    It’s taken you thirty years. OK. You’re entitled to relish this moment.
    However, this teasing guessing game you’re playing meanwhile is outrageous. All of us who’ve naively done harm to ourselves over years of following misguided advice from professionals are on the edge of our seats.
    Job done.
    If you do indeed have the answer to the atherosclerosis process is, withholding it is doing harm by omission, is it not?
    First, do no harm.

    Reply
    1. Dr. Malcolm Kendrick Post author

      Its a point. However, it is one thing to have worked out the underlying processes of CVD. It is yet another to get people to accept it. I not naive enough to believe that the world will collectively slap its forehead in sudden acceptance. Experts will not suddenly announce ‘we were all wrong, our ideas were wrong.’ The history of scientific progress is less Eureka like. John Snow proved that Cholera was a water borne infection. Thirty years after his death the medical establishment accepted he had been right. Frankly, I would rather that people found the answer themselves. in part, this is what is happening here.

      Reply
      1. JDPatten

        Sure. As it happened with lead in gasoline and with smoking and cancer. Well established mental and political inertia – and pride – are huge blocks. I understand.
        So, it’s to be a book?

      1. Anne

        Well that’s a relief with all this talk of inflammation as I have small airways disease which is inflammation of my small airways caused, so the respiratory consultant says, by pollution. I have to take a low dose inhaled steroid to stop me coughing so badly (still cough). I was brought up by parents who were heavy smokers and I live near London – so cause of the inflammation pretty certain.

  77. Lebret

    No no no !
    You’re missing the point !
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155759/
    “Therapeutic consequences
    There is experimental evidence that statins preserve the adventitial vasa vasorum architecture and prevent neovascularization development in hypercholesterolaemic pigs, independently of cholesterol lowering.114 Statins could also influence the consequences of microbleeding due to their ability to limit the cholesterol content of RBC membranes.115 In particular, statins change the profile of cellular phospholipids by reducing the sphingomyelin content of cell membranes.116 In parallel, statins are also able to limit neutrophil transendothelial migration.117”

    OK I haven’t checked the validity of the references.

    Reply
  78. Lucy

    I hate going to my doctor. I have developed a fear. EVery time I go in they start with “you need a statin.” Thanks Dr. Kendrick. I just saw another study that Statins raise diabetes risk quite a bit, maybe that’s a clue. I believe that heart disease is some kind of immune response. People with high LDL have lower rates of cancer and a stronger immune system.

    Reply
  79. robert

    Some time ago I read a paper by Subbotin, published in 2012 in “Theoretical Biology and Medical Modelling”. https://www.ncbi.nlm.nih.gov/pubmed/22490844

    “Neovascularization of coronary tunica intima (DIT) is the cause of coronary atherosclerosis. Lipoproteins invade coronary intima via neovascularization from adventitial vasa vasorum, but not from the arterial lumen: a hypothesis”

    It does away with LDL somehow “piercing” the endothelial layer from the lumen. According to this hypothesis, the innermost layer of an artery somehow thickens, which causes hypoxia in the layers below it. New tiny blood vessels grow where there usually aren’t any, to avoid cell death by suffocation, and bring LDL with them.

    As far as I understand, the mechanism seems logical. Unfortunately I couldn’t extract what the “initial insult” might be that triggers the thickening. I also cannot see from this why it wouldn’t happen in arteries ferrying low-oxygen blood to the lounges.

    Reply
    1. Vladimir Subbotin

      Good question. I have attempted to answer it in anther analysis, which is currently under a peer review process.

      Briefly: Mainstream publications suggest high LDL-C levels as the major cause and pursue it as the therapeutic target, explicitly assuming that the tunica intima of human coronaries consists of only one cell layer – endothelium, situated on a thin layer of scarcely cellular matrix, and subendothelial lipoprotein/macrophage penetration/retention as the disease initiation. However, coronary atherosclerosis begins with excessive cell proliferation in the normal but invariably thick multilayered avascular tunica intima, named “Normal or Diffuse Intimal Thickening (DIT)” converting the coronary tunica intima into Pathologic Intimal Thickening or PIT. This transition resulted in intimal expansion and hypoxia, followed by neovascularization of inner intima from adventitial vasa vasorum. Neovascularization allows lipoproteins extraction and retention by previously avascular deep intimal tissues. Facts show that excessive proliferation in the coronary tunica intima can be triggered by a variety of diverse, non-specific signals. Unfortunately, we investing all efforts in study of non-specific triggering signals in hope of elucidating therapeutic targets, which is unproductive. This analysis suggests that unless we incorporate correct coronary morphology in approaches and concentrate on mechanisms controlling normal coronary tunica intima differentiation, renewal and dimension, our research and therapeutic efforts will likely be off-target.

