What causes heart disease part 55 – albumin

17th September 2018

I have headed off into different areas from time to time, but to be frank I never thought I would start looking more closely at albumin. This is a substance that almost always ends up getting measured when you do a general blood screening test for patients – for some reason or other.

Albumin is a protein that floats about in the blood. It is made in the liver and, I suppose, it has some important functions in the body. Although I have never really quite known what. At medical school, silence. In medical journal, silence. It seems to be a ubiquitous substance, like nitrogen in the air. We all know it’s there, but we don’t know how it got there, or what it does.

About the only thing I know about albumin is that as the level drops, fluid leaks out of the blood into the abdominal cavity, due to a fall in osmotic pressure. This causes the stomach to swell up like a balloon and is known as ascites.

Small starving children in Africa have ‘pot bellies’ because they cannot make enough albumin. The syndrome is known as kwashiorkor a.k.a. oedematous malnutrition. Alcoholics often have ascites because their livers start to fail, and they cannot make enough albumin either, so fluid – sometimes many tens of litres – fills their abdominal cavity. I have happily drained bucket’s full from stomachs in my time. Just stick in a wide-bore needle and stand back. The pressure can be quite high.

Other than that, I knew nothing about albumin, apart from the fact that, whenever I request a blood test in the elderly, the albumin is almost always a bit low. I have no idea what to make of such a result, or what to do about it. ‘Tick and file – and forget’ represents my normal action.

However, after writing an article about the glycocalyx, and how important it was for arterial health, I wondered if having a low protein/albumin level in the blood might be a bad thing. In that the protein part of the glycocalyx might need to be replenished from somewhere. Perhaps by albumin? Therefore, a low albumin level might be a bad thing – from a cardiovascular disease perspective.

Following such thoughts, I found myself reading papers such as this one: ‘Degradation of the endothelial glycocalyx in clinical settings: searching for the sheddases.’ I definitely need to get out more. In fact, this paper was fascinating. It discusses the role of the glycocalyx, and things that can damage it. [jargon warning].

‘The endothelial glycocalyx has a profound influence at the vascular wall on the transmission of shear stress, on the maintenance of a selective permeability barrier and a low hydraulic conductivity, and on attenuating firm adhesion of blood leukocytes and platelets. Major constituents of the glycocalyx, including syndecans, heparan sulphates and hyaluronan, are shed from the endothelial surface under various acute and chronic clinical conditions, the best characterized being ischaemia and hypoxia, sepsis and inflammation, atherosclerosis, diabetes, renal disease and haemorrhagic viral infections.’1

Which is pretty much what we already know. Many factors that increase the risk of CVD, damage the glycocalyx, and in atherosclerosis there is clear glycocalyx loss/dysfunction. The bit about haemorrhagic viral infections is fascinating and could be worth a future blog.

However, the information I was looking for was to find out if albumin really did help to maintain the glycocalyx and noticed this. ‘…plasma components, especially albumin, stabilize the glycocalyx and contribute to the endothelial surface layer.’ Something I would never have thought to pay the slightest attention to before now. Anyway, in short, yes, albumin does help to maintain the glycocalyx.

Next question. Is there any evidence that having a low albumin level contributes to CVD risk? Well, of course, there is. Here, in the paper ‘Critical appraisal of the role of serum albumin in cardiovascular disease.’ 2

When they looked at serum albumin levels and patients with stable coronary artery disease, the risk of a major adverse cardiovascular event was raised 368%, and the risk of overall mortality went up 681% (relative increase in risk). In their words…’This study unequivocally confirms the important association between SA (serum albumin) and individuals with chronic stable CAD’.

So, you may ask, can you do anything about your serum albumin level? I am not sure that you can do very much. A high protein diet may help, in that the more protein you eat, the more amino acids are available to make albumin from, and Kwashiorkor is due to a low protein diet – so this could do no harm.

At this point, however, the main point that I want to make here – again – is that, once you start to understand CVD as a process that is triggered by endothelial damage, you can start to look at the research on CVD in a completely different light. You can make associations where, using the LDL hypothesis, none exist. It also makes sense.

I find that it is also like freeing your mind from a tyranny. I find it refreshing, and exciting, and I hope that you do to. ‘The difficulty lies not so much in developing new ideas as in escaping from old ones.’ John Maynard Keynes.

Next, they just fired Peter Gotzsche from the Cochrane Collaboration. This is a bloody outrage.

1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574825/

2: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5681838/

146 thoughts on “What causes heart disease part 55 – albumin

  1. John E Midgley

    From the GARD Information Centre:
    Congenital analbuminemia

    Other Names: Analbuminemia; ANALBA
    Categories: Blood Diseases; Congenital and Genetic Diseases

    Congenital analbuminemia (CAA) is a rare disorder characterized by the absence or very low levels of human serum albumin (HSA). Although albumin is the most abundant plasma protein and has many functions, patients with CAA present with only a few mild clinical signs, such as fatigue, low blood pressure, and swelling (edema). However, CAA patients may loss fat tissue (lipodystrophy) and present with high cholesterol, which may result in early atherosclerosis and heart problems. Rarely, CAA may be complicated by hypercoagulability (when the blood tends to clot too much), osteoporosis (which causes bones to become weak and brittle) and respiratory tract infections. It is more severe in the fetus or during early infancy.[1][1134] CAA is caused by mutations in the ALB gene.[1] Inheritance is autosomal recessive. Treatment aims to prevent heart and vascular problems and may include statins and periodic albumin infusions.[2]

  2. Maureen Berry

    Well, I have to confess, for the first time ever, I did not properly read this blog post! I am very glad that somebody is thinking about all of these things, but equally glad that it’s not me! I feel overwhelmed by it all! What with the diet (not a problem, love LCHF) the statin refusal, the refusal of ‘The Cardiac Cocktail’, which, amazingly Cardiologist agreed with. Another factor, prior to this, never considered, is a new fact (or thought) too far!

    But, Dr Kendrick, I am so glad that SOMEBODY has an open mind and an enquiring mind – but will await your final judgement! Just now, my head hurts!

  3. Göran Sjöberg

    Great food for thought as always!

    Usually I embrace the “consensus” about how much protein one should consume each day which is about one gram per body weight which for a normal grown up person corresponds to about 200 grams of meat/fish/egg/diary or even vegetable proteins,

    However I realize that I am usually well above this limit (perhaps twice?) and have had difficulties in defending my excesses on this point.

    Now I have been given, as a “CVD victim”, a perfect excuse for my “immoral” behavior.

    Thank you for this input!

    BTW I usually say that if I had not turned as ill as I got twenty years ago I would never had turned into this LCHF diet. But today wherever I look into different “well fare” diseases I also find support for a ketogenic diet to improve health

    1. Gary Ogden

      Göran: I would call the 1g/kilo of body weight for protein a baseline figure. On days when I do full-body workouts, I consume double or more than that. It turns out that protein can potentially harm the kidneys in only a minuscule percentage of people with kidney disease.

      1. Mr chris

        Interesting comment. My own case is that I don’t think I even get near to the one gm per kilo of body weight, and without resorting to body-building powders I don’t see how I could. I know this is straying into dieting, but how do you do it?

