Vitamin Supplements – Part Four
In this final post on supplementation (vitamin and others), I'm going to put out the exceptions to my general stance — that's not necessarily strictly against it, per se — that most of it is probably unnecessary. But first, a quick review.
In part one, I laid out the general position, which is that supplementation ought to be the exception, not the rule, and there ought to be clear reasons for supplementing. Study after study seems to have failed to find measurable benefit. In part two, I diverge into a criticism of what I'll call Neolithic Authoritarianism, and most particularly, the tendency of people to submit themselves to the will and authority of others; to, in essence, default on their responsibilities as rational animals. Finally, in part three, I demonstrate very clearly that a diet consisting of natural animal fats, meat, fowl, fish, vegetables, fruits, and nuts to the exclusion of all grains, rice, legumes, heavy starches, vegetable oils — and most particularly, all the 'frankenfood' derived therefrom — literally knocks the average ADA, AHA or any other alphabet soup agency's "eat-more-whole-grains" recommended diets out of the water in terms of nutritional content. In some cases, the nutrition is 300% higher and more.
So, to summarize, it ought to be the position of Paleolithic eaters to source whole, real food, eat it, and enjoy the superior nutritional benefits. Finally, there's one case in which I do advocate heavy supplementation (you name it): if you're eating the crap grain-based diet most people eat. It's probably not going to do you any good, but what the hell.
– By far, the most necessary supplement is vitamin D, and it should be in the D3 form and not the plant-derived D2 form. I have posted a lot on vitamin D, so I'll not rehash. You can click here to access most, if not all of my past posts. The epidemiology is pretty clear: you need a 25 (OH) D level of 50 ng/ml to get to the point of real (associated) protection from cancer and a host of other bad things. Take it in gel cap form only, and the most consistent recommendation is in the area of 5,000 IU per day (you can take the whole thing weekly, too). But get tested after about three months and adjust as needed. I'm shooting for a level of 80. I take 6,000 IU per day, and I use the Carlson mini gel caps.
Why supplement with D? Most people are severely deficient, and even more so the darker their skin and the father away from the equator. To make matters worse, we're indoors most of the time, now, and as you age, your skin's ability to synthesize the hormone (it's not actually a vitamin) diminishes.
– Next on the list of important supplements is omega 3 fatty acids. The reason for this is that a natural, Paleolithic diet would have a ratio of omega 6 to omega 3 at anywhere from about .5/1 to 4/1. The typical American diet with its processed foods, most particularly high n-6 vegetable oils lies in a completely perverse range of 15/1 to 30/1. I have not blogged a lot about this, but here's a post that addresses some of the problems, and be sure to read the reference links.
So, because of the difficulty of ingesting too much omega 6, I want to get some omega 3 in my diet to atone for my sins. Probably the chief way I get too much omega 6 is that I don't always buy free range beef and eggs. Animals fed grains have a different fatty acid profile. The other thing is that though I've been eating a lot of fish lately (good source), it's not always that way. So, I take about 5 grams per day of fish oil, 3 as Norwegian salmon, and 2 as cod liver oil. I use these two Carlson products, here and here. On a final note, be careful with CLO. Some products have way too much vitamin A (like 10k IU per gram and more). The product I use has 2,000 units, so my daily dose is only 4,000 of A (note: I don't take this for either the A or D, but for the n-3). There have been some concerns lately about vitamin A toxicity, and there may be, but what it is is really vitamin D deficiency. Stephan explains completely.
– The last of the essential supplements is vitamin K2, menatetrenone (MK-4). This is one I've also blogged a lot about, so for the reasons why, click here to access most or all of my posts. There is now another issue regarding K2 that has just recently come to light, and that has to do with the potential benefits of the longer chain menaquinones -7, -8, and -9. These are forms created by bacteria during fermentation, for things such as (real) cheese. The -4 subform is the kind made by animals (from K1) for other animals (like us). It's interesting to note that the richest natural sources of MK-4 are to be found in eggs and mammalian milk (including humans).
So, though I think that -4 is the one to take, in the interest of full disclosure, here's the latest news I blogged about last week. And, be sure to read Stephan's review of the study full text as well. Here's the thing to keep in mind about K2. It works to activate vitamins A and D, and helps to ensure that calcium and other salts go everyplace they should (bones and teeth), and no place they shouldn't (arteries). Note in some of my posts that atherosclerosis has been reversed in rats through K2 (MK-4) supplementation. This is also the stuff Weston Price used to use, in combo with A and D to recalcify dental carries (cavities) back in the 1930s.