      If the second question is related to lungs, there is an answer. Lungs of mammals have a dual blood supply: low oxygen blood from pulmonary artery (right heart) and oxygenated blood from systemic lung arteries (left heart). All lungs’ big vasculature and bronchial system received oxygen and nutrients from systemic lung arteries.

      With great respect and appreciation of attention to my writing,
      Sincerely,
      Vladimir Subbotin

      Reply
      1. JDPatten

        Vasa vasorum:
        Dr Kendrick, you suggested I study this.
        Dr. Han suggests here that the coronary arteries are actually cardiac vasa vasora.
        http://www.ncbi.nlm.nih.gov/pubmed/19897316
        The poor things get squashed flat within the myocardium on each beat. That’s gotta be rough.
        I wonder if this, Vladimir’s contribution, and perhaps my other links “along these lines” might have a bearing on the CVD “process”.

      2. Dr. Malcolm Kendrick Post author

        I like the ideathat coronary artery are cardiac vasa vasora. It may explain something that has puzzled me for a long time. Why does atherosclerosis not develop within the chambers of the heart?

      3. Diana

        Vladimir Subbotin

        “This analysis suggests that unless we incorporate correct coronary morphology in approaches and concentrate on mechanisms controlling normal coronary tunica intima differentiation, renewal and dimension, our research and therapeutic efforts will likely be off-target.”

        Has the multilayer morphology of tunica intima ever been confirmed by differential staning, or so?

      4. Gary Ogden

        JDPatten: Thank you so much for this link. Fascinating. I had no idea that “lipoproteins constitute an innate immune system.” That an infective agent may play a causal role is most interesting. The complexity of biology seems to grow by the minute. I wonder what other work has been done along these lines.

      5. Dr. Malcolm Kendrick Post author

        Thank you. Yes, I know this work very well, as it is from Uffe Ravnskov. Founder of the International Network of Cholesterol Skeptics (thincs) of which I am a member.

      6. Diana

        Vladimir Subbotin

        I need to apologize for my question. I had to re-read your 2012 paper, and found the staining of DIT there, of course (van Gieson and Sudan IV)

  80. John Scott

    Guys and gals, lets face it. This genius takes 30 years to collect his thoughts and he is on the case thinking about it in his workplace.
    The beauty of this blog is the collective thinking around the subject.
    Whatever the underlying process, rest assured that 40 plus years of ill advice on nutrition and the deep pockets of big drug companies have stopped us thinking.
    The fact is work with your body and get back to basics. Eat proper food and get the vitamin balance right. Go into a supermarket and stick a red sticker on anything that has added sugar.
    You will end up with raw veg and fresh meat to eat. It is not rocket science, we have just lost touch with our own hormones.

    Reply
  81. rob

    So aspirin and steroids would be turning off the healing process, as inflammation is the immune response. Lack of Vit C reduces plaque instability. Endothlial cap breaks down, clotting factors released to wall off artery and protect from contents of necrotic core, and ischaemia/infarct occurs? NO keeps blood vessels open and smooth muscle relaxed, so reduces pressure inside artery. Stress increases smooth muscle contraction.via adrenaline.

    Reply
      1. rob

        I can see that these EPC’s are important for endothelial repair. There are lower levels in young children with primary systemic vasculitis, lower levels in the morning, and they’re lowered by blood sugar so explaining some of the conditions you’ve mentioned. It seems to be a defective immune system is implicated.

  82. Anne

    “Indeed. The french now eat more MacDonalds than anyone else in Europe.”
    The French also get more sun, aka more vitamin D than people in more northern climes who eat MacDonalds. But I know the northern French get more CVD than the southern French – again the sun/vitamin D connection ? But maybe in several years time all the MacDonald eating French, whether northern or southern, will have CVD ? Meaning there are various independent causes which can all lead to CVD ?