        1. Gary Ogden

          Mr chris: Not really straying into diet. I am convinced that muscle retention and/or building are really important as we age. To build muscle we need more protein than to maintain what we have. Mark’s Daily Apple has had posts about this. I simply eat more protein-rich foods on workout days, usually at breakfast, and occasionally high-quality whey protein, which gives 26 g per scoop. I have increased upper-body strength nicely over the nearly five years I’ve been doing this, and it makes me feel so good. Like Goran, I garden, too.

      2. BobM

        I’m well beyond that level. For instance, I had about 1 pound of london broil for my breakfast/lunch and that’s about 96 grams of protein right there. (I also had some bacon, to add some fat.) That’s over my daily limit using that formula of 1g/kilo.

        I bought a continuous glucose monitor (CGM) to test what happens to my blood sugar level based on protein. I could not find any increase in blood sugar, and I ate tons of protein per meal (upwards of 200 grams in a single meal). The only detriment I can find is that too much protein without fat (as in london broil) causes a malaise-type feeling. I don’t feel good. So, I’ve added fat to increase the level of fat, if the meat is too low in protein.

        But I’ve gone from eating a lot of fatty meats to eating less fatty meats (think eating ham instead of pepperoni). I currently eat near all meat, but do dabble with vegetables, dairy (cheese, yogurt, cream, sour cream), and will have keto meals (higher fat) sometimes.

      3. chris c

        IMO protein leaks through damaged kidneys, but the damage is usually caused by glucose. Protein gets the blame for being there, like “cholesterol” in arteries,

    2. James DownUnder

      I trust you are following Dr K’s advice re’ social support / eating with Good Friends…as you commit such heinous sins… 🙂

  4. Gay Corran

    Fascinating! We continue to learn with you, Dr K. And thank you, too, for halting Leon. I watched the exchanges with a sort of unholy intrigue, but his aggression and outright rudeness towards other posters and finally yourself were taking over your blog and becoming distressing. He is on a mission to “make people stop eating meat” and your blog is not the place for that. I do wonder if he was placed, like a “mole” by the Pharma and Big Food companies…

    1. David Bailey

      There must be a lot of highly placed people who dislike this blog intensely, and I think it is conceivable that Leon’s task was to spoil this blog. He might even be tucking into steak and chips right now!

      Malcolm, I’d love to know your readership figures – I imagine this blog must be becoming very popular!

      1. Dr. Malcolm Kendrick Post author

        I get around 10 to 20K views for each post. Not sure what happens on facebook and suchlike, also people ‘liking’ it and sharing it. I am at around 3 million overall views. I spot my own words and phrasing being used in various different places from time to time. There are around 5.5K ‘followers’. Not sure if they count on visitor figures as they get the blog direct. That is as much as I know – for sure. I have had no action taken against me that I am aware of. I think some people visit to stir up trouble. I try to accommodate everyone’s views as far as possible.

      2. chris c

        Every blog and Twitter feeds has an Embedded Vegan. It’s kind of a law. I expect he will be replaced. I could give a damn what other people eat but these people are in the business of stamping out LCHF and all other diets. How often do you see a low carber or similar disrupting vegan blogs?

      3. Chris Morriss

        I came here via reading the excellent ‘Too Many Pills’ by Dr James Le Fanu. I’m not sure how I got to Dr Kendricks site, but I’m glad I did!

    1. Göran Sjöberg

      Well, I was just in contact with Peter Gotzsche to support.

      His “simple” answear was:

      “The fight continues!”

  5. Gary Ogden

    Refreshing and exciting, indeed. I have one test result which shows albumin, and it is smack dab in the middle of the range, which gives me heart. Intriguing that albumin is critical in stabilizing the glycocalyx. How powerful is freeing the mind! The scales began to fall from my eyes with pharma tyranny here in California in 2015, and the ridiculous political nonsense in the U.S. since 2016. There will be no going back to ignorance and belief. Trust is gone in institutions, but trust is regained in the power of knowledge, reason, and love.

  6. Charles Gale

    …which got me checking all my blood tests…and there it was under “Liver Function”…All very anonymous.

    The lab ranges for normal albumin were/are 35-50 g/L.

    During my time in intensive care it was 37 g/L

    1. Gary Ogden

      Charles Gale: Here they use g/dL, so translating would make the range you got 3.5-5.0. On my only result I have, mine was 4.4, with the range considered to be 3.6-5.1, almost the same.

  7. Sylvia

    Would good potassium levels help, which brings us back to diet. Vegetables and herbs rich in this mineral and all the other minerals we are probably deficient in.

      1. Margaret Sunderland

        Potassium chloride is commonly and cheaply sold in the USA as Morton Salt Substitute. It is available in most big grocery stores. Also, Morton Lite Salt is 50:50 mix of Sodium Chloride and Potassium Chloride.

  8. Charles Gale

    and here’s an excellent companion piece to this post by good guy Dr Mike Eades. It’s from 2007 but with comments up to 2017. Here’s the link:


    Some points covered incl:

    – albumin a good barometer of health
    – serum levels influenced by e.g. malnutrition (esp protein), smoking
    – monitored closely in intensive care
    – more dietary protein increases levels
    – Dr Eades lists its functions e.g. maintains osmotic pressure i.e. keeps blood in blood vessels
    – the elderly, heart disease and statins and mainstream media

    Dr Kendrick may smile at Dr Eades’ response to a commenter that the commenter is confusing the blog with a Q and A column and lists all the other demands on his time!

  9. jhm

    My latest physical returned albumin higher than the normal range (which I attributed to too much protein). Any info on what extra does? What’s the rationale for the upper bound of the range?

  10. JDPatten

    Having looked up info on kidney function and albumin, I further recalled that conventional wisdom tells us that high dietary protein can be a burden on our kidneys. Counterproductive??
    So, I looked that up. No scientific evidence for it in this paper:
    More protein for us oldsters helps retain muscle mass and strength. All good.

    That’s heartening. But, how much credence should we give a single research paper?
    (My various doctors usually disdain interesting but unique research papers I bring them. Favorites for my cardio to disdain were the various Ravnskov papers. He cited “weight of evidence against”. That’s the fellow I fired.)

    1. SW

      Follow the work of Professor Stuart Phillips , his area is Protien. No protein does not harm kidneys unless you already have kidney disease . His area is aging, sarcopenia, muscle and skeletal health vis a vis protien.

    2. Göran Sjöberg


      Yes, although I am just able to run short bursts, due to my old MI, I am still very strong with large muscle mass at 72 which surprises both myself and my surroundings.

      1. JDPatten

        Yes, Goran. Short bursts. You and me both. Once I warm up (it takes longer now) I can do most of what I’m used to doing: Stone masonry, timber construction, gardening that includes tree transplanting, and, of course, chopping and stacking firewood. More rests than in youth. A relaxing pace. At 74.
        Your body: “Use it or lose it!”

  11. Keith Riggle

    When I read the word “albumin,” I had to wrack my brain to remember what it was, and came up with egg whites. Seems like eating more eggs might help increase albumin (without any risk of increasing cholesterol!). Excellent article, as usual.

    I look forward to your take on the sacking of Peter Gøtzsche from Cochrane and the deeper, darker story of industry influence on their review of the HPV vaccine. Such a pity, as I used to feel we could trust the Cochrane Reviews, but no longer.

    1. Gary Ogden

      Keith Riggle: That’s right, Cochrane, as a trusted, independent source, is history. They’ve been bought by the Bill and Melinda Gates Tax Dodge. Apparently Tom Jefferson is standing by Cochrane, who knows why.