I used to take the very thing Weston Price used, butter oil, from grass fed cows. The butter fat is clarified and then centrifuged, and it's only a certain portion that has the K2. This is the Green Pastures product I used up until just a few weeks ago. The "Activator X" is the K2, as explained by Chris Masterjohn. The problem is that I don't know the dose, and nobody seems to, so I've gone to a synthetic, by Thorne Research. Each drop is 1 mg. I was taking one, but I've gone to two as I found that two made my skin baby soft overnight. That's quite a bit more than you would get from diet unless you eat a lot of foie gras (huge content), but I'm just going with that, for now. I do have a small bit of calcification in one of my coronary arteries, according to a recent heart scan, so I'm taking this as a therapeutic measure. In another six months I'll have another scan. If you want to simulate how you might get it from diet and don't want to eat a lot of fish eggs and beef (or venison) liver, then you could put a drop of the Thorne product in something that you consume over 3-4 days.
– There's one non-essential supplement I use, and that's whey powder. I posted about it back here. Because a Paleolithic diet leaves one in a state of rarely being very hungy, the whey gives me a chance to get protein in a very light meal a couple of times per week. I typically have it the morning after a workout day, and I always mix it with one or two eggs and plenty of fat in the fom of heavy cream and coconut oil. It's a fully nutritious meal, just not bulky and filling.
~~~
On a final note, I am open to other suggestions for essential supplementation. Drop 'em in the comments. Moreover, I fully recognize that there is a whole science to supplementation in the pursuit of life extension. Any information on that score is welcome too. I consider that far different than what I'm doing here, which is bare nuts and bolts, and most people can understand why they would and should take these supplements.
However, some of the regimes of the life extension folks are pretty extensive, including dozens of various supplements. My opinion is that nobody should undertake such a regime without knowing as much as can be known about every single supplement they take and why they're taking it.
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Justin
This link to Dr.Davis will explain a little further what Brock has already correctly described.
https://web.archive.org/web/20180524054619/http://heartscanblog.blogspot.com:80/2009/02/what-vitamin-d-form.html
Richard,
I have learned a lot from you about Vit D3 and K2…thanks. I would personally suggest you go light on the heart scans. While there is an urge to check up on things, and some benefit to knowing, you need to weigh this against the radiation exposure. The amount of ionizing radiation in a CT for coronary calcium scoring is enought to significantly elevate your lifetime risk of lymphoma/leukemia…perhaps more than D3 and K2 could make up for. Also, check back on Art Devany's blog for my answer to your question about your Dad's glucose level.
Doug McGuff
Hi Richard
Great blog. I've heard from various sources that modern soils, especially conventionally farmed soils provide crops with less nourishment (minerals) than say wild plants would get. Since plants obviously have been part of the ancestral diet, wouldn't that suggest ancestral man would have been better nourished than us even eating paleo? Do you think this gives us some grounds for taking a multi-vitamin albeit less frequently than daily?
Its the minerals mostly that I worry about. I take calcium and magnesium. I also take one or two multis a week to make sure I'm getting enough minerals.
Richard,
I've been taking D-3 supplements for about a week now, but in pill rather than gel-cap form. Is there a particular reason why gel-caps are preferable?
Also, a cursory search of local vitamin stores/pharmacies turned up no Vitamin K2. I suspect I will need to order it online.
Again, thanks for the post. Between you and other blogs, I've been adding to my collective knowledge day bay day. I started the Paleo lifestyle about two weeks ago (after two weeks of Atkins induction). In the span of four weeks, I've lost nearly 20 pounds and have gone down a pant size (235lbs to 215lbs, size 38 to size 36). And, that's without going to the gym…though, I plan to start going soon. I'm 5'9", 37 years old.
My ideal weight is 180lbs. I've told myself for years that there was no way in hell I'd ever see the other side of 200lbs. Now, it looks like I'm going to break that barrier.
Please, keep up the good work.
-Justin
Justin, Dr. William Davis has found that when you take the tablet form of D3 your blood levels of 25 (OH) D don't change very much. This is probably because D3 is fat soluble and your body can't absorb it well unless it's dissolved in an oil. But regardless – take the oil caps. That's how it reaches your blood stream.
I guess this is going to sound like I am bashing all doctors (which I'm not); but I'd rather read blogs like yours, Richard (and the ones you link to) than have to deal with a statin pusher of a doctor.
One of the other commenters on Dr. Michael Eades's blog said that she went to 10 doctors before she found a "gem." Well, even if I had the money to do that (at how many dollars a pop for an office visit?), I'd not be inclined.
If I can find one simpatico with low-carb through word-of-mouth, I'd consider going. Right now I am going to a county clinic, because that's what I can afford.
The nutritional ignorance of many doctors, coupled with their arrogance, is something I just find extremely off-putting.
Over four years ago, I went to see a doctor whom I knew socially slightly. I suspected I had diabetes (which he confirmed). I took with me a bunch of material on low-carbing, etc., none of which he would even look at.