    Reply
  83. Barry

    BobM (Jan 20).
    By “western diet” I’m referring to a diet that contains far too much heavily processed carbohydrate in the form of flour and sugar based “foods”. These days it’s the SAD for simplicity and I think this is what most people think of when the western diet is mentioned. Historically Weston Price noted that when traders exchanged foods that westerners had developed to withstand long sea journeys with minimum deterioration for whatever with various native groups they quickly developed western health issues. Today the problem is worse as a direct result of flawed dietary advice that developed in the wake of Ancel Keys and American health (illness) statistics reflect this. I can’t think of a single group of people that have seen an overall improvement in health by adopting the “western diet”. Today the problem is compounded by processed oils and many additives.

    As for Japanese Americans it really depends the source of information – here’s one that points out that those that retain their native culture matched their counterparts in Japan whereas “ The group that was most acculturated to Western culture had a three- to five-fold excess in CHD prevalence” https://www.ncbi.nlm.nih.gov/pubmed/961690.

    I could say what about the studies showing the health problems African Americans in America – they suffer far higher rates of diabetes and CVD than do those in Africa. One reason is that many are severely vitamin D deficient.

    I never mention the so-called Mediterranean diet (see Nina Teicholz’s book for the background) because it is a myth – here you truly can make it what you want depending upon which Mediterranean country you choose to base it on. Yes, you can argue the same, to a degree, about the western diet but such is the influence of the major American food corporations upon the western world and unfortunately spreading that again I’ll use the SAD as the base. Variations will occur according to culture but it is the cheap energy dense nutrient poor base materials so beloved by mega food companies (just about everything in a cardboard box at the supermarket) that are at the base of the problem.

    I think there are many reasons why rates of heart disease vary between people in the same country but this is a blog and I’m not writing a book. However let’s just consider a few.
    Are they all eating basically the same? I suspect not. I know that what my wife and I eat is very different to what our children eat yet many would think that a family group would have similar ideas on food. Add in different ethnic backgrounds, different social groups with widely varying incomes which may be reflected in food choice, different life styles, exercise, supplementation etc. Even where you live will have impact, especially with respect to vitamin D generation.

    Reply
  84. Barry

    StephanT (Jan 20)
    Thanks for the link! Another minefield full of vested interests. With precious few exceptions self-interest and corruption rules. The sources of truth are few and the sources of disinformation many. To quote Johann Wolfgang von Goethe: “Truth has to be repeated constantly, because Error also is being preached all the time, and not just by a few, but by the multitude. In the Press and Encyclopaedias, in Schools and Universities, everywhere Error holds sway, feeling happy and comfortable in the knowledge of having Majority on its side.

    A true A to B understanding of heart disease is no doubt a holy grail for a few (I look forward to Dr. K’s revelations) but it also the source of a whole industry making a killing and I really wonder if “they” are trying as hard as they could or it’s on the back burner. Like you I try to be healthy and do what I believe to be best and modify my approach if new information comes to light. It’s the old story of the more you know the more you realize you don’t know.

    Reply
  85. Barry

    Linda (Jan 21 10:49)
    Wishing you success! I guess you’ll add in the K2 when you get it and Dr.K’s book will provide ample information on its use and how vitamins A,D & K2 interact. If you want more info on vitamin C I recommend Ascorbate The Science of Vitamin C by Dr. Steve Hickey & Dr. Hilary Roberts. It covers the Pauling/Rath theory and a great deal more.

    I hadn’t heard of your illness before and having looked it up a rock and a hard place comes to mind. Most of us start off sans illness and blissfully unware of what troubles may be ahead in life.

    At least you have found a couple of doctors that aren’t statin mad – or at least won’t pester you every time you see them.
    Again, best of luck!

    Reply
    1. linda

      thank you Barry just ordered the k2 ,I will be buying a few books especially the DR K
      What is the amount of k2 I should be taking ?
      Just looked on some sites some are a little different .
      It has been hard to accept all what has happened since 2011 as I have had 5 children never been ill ,I don’t smoke or drink, very active and then find out im on waiting list to have the triple bypass .
      I have tried all sorts I started having cia seeds ,porridge ,reducing sugar , fat and saturates ,taking plant sterols ,opti omega 1000mg and being told by doctors a diet is not enough as what I have is genetic .

      Reply
      1. Barry

        Linda,
        100 mcg of MK7 is sufficient if you are obtaining some from food, in normal health and not taking mega supplements of vitamin D (better obtained from sunlight but impossible in the winter months at our latitude – assuming you live in the UK). However in your position, where you may have a calcium issue, then I’d increase to 200 mcg or more per day. Not toxic so no harm in taking 500 mcg a day at first to see if you notice an improvement and take it from there. Once you have read Dr. Kate’s book it’ll all be clear.