  12. sundancer55

    Which amino acids are responsible for making albumin? Which type of protein would be best? Animal protein, vegetable protein? What about things like whey protein powders (which I avoid unless I can find grass-fed sources)? Would just taking an amino acid complex supplement be sufficient?

    Lotsa questions here.

  13. Richard Smith

    Fascinating – as always. Love the style of writing, and the facts presented without the flawed bull that we’ve been fed for so long (especially regarding Cholesterol etc). Well Done Dr. Kendrick – keep the flow of great info coming!

  14. Frederica Huxley

    Fascinating new line of thought. As I was reading, I kept on thinking of egg whites, as they are albumin, and sure enough,egg whites are one of the established ways to increase albumin in the body, along with the meats you mentioned. I had not realised that albumin is the main constituent of plasma!
    As for the deplorable sacking of Peter Gotzsche, I learnt that the Gates Foindation has just made a major donation to the Cochrane Collaboration. Make of that what you will.

    1. Binra (@onemindinmany)

      Me too on egg whites – and a Mercola interview in which albumin was stated to be a precursor for (senior moment… …If I recall correctly, serotonin. OK – not quite… it is the precursor for trytophan which is a precursor for serotonin. I laughed because for years Mercola has been giving all his egg whites to his trainer. It may have been an interview with the Nitric oxide dump exercise guy – name escapes me… … I think it was the Dr Zach Bush.
      (Might be wrong). But the egg white>albumin>triptophan>serotonin is simply checked with a search. I am not an adherent to believing matter makes us so much as what matters to us becomes our defining reflection, but in this forum I venture that serotonin or the lack of it plays a role in heart function/failure.

      Has the UK Sun run a ‘Gotzsche!’ headline with a gloating Gates doling out huge wads of money to those who did the right thing and ousted the ‘babykiller’. (A phrase that Gates used to describe anyone undermining the vaccine agenda – ahem – aid program). A PC on every desk running Windows? Well he got close enough on that, but perhaps he will have a bit more regulatory support to make sure we all take our shots. Have you considered that we are simply suffering from a lack of aluminium in the brain? Obvious really. When you get thoughts of disquiet and dissonace as if “Everything is BACKWARDS; (everything is upside down! Doctors destroy health, Lawyers destroy justice, Universities destroy knowledge, Governments destroy freedom, Major media destroys information, And religions destroy spirituality”. ~ Michael Ellner).

      “No – its a disease called consciousness. You don’t need to trouble yourself. We are looking after you’. We protect you. You can trust us”.

      I would like Dr Peter Gøtzsche to bring true witness to the nature of deceit in ways that can be understood and joined with. Fighting is a different dynamic than standing in the truth. Emotional reaction is different to fully felt expression. If we take the bait of reaction, we are not so hard to trip up. Jordan Peterson is focussed in a different arena but is speaking from an integrated sense of self integrity and not simply reactive as a sense of moral outrage.

      I appreciate the way Dr Thomas Cowan holds his focus – and he has just published another book – and Mercola interview. (Author of Human Heart Cosmic Heart).

  15. Soul

    Oh, I’m getting into areas I know little about it. It just has me speculating this evening if Peter Gotzsche was let go due to his recent critical study work on the HPV vaccine side effects. I’ve noticed that some individuals of late are greatly upset over those that criticize the HPV vaccine. It is not good to notice things.


    ….Gøtzsche says the decision is likely related to a frontal attack on a Cochrane review about vaccines against HPV, a cancer-causing virus, that he and two co-authors published in July. The review, published in May in the Cochrane Library by researchers from Belgium and the United Kingdom, supported the mainstream view that such vaccines can prevent precancerous lesions in adolescent girls and young women. In their criticism, published in BMJ Evidence-Based Medicine, Gøtzsche, together with Lars Jørgensen of the Nordic Cochrane Centre and Tom Jefferson of the University of Oxford in the United Kingdom, argued that the review “missed nearly half of the eligible trials,” “ignored evidence of bias,” and did an incomplete assessment of the vaccine’s side effects. The review didn’t constitute the “trusted evidence” promised in Cochrane’s official motto, they said….

    1. Göran Sjöberg

      Thank you for this clarification!

      (It is great with “many eyes” watching!)

      It is also interesting to note that “Science” is bringing this controversy up.

      What does that tell us?

      1. Soul

        It isn’t something I take all that much interest in personally. But as far as I can tell there are several controversies with the HPV vaccine and it’s marketing. With side effects, the main controversy is that more women and men that receive the HPV are experiencing non recoverable side effects verses those that are being potentially helped by the vaccine. As an example, in America in a 2009 article it is mentioned that – women/girls and their doctors report 2000 did not recover adverse events for a disease with 4000 deaths. It is estimated that only 20% of adverse events are reported, we could be dealing with ten thousand did not recover events in an illness that affects 12,000 women per year…..

      2. Gary Ogden

        Göran Sjöberg: There is new book coming out on October 2, “The HPV Vaccine on Trial,” by Mary Holland, a law professor at NYU. This is clearly one of the most dangerous vaccines ever licensed, probably because of the aluminum burden (these are antigen-adsorbed nano-particles of Al salts, and are proprietary, so no independent scientist has access to them). The clinical trials were too short to pick up most of the serious adverse events, and because of type replacement, it may very well increase pathological conditions in the cervix as reduce them. A cesspool of corruption brought this to market. It has injured and killed many, and a slew of lawsuits are pending. Japan no longer recommends it, and uptake has dropped to 1%. Sorry, completely off topic, but this does relate to what is happening to Dr. Gøtzsche and Cochrane.

      3. Göran Sjöberg

        I am fully on Gotzsche’s side when being upset about the documented criminality of Big Pharma he exposed in his book: Big Money – Big Crime!

        There is a saying among us LCHF-adherents.

        “Every day without a pizza is a victory!”

        I would extend that saying to

        “Every day without pharmaceuticals is a victory!”

      4. BobM

        I also heard that the HPV vaccine was tested against a “placebo” with aluminum adjuvant…so there were many fewer side effects reported.

        1. Gary Ogden

          BobM: This is typical. In virtually all vaccine trials the “placebo” is either the adjuvant minus the antigen, or a different vaccine. Interesting that, in one of the Gardakill trials listed on the CDC website, there was a small, saline, third arm. But the data from this saline arm were combined with the data from adjuvant arm in the report, thus masking any differences. There simply are no proper RCT’s for vaccines that I know of.

        1. JanB

          Thank you, Goran, for that link. How distressing it is. I fear we live in an ever-increasingly corrupt world, always chasing the big bucks whatever the consequences.

    2. Martin Back

      There will always be subjective differences in assessing trials, as an article in the BMJ points out. Perhaps the current kerfuffle will lead to an unambiguous methodology, but I doubt it.

      Even when there are agreed criteria for including or excluding a study or for assigning a particular score to an aspect of the methods, multiple subjective judgments need to be made. What if one trial used a slightly different version of a vaccine, or a new (better) test for a primary end-point, than the one named in the protocol? What counts as a placebo? Because of the need for judgement on such questions, two systematic review teams can produce different findings even when both teams are expert and use identical checklists and statistical methods.https://blogs.bmj.com/bmj/2018/09/17/trish-greenhalgh-the-cochrane-collaboration-what-crisis/

  16. puddleg58

    Albumin is a marker of liver function (not inflammation like the other markers). Its role is to carry free fatty acids to cells. This would be important for heart failure risk, and its negative association with liver function is consistent with correlations between liver disease and CHD.
    Good find that it also feeds glycocalyx; this may correlate with the use of FFAs by the endothelium, as that would supply both forms of nutrition.