He wanted me to go on Slim-Fast! He was stuck on stupid, as in a calorie was a calorie, that's what he'd been taught, and he didn't want to be confused by anything more up-to-date.
He was ignorant and arrogant. Boy, was it ever a mistake going to see him.
My significant other, Sam, was never even a patient of his.
Sam, however, had undergone cardiac bypass in his mid-40s. He has low vision, and also has never learned to cook very much for himself, so he has mostly relied on restaurant food of one sort or another.
A couple of years ago, Sam had some chest pain, for which I took him to a local ER. Before he went, however, he e-mailed some friends to let them know what he was up to, one of whom was Dr. Stupid.
Sam ended up with a couple of stents being placed. I'm not in favor of this kind of treatment–I'd rather undergo chelation if something must be done.
Well, during the several days Sam was in the hospital, Dr. Stupid called up. We chatted a bit about Sam's problem. Then, out of the blue, he told me that if I were to discourage Sam from taking statins, I was helping to dig his grave! Now, remember, Sam was never even Dr. Stupid's patient, and I had told Dr. Stupid that I wanted to seek out a doctor who was more nutritionally aware.
I got off the phone in a hurry after saying that I didn't have the time to argue with him. I then sent him a nastygram in e-mail, telling him not to ever call our house again, and also cussing him out.
This moron forwarded my note around to a lot of people, with him stating that he had no idea why, out of the blue, I had gotten nasty. This moron had ABSOLUTELY NO CLUE that he had insulted me.
I guess that one of the lower division courses in medical school must be Condescension 101… that, or else they absorb it by osmosis.
At any rate, I have done medical transcription for over 20 years now, and I don't see much evidence of the tide turning. They are still turning out statin pushers from the medical schools.
One of the hospitals I transcribe for is a major teaching hospital down here in So. Cal., and it seems that the interns and residents are being robotically (and idiotically) trained to push statins, just like the full-fledged doctors do.
Just about every patient has a diagnosis of "hypercholesterolemia." Just about every cardiac patient is discharged on statins and a "heart-healthy, low-fat diet."
I get the gut feeling that Taubes's GCBC is a best-seller among lay people, but it's rather a harder sell among medical professionals, who don't want to be confused with facts.
If I broke an arm or a leg, I'd have no hesitation about having the fracture set.
However, my family tree is riddled with cancer, and I've long been disgusted by and scared of conventional treatment for such a degenerative disease, so once I got out on my own, I started reading bits and pieces regarding alternative medicine.
I remember what an uncle went through after being diagnosed with laryngeal cancer–it wasn't pretty–and it got me to thinking that there had to be a better way to deal with such things.
I'm attempting to better my health by following at least some of the suggestions here and on other blogs.
Oh yeah, one of the first things Dr. Stupid wanted to do (even before any lab results were in) was to write a prescription for a statin!
I was willing to take metformin (a lot of people in the life extension community use it to help lose weight), and maybe a blood pressure medication, but I absolutely refused to take a statin.
He also just "forgot" to order a CBC, which I thought was something necessary to get an idea of a patient's baseline status; and so that I would be able to know whether my fatigue was due to not only diabetes but perhaps to anemia (found out later I'm not anemic).
One more comment, on a somewhat different subject: I know that we're supposed to live in sync with the sun, and that it's healthier to live that way, but I've always been nocturnal. I function better in the evening and at night… I even frequently type faster after midnight.
I have just started taking a D3 supplement this past week (4,000 IU daily, plus cod liver oil). My next supplement to try is the K2 (MK-4); either I'll go to the Vitamin Shoppe or order some raw butter from Organic Pastures.
http://www.proteinpower.com/drmike/statins/statin-panic/
As you already know,
Dr. Eades protests primary prevention, but is somewhat favoring seconary prevention. The general public misses this point.
From his blog…
"The three papers used for the section on men diagnosed with heart disease were the LIPID study and the CARE study, both published in the New England Journal of Medicine and the Scandinavian Simvistatin Survival Study Group study publised in Lancet. As you can see from the abstracts, the LIPID study and the SSSG study both showed a decreased risk of another heart attack, decreased risk of dying from heart disease, and a decreased all-cause mortality. But, these decreases in risk are smaller than they appear because they are couched as ‘relative risk reduction.” The absolute risk reduction ain’t all that great, which was why I wrote that the risk reduction was slight. The third study, the CARE study, shows a reduction of risk of recurrent heart disease but no decreased risk of death from heart disease nor from all-cause mortality.
Hope this helps.
MRE"
Statin after stent placement or in an ACUTE MI is given for a different reason. Too bad the doctor bashers dont read the package insert or understand the mechanism. Thats why I paid $200,000 for med school. However, for general cholesterol management, try any diet possible before getting on a statin.