        Yes, your problem is genetic but that doesn’t mean you’re powerless to help yourself and bypass surgery hasn’t got a good track record (please research this for yourself as it’s better to determine the risk/benefit before undergoing a procedure – it’s a one way path). Any decent doctor should listen to your concerns and not adopt a dictatorial take it or leave it approach – bet he/she wouldn’t be so keen to undergo bypass surgery. Diet alone may not be sufficient, but diet plus a logical supplement plan of beneficial substances way in excess of what you can obtain from food? Vitamin C, which is of vital importance, cannot be obtained the required levels from diet and it is highly unlikely that you’ll obtain the amount of vitamin K2 which you are likely to need from diet. Do not expect the average doctor to understand this – they are not trained in nutrition (unfortunately).

        You’ve already noticed some positive changes from the action you have taken. Your total cholesterol is down, which is an indication that some positive changes have occurred. Nothing to do with CVD risk directly, as Dr. Kendrick has pointed out many times, but if you consider cholesterol as the fire fighter more indicates a health issue and less a reduction in that issue. Forcing cholesterol down by drugs is not a good idea. Homeostasis will determine your natural level.

        Regarding diet I would try to reduce your carbohydrate consumption as much as possible. Carbohydrate provides nothing but energy and in today’s society our consumption (in general) is way over the top of what we require. Reducing carbohydrate consumption (especially refined) will reduce triglycerides and the associated insulin response. Please have a look at Amy Berger’s extensive blog on insulin for info http://www.tuitnutrition.com/2015/09/its-the-insulin-1.html.

  86. B

    Am I right in saying Avastin stops new blood vessels and VEGF signals angiogenesis which makes new blood vessels from existing blood vessels …. Can doing more physical activity than and individual is use to increases EPC levels which could also help promote new collaterals to grow and have benificial effects on cardiovascular disease… Do you agree Dr Kendrick

    Reply
      1. Stipetic

        EPCs promote the release of VEGF, eNOS, ANG-1, and other things, with the resulting restoration of the EC via NO production et al. If not its role in angiogenesis, the trigger we are looking for directly affects EPCs or affects the cascade before it?

  87. Marlene Jenkin

    Sadly I have not had time to read all the posts above. Nor do I know what is the cause of CVD. I have recently bought the book – Thyroid and Heart Failure – From Pathophysiology to Clinics. It details research done globally detailing the connections between the thyroid and the heart. For the first time cardiologists and endocrinologists have come together for the purposes of research edited by Iervasi and Pingitore. The book is available at great expense on Amazon – and you can browse inside to view the contents/topics. It seems that Liothyronine ( T3) is the star of the show 🙂 The researchers indicate clearly the involvement of thyroid hormones and the fact that heart conditions are systemic. Thankfully I live in Crete and can buy my T3 OTC…..

    I am NOT a medical person – but found the book interesting.

    Reply
  88. spasticplatula

    A possible clue about the artery/vein difference: CO2 is a peroxynitrite scavenger. Is CO2 much higher in veins than in arteries? Is it enough to tilt the NO/ONOO balance away from peroxynitrite toward nitric oxide?

    Reply
  89. CBBW

    Reduced nitric oxide bioactivity starts the cascade into CVD? Russian miners and nitroglycerin explosive use (thinking your Monday morning reference is a clue) affecting their NO production? Smoking/ obesity/ blood pressure medication affects NItric Oxide ETC. Conversely, vitamin C is beneficial to NO? Love a mystery!

    Reply
    1. Barry

      Linda,
      I think your doctor is the best person to advise you as to which test(s) are most suitable and of course those that are available to you. I don’t know how willing your doctor is to consider alternative treatments to the standard procedures which you are currently scheduled for. Hopefully, he/she will be at least willing to help you determine if the alternative treatment you are pursuing is helping and for that you need a status check now and then in a few weeks/months to determine what, if anything, as changed. Meanwhile a reduction in angina or any other issues you are suffering is a good indication that things are getting better.

      An internet search will provide many and often confusing options (its big business) and I suspect you have already done that. CADS (Carotid Artery Disease (Plaque) Screening) using Doppler ultrasound is a straightforward and painless test and will provide images of the carotid arteries plus blood flow. There’s also EBCT (Electron Beam Computerized Tomography), which is designed to measure calcium deposits, but the drawback is that provides a total calcium score i.e. a number of small partial blockages will not be differentiated from a single large blockage. Nevertheless I understand that you should have a score of less than 100 with lower being better and zero the ideal.