  17. Dr. John H


    Thank you for your insight!
    Do you have a brief summary somewhere (or be willing to write one) about what causes arterial plaque, how to prevent it, and how to treat it once it’s there?

  18. Bill In Oz

    For me reading your posts is like watching pieces in a 4000 piece jig saw puzzle gradually fiitting together to reveal the big picture..Lovely work ! And thanks !

    One thought occurred to me as I read ‘hyaluronan’ in the source you quote…Ummmm ? A couple of years ago a chap named Jeff Bowles in the USA started proclaiming the benefits of hyuralnic acid….That it was important in any antiaging program. Now could this be part of the reason why ?

    1. Peggy Sue

      Hyaluronic acid has been a major trend in anti-ageing face creams, serums etc. for a while now – supposed to “visibly plump”. The profits made in the cosmetic industry are probably as eye watering as the pharma industry.

      1. Bill In Oz

        Yes that’s true Peggy Sue. The assertion is made that as we age the body produces less hyuralonic acid and the skill loses elasticity asa result. But it is probably also a similar process in the arteries as well.

  19. foodnstuff

    I also think of egg whites when albumin is mentioned. Had no idea it was in the blood and actually made in the liver, so looked up my last blood tests and there it was. A year ago and 6 months ago……38 and 39 g/L respectively. Limits were given a 35-50. Hmmn…I’m on the low side….more eggs? C’mon chooks, get to it!

  20. annielaurie98524

    Interesting. You have probably seen articles espousing the new dietary “wisdom” that protein is the villainous successor to saturated fat as the cause of all evil. I think this “insight” is based on a single poorly-designed study of 3-4 years ago that found a direct correlation between mortality/morbidity and protein level in the diet. The “study” indicated that there was “break point at about 20% dietary protein where one risked all manner of perdition if one exceeded that level. EXCEPT. The correlation “flipped” for subjects over 65 years of age, at which magic age, higher dietary protein was the veritable fountain of youth.. The authors made no attempt to address why opposite results accrued once one passed that magic “senior moment” of turning 65, but proceeded to warn of protein surfeit in Western diets, the dreaded mTorr effect, etc. As a scientist, had I gotten results like this, I would have been dying of curiosity, like the proverbial cat, about the reason for the apparent “flip”. Not to mention the fact that most primitive diets were at least 20-25% protein (i. e., the dietary level with which man evolved). But, no matter, too much protein in the diet fit the financiers’ agenda, so the anomaly seemed to pique no one’s interest.

  21. annielaurie98524

    My familiarity with albumin comes from my history in animal rescue. Albumin that shows up at an abnormal level in lab testing of cats and dogs is associated with protein leakage into the urine, a marker of geriatric kidney disease. The previous conventional wisdom in veterinary circles was that the best course for a dog or cat (especially cats that seem to be more prone to kidney issues) was a low-protein diet, which seems counterintuitive for a carnivore. Indeed, the new approach, at least among the more enlightened vets, is NOT to restrict protein. Cats, as animals which evolved primarily in desert environments, would normally get enough liquid from their prey, and so are not inclined to drink a lot of water. Modern domestic cats, eating dry kibble and drinking little water, are more inclined to kidney issues than dogs. The approach now is to feed a wet diet, or soak the kibble, and give tasty liquids like those from canned fish and seafood. Interestingly, although no veterinarian ever correlated it with the albumin issue, cats and dogs with kidney problems are far more prone to CVD — hypertension, heart attacks, strokes, etc, etc. Now, I understand why this would be the case.

  22. Peter Elvidge

    Hi there I know you well past the cholesterol phase of heart disease but amazing how now other doctors are coming on board…..yesterday I saw an article in Daily Express on how medications are being substituted for lifestyle change in many surgeries, knowing that pill popping isn’t the answer and just sustains a sedentary way of life. Dr Malhotra, who I have seen on TV was saying they are now poo pooing cholesterol in actually causing death, how it is actually something the body needs – that clever invention the human body – and also how medicine ‘rules’ are changing all the time and it is hard to keep up with what is current…anyway it was quite eye opening and reminded me of your articles, hope you can get to read it anyway altho as I said you are on number 55 now!

    Teresa x


  23. AhNotepad

    I’m glad I don’t know what any of my measurements are, as I haven’t any tests. I’d be another of the worried well if I did.

  24. Mr chris

    Thought provoking as ever. Are album in levels indicatifs of other problems, or is low albumine an age related thing?
    Which leads me to á second reflection, is high Lp(a) bad in itself, or is it an indicator of a need?

  25. TS

    Is this of any interest? My husband and I have recently been suffering from the ghastly flu-like virus that is doing the rounds in the UK. In its very early stages we were astonished to cough up a little blood. (This only happened the once.) As our coughs had not yet developed and could not be held responsible for any mechanical damage, I’m assuming the virus caused the leakage from blood vessels.

  26. Mike Smith

    I suppose the immediate paradox that comes to mind is why the Veggies and Vegans have lower CVD considering the lesser protein (from animal meats) and B12 intake ?

    1. Mr chris

      Mike Smith,
      I do not want to restart the diet déviation, but I havé never read or seen quoted á reliable study that showed that.

      1. Bill In Oz

        Neither have I Mike. So I strongly urge that e not go down the deviating rabbit hole again. It leads to boring, confusing nonsense like we experienced recently.

    2. Gary Ogden

      Mike Smith: Do we know this, that vegetarians and vegans have lower rates of CVD? I would be very skeptical that any proper RTC’s have looked at this.

  27. Andy S

    How refreshing to return to diet discussions. Albumin is produced by liver from dietary amino acids. If liver is being trashed by consuming too many carbs and insufficient protein then one can expect albumin problems. The cause is experts promoting bad dietary advice.

    Fasting curtails albumin production by liver. Fasting is an essential catabolic repair process. Too much of a good thing could be damaging. Eating is what we do a lot of, the question is what, how much, and how often.

  28. Gordon Ferris

    I too am appalled to learn about Peter Gotzsche’s expulsion from the board of Cochrane. Doubtless authoring a book called: Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare played a part. As Peter said, “The main reason we take so many drugs is that drug companies don’t sell drugs, they sell lies about drugs. This is what makes drugs so different from anything else in life…Virtually everything we know about drugs is what the companies have chosen to tell us and our doctors…the reason patients trust their medicine is that they extrapolate the trust they have in their doctors into the medicines they prescribe. The patients don’t realise that, although their doctors may know a lot about diseases and human physiology and psychology, they know very, very little about drugs that hasn’t been carefully concocted and dressed up by the drug industry.”

  29. Brian Wadsworth

    I am introducing new people to this blog. Some have CVD diagnoses.

    Can I suggest, Dr. Kendrick, a short summary of events to date as article no. 56? For those that are new the challenge of catching up has become formidable, perhaps too hard.

    Please allow me to thank you for what can be life-changing wisdom. You have a superb brain and the character to use it well. Thank you.