Orcas in the ER…I see that everyday, now in younger and younger patients. I am a radiologist and we are involved in a study evaluating visceral fat with MRI. Its amazing how many obese kids are out there.
Richard, you are absolutely correct about the robotic thing. In medicine its called "evidenced based medicine". We follow a treatment algorithm based randomized control trial double blind studies, and thats what the transcriptionist see. Patient that comes in with chest pain, has a cardiac cath, found to have coronary artery disease not requring immediate intervention gets discharged on aspirin and statin. Same with stroke. Does that solve their obesity and bad diet? No. Does it reduce the risk of having a second cardiac/stroke event? Yes!! (As you pointed out in your comment to Pam.)
I would have to disagree with Pam on not giving a statin to her partner after stent placement. I would even go as far as removing myself from that patients care or document refusal. The thing that bothers me is non scientist and non medical people with peripheral knowlegdge applying it haphazardly. That is more dangerous than not knowing at all. (Not you, Richard. You have done your homework, along with many other people on this blog.) No statin after stent placement??? thats just as stupid as Dr. Stupid.
On the otherhand, doctors need to listen to their patients more and respect their wishes.
Good job, Justin.
In case you didn't see the replies to your comment see Brock's and 1968Tigers about the D3 and why it should be taken in gel caps. Nice thing is, it's pretty inexpensive. As to the K2, I've seen some in various places, but it's usually the -7, and it's often way to high per dose, like 15 mg. You'll probably need to get that online. If I was going to do that now, I might be inclined to go for the Life Extensions product I linked. The Thorne, however, is very easy to dose.
I guess the doctor-basher bashers completely missed the point that Dr. Stupid wanted to put me on a statin even before he had any laboratory work back.
They also seem to have missed that I came to Dr. Stupid's office armed with a bunch of stuff on low-carbing, which he refused to even look at.
He was really only interested in pushing statins and other pills.
And in any case, from where I sit, doctors don't seem very interested in keeping up with the latest in science-based nutrition, which just might avoid any so-called need for statins, bypasses, and stents in the first place.
I guess no one's ever heard of chelation, either IV or oral?
It's pretty radical and traumatic to immediately progress to cracking one's chest open, but I guess that to those with the fancy MD degrees, it's all just routine now.
And they advocate diets which caused the inflammation in the first place, then advocate more of the same.
I've read some stuff which indicates that for many people, there isn't much of a long-term benefit (in terms of overall longevity) in many of these cardiac interventions. You don't necessarily live longer just because you've had a bypass.
And the conduits, in any case, frequently get blocked up over time, sometimes within a matter of weeks (and this "necessitates" another $50,000 operation).
I guess those fancy medical degrees entitle doctors to condescend to the rest of us, who actually are looking for guidance, but who really want something more, better, and different than what we are being offered by the mainstream doctors.
Thanks, those of you who look down your nose at those of us who aren't enthusiastic about your "treatments." You just gave me one more reason to stay away from you and take vitamins instead.
Speaking of paleo-friendly, low-carb friendly, non-statinating doctors, can anybody here recommend one in the Dallas-Fort Worth metroplex?
As a transcriptionist, I have one more comment for all of you Masters of Condescension… if all of you MD types are so brilliant, then why do so many of you sound like total idiots when it comes to dictating your reports?
It seems it wouldn't be too much to ask, if it's so all-fired important to transcribe your reports correctly, that doctors enunciate half-decently instead of mumble, and that they refrain from chewing gum, eating, slurping cough drops or hard candy, sniffing their runny noses, etc. (which are right in our ears) while they are dictating.
They don't seem to realize (perhaps not to care) that all the shlomping sounds made when chewing go directly into our ears.
A lot of people might be surprised at how poorly-spoken many doctors are (even the U.S. born ones). And a good transcriptionist always verifies the spelling of ANYTHING a doctor spells out, even the patient's name where possible.
Yeah, I realize that dictating reports is the last thing a doctor might want to do, especially at the end of the day, and that doing your reports often doesn't put money in your pocket… but for crissakes have some respect for those of us who make a living transcribing your crappy dictation.
I for one don't like the authoritarian attitude of the one doctor I wrote about above.
When I go to a doctor, I want information. I want to be able to ask questions, not be actively discouraged from learning more about health. I don't want to be patted on the head and told that doctor knows best, and to just shut up about all the other treatments the doctor doesn't want you to know about.
Hey, Richard, what about the well-documented hazards of statins? Losing your memory. Getting horrific leg cramps. Aren't those to be considered?
I don't know about anyone else, but I've transcribed reports for people who spend the last decade of their lives being shuttled back-and-forth between the retirement home and the emergency room.
They can't recognize anybody (sometimes not themselves), they have to wear a diaper, but boy are they on statins! I guess nobody seems to care if maybe their mental degeneration was at least somewhat connected to statin use?