      From a personal perspective I’d try to avoid invasive procedures and for a quick and relatively cheap test an ultrasound would appear to be the most cost effective option. Difficult for a doctor to object on cost grounds and useful to you and your doctor to see any change.

      Reply
    2. Andrew Ward

      Linda, I agree with Barry, the only safe test is the ultrasound as EBT uses a lot of radiation according to my naturopath.

      Reply
  90. Paul v Nguyen

    What causes (or cause) atherosclerotic disease (and specifically heart disease)?

    My take:

    1) The blood vessels have to be located in the part of the vascular tree with a high pressure, high shear-stress blood flow (coronary arteries, bifurcations of large arterial trees (carotid, femoral, iliac, popliteal bifurcations, etc where the blood flow is quite turbulent) thus constant damages to the lining of arteries, mostly the endothelial cells. This explain why there is no atherosclerotic processes in vascular beds with low pressure flow (veins in systemic circulation, pulmonary arteries and veins). Mother Nature has surely provided repair mechanisms (cholesterol , inflammatory processes,…) well adapted for these continuous damages.

    2) And it is the impairment of these repair mechanisms by the presence of medical conditions listed (Lupus, Kawasaki, Avastin, periodontitis, diabètes, old age, smoking, stress, cocaine,….you name it) that start the whole downward spiral (positive feedback loop)

    Thus, in short, What cause Heart Disease ?
    IMBALANCE of the YING and the YANG

    Reply
  91. smartersig

    While ever we keep looking for single reasons for heart disease we will find contradictions. The simplest solution is to look at populations that do not get heart disease and indeed live the longest and the healthiest. They are not all exotic islands with conditions that cannot be replicated. The longest living are probably the 7 day Eventists of California. What do they tend to have in common?, low or no meat consumption, high fibre, high veggie, fruit and nut consumption along with low dairy although not in the case of one subgroup who run a round mountains herding sheep. So eat a whole food plant based diet because it appears to work.

    Reply
    1. Dr. Malcolm Kendrick Post author

      Perhaps. It certainly does no harm. However, the other long lived populations of the world do not have a plant based diet. Also, when you look more closely at the 7 day Adventists they (many of them) eat a lot of dairy products. Milk cheese, butter eggs etc.

      Reply
    1. tedhutchinson

      But be aware the amount used in this study, 100mcg, was just 4000iu daily.
      Although a useful amount, it’s less than half the 10,000-20,000iu amount made by UVB action on 7dehydroCHOLESTEROL in skin following 30 mins non burning midday summer sun exposure.
      People are different sizes so recommending a one size fits all daily intake will fail obese people.
      The response to daily vitamin d varies over 250nmol/l from lowest to highest responders. Grassrootshealth.org have a series of charts enabling people to work out how much DAILY CHOLECALCIFEROL vitamin D3 is required to stay at the natural level 125nmol/l measured in indigenous peoples and which enables vitamin d replete breastmilk.
      Postal Vitamin d test’s are cheap particularly if you bulk buy and share with friends. UK readers can use BETTERYOU VITAMIN D TESTING SERVICE £24ish if you bulk buy and share with friends.
      Earlier in this series I included a link to “Dietary Vitamin D and Its Metabolites Non-Genomically Stabilize the Endothelium”
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607301/
      The basic Cholecalciferol form is used for signalling by which D3 acts directly on endothelial cells to prevent vascular leak.
      It’s half life is 24 hrs so only research using DAILY supplementation protocols will achieve results and only when 25(OH)D levels rise to nearly the natural level of vitamin d equilibrium 125nmol/l is free bio-available cholecalciferol measurable in tissue (and breast milk)
      We will only see the full effect of daily oral vitamin D when 25(OH)D levels between 125-150nmol/l are maintained for more than 12 months.

      Reply
  92. mrtmeo

    Flush the liver of all cholesterol balls, toxins and fats using the Dr Hulda Clark Liver flush until you pass at least 2,000 balls, eat lowcarb (to keep the liver clean) and keep your D levels in the optimum range of 60-80ng/mL and CVD goes away.
    Clean the kidneys, liver, eat lowcarb, get D levels up, get iodine levels up and all diseases will go away.
    “If you are vitamin D deficient, your chances of having a heart attack is 50%.
    If you have a heart attack and are vitamin D deficient, your chance of dying from that heart attack is 100%” Dr Michael Holick.

    Reply

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