  30. healthyhealthyed

    Malcolm may low stomach acid as we age could be a contributing factor as acid is needed to break the protein down…your thoughts Ed

    On Mon, Sep 17, 2018 at 7:27 PM Dr. Malcolm Kendrick wrote:

    > Dr. Malcolm Kendrick posted: “17th September 2018 I have headed off into > different areas from time to time, but to be frank I never thought I would > start looking more closely at albumin. This is a substance that almost > always ends up getting measured when you do a general blood scr” >

  31. Jean Humphreys

    Regarding the disraceful treatment of Dr Peter Gotzsche, I used to comfort myself with two thoughts.
    Doctors can only be as good as the information they have been given.
    At least one place exists where the truth of the information given to doctors is tested.
    Only one of those applies now.

    1. Binra (@onemindinmany)

      If Doctors and everyone else are not starting to re-educate themselves, then they are content to be managed and misinformed.
      Many studies are not as scientific as they seem, and those that in any case decide what is and isn’t standard of care etc are the one with the carrot and the stick.
      It may be a blessing yet for Dr Peter Gøtzsche et al to be released to other possible activities.

  32. Andy S

    Dr. K. you have introduced many factors that can contribute to CVD. My favourite so far is hyperglycaemia. Anything glycated cannot be good, even albumin. High glucose can destroy glycocalyx resulting in endothelial dysfunction. High glucose makes monocytes and macrophages angry. Insulin and receptors can be glycated, contributing to insulin resistance.

  33. TS

    It’s lovely that so many people on this blog know their test results. In the UK you have to ask for them and it’s amazing how people don’t even ask what their blood pressure reading was – being content with a ‘That’s ok’ or ‘It’s a bit high / low’.

    1. Göran Sjöberg

      Not me!

      We don’t do any testing with doctors involved! (Although at home we do check BS to see if we are on the right track and occasionally we also check the degree of the ketogenic state we are in by conveniently measuring the ketons in our exhaust air.. Blood pressure, we also check at home, though very seldom since it is usually “just perfect”.

      Keep away from NHS is our motto and let Big Pharma cry!

      1. TS

        Yes, I can’t remember the last time I went to our GP, even though I like and respect him. Annual MOTs are particularly to be avoided, and of course the flu jabs which they keep leaving me text messages about. They must have a large supply of the stuff that needs some victims?

  34. Charles Gale

    Mr Chris and your 2 questions re. (1) low albumin and age and (2) lp(a) levels

    (1) low albumin and age – hopefully you have had a chance to click on the link I provided to Dr Eades’ blog on albumin, in which he states that levels drop with age but more dietary protein promotes the production of albumin

    (2) lp(a) – simplistically, it’s a mobile repair molecule (and a CVD marker). My understanding: high levels indicate that repair is going on. The lower the better.

    1. Mr Chris

      Yes checked that out. Note that there appears to be nothing after 2017 on his blog.
      About Lp(a), yes that’s my conclusion, repair is going on. But is that good or bad, does that mean that my endothelium is in bad shape. By the way, 2 gms vit C and flax seed brought it down from 78 to 38, and the limit is 30.

    2. Gary Ogden

      Charles Gale: Thank you for answering the question I’ve been pondering: that dietary protein promotes the production of albumin.

  35. Clathrate

    Hello Dr. K, reading this #55 reminded me of researching elevated bilirubin / Gilbert’s syndrome (GS) and the decreased risk of cardiovascular effects in individuals with GS – I had to double check but remembered reading of the dissociation of bilirubin from albumin [I don’t have the study to hand]. As an aside, there is a recent review of bilirubin (American Journal of Physiology, Aug 18, https://doi.org/10.1152/ajpheart.00417.2017 {‘Bilirubin acts as a multipotent guardian of cardiovascular integrity’}).

    At the weekend, I’ll aim to dig out the bilirubin research – be interested to see comments from anyone else who has looked into bilirubin / GS. It has popped up in the forum on occasions and a quick check shows, e.g., Emma (#VIII, 11 Mar 2016, 10:37pm & 10:44pm) discussing the ‘protective’ effect conferred by GS & Kelly Trosper (#XV, 2 Jun 16 4:59pm) replying to question by nickhall128.

    1. Gary Ogden

      Clathrate: Bilirubin is such an amusing word I remember it. I have one result: 0.6 mg/dL, the reference range being 0.2-1.2. Good, bad, or indifferent?

    2. Andy S

      Hi Clathrate, re biirubin
      My first reaction was: where an I get some of this guardian of vascular integrity.
      Perhaps the researchers have an eye on developing a patented artificial bilirubin compound. A bit of sleuthing revealed that bilirubin originates from phagocytosis by macrophages of oxidized hemoglobin. Therefore the higher HbA1c s the more bilirubin will be produced. Something does not add up.

  36. Göran Sjöberg

    While albumin deficiency was, to me, a “new ball in the game”, with “unknown” health consequences, there are as Malcolm so clearly has pointed out a plethora of other “factors” in our environment contributing to our “ill health” and not least CVD.

    Then we are in the field of “scare/fear mongering”.

    And one scary phenomenon today is here all thousands of our “modern” chemicals which are “endocrinologically” disturbing. As far as I have learnt today, they, although today well recognized, do not follow the “normal” toxicological paradigm of safe lower limits. They may be more than a thousand times more “potent” (“toxic”) than generally assumed and not with a linear relationship to the concentration.

    Although Big Pharma and people like Leon doesn’t like him, I find Dr. Mercola again very intriguing when scrutinizing this issue. This time it is about the ubiquitous phthalates and their endocrinological effects which turn male fetuses into more and more female ones. Evidently an effect of reduced testosterone levels in the early development.


    (Ill health is BTW and thus not “all” about excessive carbs 🙂 but they have certainly contributed to the decline of the our health but certainly not the number of our human species since the beginning of the agrarian revolution 10 000 years ago – a paradox??)

  37. Adrian Molenaar

    Hi Dr Kendrick Have you seen the recent papers about the benefits of MitoQ, Nicotinamide Riboside, and Nicotinamide Mono Nucleotide and caffeine on vascular and Mitochondrial Function? Regards Adrian

    Get Outlook for Android


  38. Harry de Boer

    Thanks for looking that up doc. 🙂
    And re: Peter Gotzsche: That was predictable, if you call the pharmaceutical industry a criminal organization and write a book to that effect.
    Outrageous, but predictable. They will do everything they can to get rid of you.
    I only wonder why they didn’t just wait for his retirement.

  39. katyao

    Hi, I found your blog via Tony Kenck’s summary on his e4e blog. Here is my comment on his blog:

    “I was intrigued by this set of posts – thank you Tony for cataloguing – and so I looked into the genetic hints as to the etiology of CVD.

    One of the most unbiased ways to get information is through a genome-wide association study that looks at common variants and tests them for association with a complex (multifactorial) disease like CVD. In theory, if the study is designed well, it should yield associations with genetic regions related to all the different factors involved in the etiology. For example, in dental cavity genetics research, you get signals near genes related to oral antimicrobial peptides, tooth enamel regeneration, and saliva flow – all processes known to be related to cavity formation.

    I looked into the most recent pathway analysis of CVD – essentially a grouping of the biological pathways most related to CVD based on these types of genetic association studies. The number one most related hit was glycosaminoglycan metabolism by a factor of 100000 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5200919/). Apparently glycosaminoglycans on endothelial cells have a strong anti-coagulant activity (https://www.ncbi.nlm.nih.gov/pubmed/8495730).