From what I've read, the usefulness of statins is iffy at best, whether for men or women, and the loss of one's mental faculties is pretty serious in my book.
But from what I've read from the Doctors Eades, Mary Enig, Ph.D. (lipid chemist), Dr. Uffe Ravnskov, and others, the cholesterol theory of heart disease was pretty much made up out of whole cloth. Thank Ancel Keys and his buddies.
I'm amazed that no one talks about just how highly politicized and politically correct medicine is and has been.
Gee, a high cholesterol level? What the hell does it mean, anyway? Why is it there? How did the lesions get on the arterial walls? Seems few ever ask those questions; they'd rather just whisk out the Rx pad and start you on a statin.
Cholesterol is part of every cell, and necessary, not a demon substance. Your brain is made of fat. The whole damned body needs fat.
From other sources, it seems that the cholesterol is actually part of the body's attempt to repair a lesion that was already there.
But no, doctors have been trained in this hysterical anti-fat, anti-cholesterol crusade.
From what I've read on Dr. Michael Eades's blog, a lot of those studies purporting to show how wonderful statins are, are flawed at best, and don't really show what they're purported to show.
Sorry, but I'm just not buying it. And I'm never taking a statin, either.
About 10 years ago, I had an extremely severe case of bronchitis. I ended up in the ER three times. One ER doctor called it "viral whooping cough." It was everywhere. Kids would get over it in two weeks, but with adults it lingered for months, literally.
I coughed so hard that I thought I broke a rib and was also gagging; I had pretty severe chest pain on one side of my rib cage.
A PA put me on Biaxin, but it didn't help. A course of erythromycin helped some, but not much. I was sick for about two months. Even now, sometimes I have a catch in my breath with deep breathing, and I no longer have the breath control for singing that I used to have.
One of the times I was in the ER for that episode, the doctor ridiculed the very idea that I could break a rib from too much coughing–he claimed it was "only" pleurisy. He also ridiculed the idea of average people (like me) looking up information on the Internet; but he wasn't forthcoming with very much information, either.
However, later one of the nurses took me aside and said, yes, it IS possible to break a rib from severe coughing. She herself had had this nasty illness.
Yeah, one more comment and then I will get to work here… you MDs seem to forget that there is more to medicine, and always has been more, than what the AMA and the other alphabet-soup organizations want to be made available.
And it's appalling the persecution some courageous doctors have undergone when they attempt to follow an intellectual path which is different from what the AMA sanctions.
Doctors have usually been forbidden to advertise. If, for instance, you read Dr. Bernstein's books on diabetes, and you'd like to find someone local who knows something about his approach (because you can't afford the money and time to go see Dr. Bernstein in New York), you'll have a tough time.
Even going to Bernstein's website and forums, where I used to hang out at one time, it was difficult to get a recommendation. A lot of people had gone through multiple doctors before finding one they could work with.
Or… wow… I've read about chelation and I want to find a doctor who does that who is local to me, or I want to find a doctor who is amenable to some other kind of alternative medicine… well, good luck! Because there's a big underground, and you will have to ask the right questions.
If a doctor strays off the beaten path, he is actually liable to be prosecuted for his heroism, have his license taken away, and be ridiculed as a "quack." And patients who are interested in one of these unusual doctors are likely to be ridiculed by the mainstream as well.
All because medicine is highly regulated and politicized.
Curiously, since going on D supplementation, I have become more nocturnal myself. Whereas, I usually used to conk out around 10 or so, I now rarely feel like hitting the sack before 12 or 1 am.
Also, I rarely feel like eating much during the day. I usually eat something anywhere between 10am and 1pm, then I like a rather late dinner, 7-8m and then I like to graze on nuts to about 10 or so, or sometimes I fix a late-night omelet (usually plain, or maybe with a little onion. Curiously, and I never thought this would happen, but I don't have a desire for eggs for first meal, anymore. I get a hunger for eggs at night, now.
Sad story, Pam.
One thing I would want to note, and of course, I have no idea of the personal medical issues, but I think it's quite a different thing to put someone on statins just because of "elevated" cholesterol when no other symptoms of heart disease are present, and when there is clear heart disease. Someone can correct me if I'm wrong, but I believe statins have shown clear benefit to those with heart disease already. That's not to say that dietary and exercise changes ought not be employed too, of even that they are probably the better long term solution, but a short to medium term stint on statins may definitely be called for with a person already in dire straights.
I happen to agree with you, Paleo-N. Let's not toss the baby out with the bathwater. And, I'm sure Dr. Davis, as one example of a doctor who is not generally a fan of statins, readily concedes that they are indicated for some people in some situations.