    I was very pleased to see this hypothesis line up so easily, at least superficially, with the unbiased genetic study-generated data! Thanks for sharing.”

    1. Dr. Malcolm Kendrick Post author

      Thanks, I think. Interesting the (implied) importance of glycosaminoglycan metabolism. Who’d a thunk? I suppose my main takeaway from this is that we got landed with a causal hypothesis for CVD (the diet-heart hypothesis), before researchers even knew that there was such a thing as – for example – the glycocalyx. They jumped to conclusions without having 1% of the facts. Yet, as new facts arise, the mainstream still desperately clings to this outdated and scientifically illiterate concept. The exact opposite of science.

      1. Bill In Oz

        So now we know ( again ) how to repair the arteries, SAFELY – with Chondroitin sulfate….And the ‘diet heart ‘ hypothesis is a total bloody irrelavance and distractor….
        IHerb sell the Now Foods, pure Chondroitin Sulfate, 600 mg, 120 Capsules for $19.60a piece, if you order two containers …’m sure that Vitafoods also sell it as well…But Now Foods is the only brand I can find which is pure CS. All the other brands are blends with other stuff added..

        1. Andy S

          Hi Bill,
          Agree with you that the lipid hypothesis and the low-fat diet hypothesis are defunct.

          Re endothelial repair: are the sulfur compounds in foods that confer the benefits? (eggs, garlic, cruciferous veggies)

          “So, in my view, the best way to avoid heart disease is to assure an abundance of an alternative supply of cholesterol sulfate. First of all, this means eating foods that are rich in both cholesterol and sulfur. Eggs are an optimal food, as they are well supplied with both of these nutrients.”

  40. katyao

    Also in line with your hypothesis, supplementation with high doses of chondroitin sulfate, a glycoasaminoglycan in the glycocalyx, reduces incidence of coronary heart disease (in people who take it for osteoarthritis.).

    Amazingly, they conclude: “CS [chondroitin sulfate] interferes with the pro-inflammatory activation of monocytes and endothelial cells driven by TNF-α thus reducing the propagation of inflammation and preventing the formation of atherosclerotic plaques.”


    Makes me want to get my hands on some chicken broth for my grandparents, ASAP. (chicken broth is natural source of CS)…

    1. Dr. Malcolm Kendrick Post author

      Thanks a lot for this finding. I’m sure I had read about the possible benefits of chondtroitin sulphate and CVD before, then completely forgotten about it – not making the association with the glycocalyx. It fits very nicely. You have made my day with this one. I owe you. Love it.

    2. Gary Ogden

      katyao: Thanks. Any bone broth will do. Also eating those gristly parts of the animal adjacent to the joints and elsewhere. I relish them.

      1. Bill In Oz

        Ahhh Malcolm, sometimes even you are too skeptical or deluged in information to take it all in
        ..I too have been commenting here about Chondroitin Sulfate even since I found your blog. From memory about 5-6 times …

        But late is better than never..So All is good !

        Dr Lester Morrison was doing his research from the 1940-1970’s. In those days there were not the research tools available to allow him to discover why Chondroitin Sulfate worked to prevent heart attack mortalities..But he knew it did exactly that…
        Now this new research ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4738029/ ) shows the process of how it does this.

        I have been taking CS tablets as recommended by Morrison’s protocol ( available from NOW via IHerb online ) since early 2017…

        I suspect that my former long term vegetarian life style made me very liable to CVD problems because of a lack of all the ‘gristly’ foods high in CS..

        And that illustrates, in a personal sense for me, why we should NOT tolerate veganist & vegetarian fanatics here in this blog…

        Thanks to Katyao, Gary & Martin for bring this forward again here..
        Bill in Oz

      2. Bill In Oz

        A PS I’ve just been reading the link provided by Katyao.To my comment above : In Blog post 54, I was asking you about Macrophages in the intima of the artery wall and what happens to them when they die : ( It’s the macophages which are the repair team cells ) You replied that they become trapped and die and become foam cells.
        And I have just read in Katyao’s link : “Treatment of obese mice with CS reduced the extension of foam cell coverage in atheromatous plaques of arterial bifurcations by 62.5%”

        That’s what Chondroitin Sulfate does reduce foam cells in arteial plaques…

        Bugger ! Morrison had the solution to CVD in 1972 !!

        1. Gary Ogden

          Bill in Oz: I’m not clear about this. Is it saying that foam cells are removed from plaques? That plaques are reduces in size, including the foam cells? Or that plaque growth is halted or reversed?

          1. Bill In Oz

            Fair enough question Gary. But I will leave some of the more technically minded folk here to sort out those details..I need a lazy day in the garden ! Spring is happening here ! 🙂

          2. Gary Ogden

            Bill in Oz: Hooray for that. Spring is lovely, as is Fall. We’ve finally lost the brutal heat (normal here), and I’m getting out, too.

        2. Andy S

          Hi Bill, thanks for bringing topic of macrophages back into the discussion. They look like an important player in CVD. I could be wrong but my understanding is that there are two main types of macrophages. The M1 types are designated as inflammatory, their favourite food is oxLDL. Phagocytosis is an inflammatory process. A foam cell is a fat macrophage.
          The M2 type is a repair macrophage. Circulating monocytes can turn into macrophages, but under hyperglycaemic conditions more M2 types will be produced. Immune function is reduced because there are now less M1 types to take care of pathogens.
          It appears that chondroitin sulphate also creates less M1 macrophages that can turn into foam cells. A further complication is that there are also tissue residing macrophages.

          My hypothesis is that the circulating macrophages phagocytose most of the oxLDL. The resultant cholesterol is removed from the macrophage by HDL. Macrophages/foam cells that end up below the endothelium are harder to dislodge and keep accumulating. Solution is to reduce formation of oxLDL. This is not the cholesterol hypothesis, it is the oxLDL/macrophage hypothesis.

          1. Bill In Oz

            Andy, your hypothesis may well be on the money. But it will take scientific research & significant funding to prove it. And I doubt that any Pharmaceutical companies would pour money into it as they cannot patent Chondroitin Sulfate and get great profits from the research …..

            byt maybe if a significant group of CVD patients took CS every day, after a few years we might again prove ( as did Lester Morrison in the 1960-70’s ), that CS works…

            But then the link that Katyao provided says that their research eas baded on the evidence that people taking CS to alleviate arthritis also had fewer heart attacks….

            Ummm ?

          2. Andy S

            Hi Bill,
            My faith in pharmaceutical companies research is hovering close to zero. The internet, if used with caution can be a better tool.
            I supplement the soil in my raised beds with epsom salt (magnesium sulphate). Sulphur is essential for plants and animals. Stumbled across MSM (Methyl Sulfonyl Methane) and use it every day to supplement sulphur obtained from food. Damage will occur if vital components are insufficient. This is why I love eggs, lots of essential building blocks; cholesterol, albumin and sulphur.

      3. Bill In Oz

        Andy, re Pharmaceutical companies. my faith is close to zero as well….No argument from me on that…

        But I do not know any other major pots of gold to fund such research….
        Improving the Magnesium level in your garden soil can be a good idea. It depends on the climate as soils in dry dessert areas tend not to be deficient in Magnesium.
        Also Epsom salts is very water soluble and is lost rapidly whenever it rains. Dolomite lime with a reasonable level of Magnesium Carbonate is a better option.

  41. Charles Gale

    Mr Chris and Chris C

    Re. Dr Mike Eades’ website/blog…

    …I’m on his email list and got an update back in April and he’s been, amongst other things:

    – v.busy with Protein Power 2.0
    – dealing with other projects
    – new website is under construction and needs get that ready before migrating everything over
    – and other stuff life throws at you e.g. huge problems with weather wrecking the area where he lives.

    The current website is still of course a source of great, decent and trustworthy info. I always visit his website in response, for example, to blogs on albumin.

    He is active on Twitter. Just put his name into Google and select the Twitter option. Lots of familiar names appear as you scroll down.

    Mr Chris – lp(a)

    Like you, and a few others here, I monitored my lp(a) levels in conjunction with vit C supplementation. Like you, the levels went down BUT…

    …I couldn’t bring myself to stop taking vit C to see if the levels back went up.

    But I’m pleased to have low levels.

  42. Charles Gale

    Serum albumin levels and CVD

    As I type this (evening Wed 19 Sept) there has been 104 comments, with some commenters providing serum albumin levels:

    Gary Ogden (within normal range)
    me (within normal)
    BobM (within normal range)
    foodnstuff (within limits)

    Of the 4, I have been on the cardio slab/intensive care but I’m not sure (sorry folks) about everybody else who has posted their albumin results.

    Over the last 2+ years, I have been made aware (via Dr Kendrick and commenters) of the many causes of CVD.

    I haven’t wavered in my conviction that stress was my downfall.

    I guess I would be interested to know if:

    – anybody has had a CVD incident with low serum albumin
    – or any other experience/issues arising from low serum albumin

    In the meantime, perhaps it’s time to invest in a suitable cooking pot to slow cook those left over bones…glycocalyx, chondroitin sulphate and albumin have loomed large in recent post/comments and also to visit Mark Sissons’ website:


    1. Bill In Oz

      Charles, ye s stress is definitely a major cause..But the question then becomes how to benefit most from the body’s own repair & healing processes…

      Plaque formation in the artery is a repairing process. It is a ‘scab’ on a wound.

      But new endothelial tissue forms ‘above’ the plaque because the scab cannot peel away later.

      So the plaque/scab is now below the new endothelium layer of the artery…And the body’s macrophages start the process of dissolving the plaque.

      BUT these macrophages often become bloated foam cells and cannot in turn break down and be carried away..

      And in some way which needs further research Chondroitin Sulfate reduces plaquw. The mouse study showed a reduction of 62%..Now all of that is interesting I think and offers hope for an improved healing process. for CVD..

    1. AhNotepad

      Frances, thanks for the link. It is a very acedemic site, I prefer the syyle in “The Great Cholesterol Con” by….., um…. I’ve forgotten, but he’s a good guy.

      1. chris c

        It’s like a zombie clawing its way back out of the grave. There was a thread on Twitter bashing this study because it would scare people off their statins and low fat diets. Er no, possibly it might point people away from the LDL zombies and towards what ACTUALLY causes CVD.

        I only just got around to reading the recently posted studies on macrophages and chondroitin because I had a lot of other reading backed up thanks to Medical Twitter and other blogs. Great stuff which deserves further study.

        I was also ploughing through this

        Metabolic features and regulation of the healing cycle—A new model for chronic disease pathogenesis and treatment


        a thoughtful and complex look at the healing process

      2. Angelica

        Thank you, Chris C. I’m going to mention that Robert Naviaux article on Twitter. I know that medical center from years ago and even today, they put out great stuff about ageing and mitochondrial causes of illness that blows my mind. There’s a ‘center’ for studying Ageing there that has a long tradition of looking at Mitochondrial causes. Bruce Ames, a pioneer in studying vitamin status of people in the USA (we have more deficiencies than we thought) was once associated with it. If you haven’t heard of Bruce Ames PhD, check him out. I have an article on my blog about him ( nutrition scientist is in the title), but there are much more in-depth biographies of him. He has protege’s, thank God. Amusingly, he’s been excoriated for selling Juvenon, but many rheumatologists, including mine, actually recommend taking the two main components of it, they just don’t use the trademark name. If you’ve heard of alpha-lipoic acid taken with acetyl l-carnitine, then you’ve heard of Juvenon, but without the trademark. People in science can be so petty when there’s no pharmaco to protect your image. Not sure Juvenon is even sold anymore, but I’m glad the idea stuck.

  43. Charles Gale

    Bill in Oz

    Many thanks for all your contributions on both chondroitin sulphate (CS) and macrophages.

    Also, I appreciate the supplement brand recommendation – I try and resist adding to my supplementation regime but it’s hard to overlook the overwhelming evidence/data for CS.

    I try and see what lab testing is available to monitor levels and seem to recall there was nothing available for CS apart from those doing the research such as Stephanie Seneff. Don’t suppose you know any different?

    And I note your comments (having reviewed katyao’s link) that CS reduced foam cell coverage in arterial plaque in mice.

    Any thoughts on:

    you quote someone who said (some) macrophages become trapped, die and become foam cells. On the one hand it just seems to be another flaw in the human body that they become trapped (how – subsumed into the plaque?) while doing their repair work. On the other hand, nature/evolution turns the trapped macrophages into foam cells.

    And if your CS levels are good the foam cell coverage will be reduced.

    And if your CS levels are low, what happens to the trapped foam cells?

    I’ve attached a link to a 2017 article by Stephanie Seneff on the Weston A Price website on CS deficiency:


    Low CS levels are possible but CS can be increased/produced through sunlight, certain foods and supplementation.

    I’ll wager there are many out with low CS levels and thus with trapped foam cells (if they have arterial plaque development).

    In addition to asking what happens to foam cells with low CS levels, would there be anyway to ascertain foam cell coverage in plaques (for us folks not doing the research)?

    1. Bill In Oz

      HI Charles, I try to keep things simple as in trying to understand complexity I get confused. So since early 2017, having discovered the research of Dr Lester Morrison at Linda Loma in California, I have simply followed his suggested CS protocol. He developed that protocol in 1969. And I am not a vegetarian.

      What does CS do ? Well clearly it boosts the effectiveness of the body’s healing & repair natural processes.

      Does it reduce the causes of CVD ? Clearly it does not. But then as we know from Dr Kendrick’s writing there are many things that are causal for CVD. So eliminating all the causes for many of us is problematic or difficult.

      But staying fit, losing weight & no longer being being fat, not smoking and staying away from high sugar fods & industrial seed oils in the diet, all seem valuable as well as other supplements like magnesium, potassium, D3, K2, Vitamin E, Uniquinol etc.

  44. Göran Sjöberg

    I just had a great newsletter from Uffe Ravnskov but don’t know how to link to that if it is at all possible.

    He is the though creator of the cholesterol skeptics in his international collaboration THINCS. I am pretty sure Malcolm is a part of this network of 1200 very knowledgeable sceptic people.

    Here you can learn more about THINCS


  45. katyao

    It makes my day to make your day, Dr. K! 🙂 Thank you.

    Thank you also for the responses back and forth; very interesting that CSA was first tested for CVD in 1969! I asked the Examine.com team (they do high quality lit reviews of supplements) to do a more updated review for CSA for CVD prevention, so hopefully that will happen at some point.