And, again, setting aside the "pill pusher" dig, I fully agree that it's a wonderful thing to have all these pharmacological tools at our disposal, and especially when a patient won't modify diet and activity. The only thing I ask is that docs educate themselves about nutrition and fully inform patients that the drug approach is one, but may not be necessary long term, and that if possible, it would be better to modify lifestyle.
I also thing it's interesting, and this is by no means a scientific survey, but I have noted with great regularity over the past couple of years how many medical transcriptionists end up here and elsewhere, commenting. They see things up close, and I think they see a robotic sort of thing going on, i.e., the same treatments over and over, same dietary recommendations over and over, and yet America gets fatter and more diabetic, and people are taking more drugs than ever. And, at the same time, so many docs seem really put off and even arrogant about average people going out, educating themselves, and in many cases attaining far higher levels of knowledge about nutrition and metabolism than so many medical professionals..
Here's a good one to review:
https://freetheanimal.com/root/2008/10/orcas-in-the-er.html
white flag.
Dr. Doug:
Wow; thanks for the acknowledgement. It means a lot coming from someone of your stature.
About the scanning. I intend to have only one more (I did EBT, btw, if that makes any difference). My score, while low, was still in a higher risk category for my gender and particularly, age (48). Before I began this journey, at 230 pounds (5'10) — now at 180 and still losing — my BP was high, like 140-150 / 90-100 every time I checked. Once I hit the high intensity training (2 x 30 minute per week) BP began coming down almost immediately, and on average as well as usually being the lowest right after a workout. This was even before the diet and fasting.
Since, according to what I've learned from Dr. William Davis of Traque your Plaque, plaque can be reversed. In essence, I want to see whether I'm on the way up, or on the way down (or, at least, not getting worse). One more scan ought to give me some indication. However, I do think I'll wait a full year, so next December.
Thank you very much for your comment on behalf of my dad's high random BG over on Art's blog. I did see that yesterday, and in case you haven't seen my response, here it is:
~~~
Dr. Doug, Art:
Thanks so much. This is actually the first confirmation that I may have been intuitively right. It just made sense to me that if you go from a place to where your body almost never has to make much sugar to a place where it makes sugar all the time, there’s going to be some weird stuff there.
Back when I fist started doing IF a year ago, I had the crazy notion that I ought to do my 30-min intense workout at the end of the fast, just like an animal would typically be hunting hungry, not fed. I’ve never looked back. 90% of my workouts are in some degree of fast, from 18 to as much as 36 hours and in fact, I can no loner tolerate a workout if I’ve had anything to eat within 6 hours.
….Anyway, the point is that along the way I decided to test BG. I had already been fasted for 24 hours and it came in around 85, as I recall. Then I went and worked out, and 30 minutes after the workout, BG was 113! Clear evidence I’m metabolizing fat like crazy. So, when I heard this from my dad, I figured it was a good sign, really, that his body is relearning its evolutionary past as a fat burner.
BTW, Doug, I got Body by Science the other day for my Kindle 2 and am anxious to dive in. The first book I read when I began my journey nearly two years ago was John Little’s Max Contraction book. Interesting guy.
I've been taking D3 for 10 years. It's benefits we're above-and-beyond question even before then. I've been taking K2 for five years. Fish oil for 10 years. There are numerous other supplements that have profound benefits that you've yet to discover (I won't list them).
At almost 48, people never guess my age to be above 38, and often 35-ish. My health, which I have checked out with over 125 blood-based tests, as well as bone density scans, and arterial scans, is superb. No arterial plaque, for example. Hormones at the level of a 25-yr-old.
My 72-yr-old parents, who take a 40-pill-per-day supp program and eat somewhat healthy (still eat grains, unfortunately) are likewise is superb, high-energy health.
The right supps can make a huge difference. Now then, just as a low-carb diet is a subset of the superior paleo diet, the paleo diet is a subset of the superior longevity diet, which includes numerous supplements and other tactics that can add healthy years to a person's life. Here's my ranking of longevity tactics and the associated benefit:
o Diet — a 55 year swing of difference
o Exercise — 15 years
o Supplements — 10 years
o Hormone supplementation — 5 years
What the hell, taken from a post a post I wrote in a private forum, below are the singular supplements (not multi-formulations, like a multi-vitamin) that provide the most bang-for-the-buck. IMO, everyone should be taking these few supplements. The benefits are universal to everyone, convincingly well researched, and highly desirable for protecting a person's health. These are the current superstars, and between them have research stats showing that they can reduce all-cause mortality by at least 50% — potentially much higher.
o Vitamin C – 2000mg daily, in divided dosages (vit C has a half-life under an hour, so its benefits are not long lasting, and therefore need to be replenished several times daily).
o Vitamin D3 – numerous immunity and cancer-reducing benefits. Vit D3 alone reduces all-cause mortality significantly, perhaps as much as 50%. Most people are deficient. 6000-8000 I.U. a day recommended.
o Vitamin K2 (MK-4 version) – a very recent superstar, especially as a regulator of calcium, and keeping it from arterial accumulation (all plaque is approx 20-25% calcium). In fact, animal studies show complete coronary calcium reversal with K2. Most people are greatly deficient. 5mg a day recommended.
o Niacin – probably the best booster of HDL, which is highly protective of arterial disease. The key is to not take the no-flush version, which does not raise HDL. I take 100mg morning, and the same at night. The flushing is five minutes of discomfort I do not mind at all, because I look at it as feedback that it’s working.
o EPA/DHA (fish oil) – a long chain omega-3 polyunsaturated oil that has anti-inflammatory benefits. At most I recommend two grams daily. Polyunsaturated oils have a significant half-life (two years) and therefore do not require much daily replenishment. And since these oils are also easily oxidized (a pro-aging concern), they should be limited to as-needed-and-no-more supplementation.
o Magnesium – involved in 400+ biochemical processes, any of which can breakdown without adequate magnesium. Also required to counter-balance calcium (needed for muscle contraction) to allow for muscle relaxation. Most people are deficient. Taking the oxide form is a waste. 400mg a day recommended.
o Cocoa – a food supplement, via eating 10-15 grams dark chocolate daily (at least 70% cocoa content). Super dense in antioxidant, and especially polyphenols that lower blood pressure by generating nitric oxide in the endothelium.
o Coconut oil – another food supplement, primarily medium length saturated fat that’s processed not in the digestive tract but in the liver. Practically all animals fed coconut oil lose bodyfat, and experience reduced systemic inflammation. It’s unique energy producing pathway also poses less oxidative stress on the mitochondria. I eat about 50 grams daily, often a lot more. (Must only get the extra virgin type.) This is my exclusive cooking oil, too.
o Green (and/or) white tea – this was a leading superstar supplement before resveratrol and vit D3 stole the spotlight two years ago. Still, it’s health benefits are widely accepted and wide ranging, especially in the role of fighting cancer, boosting immunity, and in detoxification.
o Resveratrol – wide-ranging benefits, especially in terms of cardiovascular health and cancer prevention. May also extend human lifespans by positively expressing our survival genes. 250mg a day recommended.
o Pycnogenol – I hate to include a brand name on this list but this exceptional supplement is a strong anti-inflammatory (a key cause of cancers and heart disease), and also blocks the breakdown of complex carbs for up to eight hours. Well studied and absolutely safe. 100mg a day recommended.
o Melatonin – this hormone is the most important brain antioxidant, with numerous other significant full-body benefits.
Richard,
Thanks for your kind comments. I also believe plaque can be reversed. Here is another piece of unsolicited advice. It is my own theory that is not backed up by any research (just a hunch based on an understanding of the metabolic process involved).
The advice is not to invest in the money and radiation exposure to check your plaque until it is time. I would not rely on a random time (such as one year). You have made a VERY impressive transformation thus far, and I am certain you are still improving. The time to recheck your plaque would be when you have at least a "4 pack" of abs, and your bodyfat is around 10%. This is,IMO, an external signal that your insulin sensitivity on your most stubborn fat deposits is finally changing. I think this is likely the signal that insulin sensitivity is now high enough for those plaques to be de-constructed.
Good luck, and keep up the excellent blog. I check in daily.
Doug McGuff
Thanks Richard. Actually, I dont see patients anymore, only as an intern. I am now in my radiology residency. 5 more years to go! 4 years of college, 4 years of medical school and 7 years of residency and fellowship, pheww! And as a radiologist, don't get radiated so soon as McGuff says above.
Just as patients with minimal peripheral knowledge of medicine who apply it carte blanche without understanding the data, doctors who do not understand the limits of their own knowledge are dangerous. Humility is probably the hardest thing to learn for someone that has gone to school for 15 years.
What are some good cheeses that contain K2? Every cheese I've looked at uses pasturized milk (except Swiss.)
Cheese recommendations?
Paleo-N:
Perfect, really.
Here's the problem: collectivism. The evidence based approach is the best there is — if you're dealing with a bee hive or ant farm. Here's what I think: doctors are among the most caring people — as young people — who exist in society. Then, they discover the reality. They discover a world of corporate interests and political pressures (same thing, really). But after the huge investment (time, mostly — money is a secondary consideration; this is YEARS of your very, one-and-only LIFE). In a few words: I know you all care. But the system has now been oriented in a way that makes really caring for an individual patient in a way that really communicates to him so that he becomes your partner in his care is a loss (not only for you, but for your hospital, ushering in issues of competition amongst med students and young docs).