    Also I have to credit Dr. Cate Shanahan, an MD who promotes traditional/ancestral ways of eating, who first mentioned the importance of eating connective tissue (and inherent glycosaminoglycans) to health in the blogosphere. She had noticed that during her practice in Hawaii, the elderly Hawaiians who ate the most traditional foods had great health into old age.

    I’d be very interested to know more about how the genetics evidence ties in with everything. For example, they are now doing polygenic risk scores for myocardial infarction risk stratification. 2/3rds of the genes near the unbiased GWAS-generated signals are related to lipid metabolism, but the last third has “unknown” relevance to CVD. One of these studies (using mendelian randomization) out of Sek Kathiresan’s lab showed that, for example, high HDL is only correlated with good cardiovascular health due to its correlation with low triglycerides (http://www.kathiresanlab.org/our-questions/hdl-cholesterol-causally-protect-risk-heart-attack/). Genetics can be a powerful method to (dis)prove longstanding theories.

    1. Gary Ogden

      katyao: Thanks. This, then, is why the TG/HDL ratio has predictive power, but therapeutic raising of HDL makes no difference.

  46. katyao

    * I should say that Cate Shanahan was of course not the first to recognize the value of connective tissue in the diet, she was just the first person I read online back in the day who mentioned glycosaminoglycan content of connective tissue as, in theory, related to healthfulness of the diet.

    Not to overinflate the impact of compounds like CSA and connective tissue, but I wonder what vegetarian sources of these components might be, and how traditionally vegetarian societies like certain Indian ones may have assured cardiovascular health. Nowadays Indian people have some of the highest / most early-onset rates of CVD; even companies in silicon valley are creating seminars on CVD prevention geared toward their Indian employees…

    1. Bill In Oz

      Katayo, I do not mind giving credit where it is deserved… However you are wrong to state that “Kate Shanahan was the first to recognise the value of connective tissue in the diet”.

      Dr Lester Morrison was doing research on the value of connective tissue in the diet back in the 1940’s..And stayed with that research until the 1970’s. He retired in 1980.

      The curious thing is that at the time the only source of Chondroitin Sulfate was the connective tissues of slaughtered livestock. And he was a researcher at Linda Loma University in California which is a Seventh Day Adventist sponsored teaching & research institution. And Seventh Day Adventists are of course mostly vegetarian.

      My own opinion is that his research was unwelcome at the time within the institution where he worked. And this got buried.

      CS however is now mostly sourced made by genetically modified bacteria in fermenting vats. So of course it is vegetarian friendly – sort of ! 🙂

    2. Sasha

      The first to recognize the value of connective tissue in the diet were probably Chinese hundreds of years ago)). That’s why they eat chicken feet.

  47. Angelica

    I love this! Thank you, so much! It explains for the first time, why liver health seems to be at the center of my illness. Whatever parts and pieces may break down, the liver is the one that I need to improve in order to improve overall. I’ve had that experience repeated over and over in my life. In ‘the South’ (USA), women whisper to each other the ‘wive’s tale’ (which actually works) that eating liver will normalize the menses and overall helps you feel better. My mother, when I was growing up, ensured I ate either liver or another organ meat once a week, so I grew up being ok with it, and even liking certain ones. I can gush like this forever. But the point is, you’ve basically shown that a high albumin level (or a normal one) might mean clots are not forming or sticking to the endothelial tissue and that’s a huge accomplishment. It might even mean that the reverse is also true. That overworked elderly livers, that deal with overmedication as a matter of course, are what’s killing our elders, not ‘old age, can’t do anything about it, shrug’ which is where we’re at. Ask around and you’ll hear tales of elderly persons, especially women who were rescued from ‘nusing homes,’ removed from the unnecessary meds, and lived another decade. You can hardly turn around in a senior center today without hearing that over and over again about different people.

    1. Sasha

      More than a wives’ tale. Chinese Medicine says that organs contain a lot of Jing (energetic foundation of life). Chinese dietary therapy says that as people get older they should get more of their protein and fat requirements from organ meats.

    2. Gary Ogden

      Angelica: Me, too! Liver ‘n’ onions, heart once in a while (it is rich in CoQ10). During WW!! the government encouraged Americans to eat organ meat, to save the muscle meat for the troops. Today you can’t even find organs in grocery stores, other than the ethnic ones (here Asian and Latino).

  48. Gay Corran

    The boxes to tick for receiving comments and future posts have disappeared. Is this because I am using my WordPress account for some reason I don’t understand, does anyone know?

  49. Charles Gale

    Gary Ogden – heart on the menu/CoQ10

    I try to incorporate organ meats into my diet every week and tried heart once.

    I can’t remember what animal it was from but decided to slow cook it – let it gently bubble away for a few hours – to tenderise it.

    It was still very rubbery. Never tried heart again.

    With CoQ10 one of my most important supplements, any tips on:

    – best type of heart (e.g. I’d imagine a cow’s heart would be quite tough). CoQ10 guy Dr Peter Langsjoen recommends “chicken hearts are really good cos birds have 3 times the concentration of Q as, say, cow cos they’re hyper and they fly” and
    – any cooking tips?


    1. Gary Ogden

      Charles Gale: Chicken liver pate is quite good. I’ve never eaten chicken heart (the cats get it). Pork heart is good. I prepare it just like I do beef, from the Nourishing Traditions recipe: Cut it into kebob-sized cubes, marinate it raw vinegar, olive oil, cumin, salt, pepper, paprika, annatto seeds (good source of vitamin E), and chopped garlic for 24 hours in the fridge. Put them on skewers and cook under the broiler, turning once. Delicious, and not tough at all. Lately I’ve chopped liver and heart (beef or pork) and mixed it with ground beef (I believe what you call mince in the Mother Country), garden herbs, garlic and onion, and form them into patties, to be frozen for later use. I think turkey giblets are the most nutrient dense of all, but am not certain of this. I, too, try to eat organs once a week.

    2. shirley3349

      Here is my Mum’s recipe for braised lambs’ hearts:
      Allow 1 – 2 hearts per person.
      Remove the valves from the hearts and clean them thoroughly inside and out. Then stuff them with sage and onion, omit (or do not eat) the breadcrumbs in the stuffing if on LCHF diet. Next brown them lightly in lard in a frying pan.
      Next place them in as small a casserole as possible with 1 small carrot and 1 small onion per heart.
      Add half inch of water plus salt and black pepper.to taste.
      Cook with the lid on in moderate oven, 160 – 170 C for about 2 hours, turning the hearts and topping up the water as necessary.
      Serve with a green vegetable, plus potatoes if not on a LCHF diet.
      This was one of her staple meals in North Wales at the time when there was rationing during WWII and was one of my favourite meals as a child. I still cook it occasionally for myself but my husband of 48 years won’t try it, or any other offal, though he does eat shop bought liver paté.

  50. Charles Gale

    Heart (edible!) suggestions.

    Thanks guys – sounds delicious. Can’t wait for the weekend shop to try heart again.

  51. katyao

    Regarding glucosamine again, I came across a potential role for it in blood glucose regulation in mice, however I do not have time now to see if there is any evidence for it helping with blood sugar regulation in humans. Perhaps this is part of the mechanism (in addition to mechanisms cited above) by which it lowers CVD:

    “Supplementation of aging C57BL/6 mice with
    D-glucosamine mediated lifespan
    extension correlating with an induction
    of mitochondrial biogenesis as well as
    lowered blood glucose levels (Weimer et al., 2014).”


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