The odds are significantly stacked against the "youngster" to be any sort of maverick in terms of individual care. Once you establish yourself, you can be somewhat of a maverick. But how to get from one place to the other without conforming?
Here's what I think: a license to practice medicine involves a long, costly (time / money), and arduous journey to demonstrate that you can competently assign patients to an appropriate class or category and apply "evidence based medicine." Becoming a _good doctor_ is up to each licensee, and I'll add that "good" very often involves seeing patients not as members of a collective group, but as individuals.
All that said, who are the best ones to whom we ought to pound this message home? I remain thoroughly convinced that it is to the doctors themselves. In just the last two days I have received two emails from well established MDs telling me that not only have I pointed them to a thing or two, but that they want me to keep up the good work. That is encouraging on a number of levels.
Mike:
Jimmy Moore has a low-carb doctor website:
http://lowcarbdoctors.blogspot.com/
Pam:
I think your are being hard on Paleo Newbie. He's just starting his journey, and ultimately, his approach to patients is going to be a reflection of his own experience. So why try to beat him up?
Now, I don't know for sure that statins are the right thing for your hubby, qua individual human being, but I believe I'm on solid ground in saying that they probably are, given the severe conditions and the demonstrated benefit on the whole for people suffering those conditions. A Paleo diet may very well be the best LONG-TERM cure, if a cure is even possible, but it's no miracle. We have to face reality, and there's no blame to lay here; on you or the Mr. Most of us have had years of abuse to our bodies through recommended diet, and in my case, I can't believe how a Paleo-like approach has turned things around, even to the extent, really, that I feel more vibrant than I did even in college days. But, that's me, and I count myself fortunate that I discovered the way to eat before it was too late, or, before the road back would be a very long, risky and unsure road.
There's no magic. But, I hope it's not to late for your loved one.
I also hear your anger and frustration (allow this to be a general response to all your comments, unless I add something else). You so have a point. Doctors absolutely should be far more sensitive to people who have gone and done research, and they should treat them as worthy, intelligent beings. Now, consider that "Dr. Stupid" had come to you and said something like: "I know you're generally against statins, and you are absolutely right that they are WAY overprescribed, but wouldn't you allow me a few minutes to discuss with you why they might be a real value in this particular case?"
Different, eh?
So, I definitely think that you have a point, a very valid one. I thing my Paleo Newbie Dr. friend does as well, and I really want him to find out for himself, from his new experience, how he can really help patients better. And, if you don't mind my saying, where better than here, other than the top-notch blogs and other sane docs I link to?
Best to you and yours, Pam.
You know what, doc? That is very solid advice and I am going to follow it. (i.e., makes a lotta fuckin' sense 🙂
Pam:
"And it's appalling the persecution some courageous doctors have undergone when they attempt to follow an intellectual path which is different from what the AMA sanctions."
Paleo Newbie is, by his own admission, a newbie in this aspect. Can't we allow him a little space to become yet another doctor hero? I'm absolutely certain that he is seeing his patients as individuals, but he has a lot of training to "overcome," (that is, in a measured and deliberate context") it doesn't happen overnight, and he has a job and reputation to uphold. It would be great if he could be a maverick right out of med school, but all is set up to make that very unlikely if success is the goal.
Pam:
Of course, these are all in the fine print. That does not excuse the drug companies or med profession for not taking people as individuals. At the same time, there is a clear balancing act. If, for example, you have a patient who is in the 90th percentile for deriving a benefit from statins, isn't it worth the risk to get them on initially, particularly in dire cardiac distress conditions, and just monitor and see? We're not omniscient, and sometimes we have to take risks (but nobody ought to have to if they don't want).
But, I think it's hard to expect more from the med profession, such as it is, to have to try to know EVERYTHING in advance. I know I don't behave like that in my own life, even when in complete control of what I'm doing. At a point, I just reason that the risk is acceptable, and I launch.
As far as I know, anyone can stop taking meds at any time.
Pam:
But, now you're collectivizing. Yes, the sat fat and cholesterol crap is all just that.
That does not mean that statins (or any other rigorously approved drug) is not hugely beneficial to some people in some circumstances.
Here's what I want: I want to see docs that recognize there are some dammed informed people out there (maybe even more informed than they, with no plaques on walls). And, I want informed individuals to recognize what good doctors are up against. Do you thing Eades, Atkins, Davis, Enig, Ravnskov, Kiiwsnowski (sp?) and host of others just came out of med school cracking a whip?
Now, where I draw the line is with published research designed to either show the result they wanted in the first place, or manipulated, There, I name names and I will never be kind. I want to see their fraud highlighted in Google searches forevermore.
Don't sweat it, man. Pam is dealing with real family issues. I hate this sort of thing, but I hope my comments in reply have served to tone down the emotion, a bit. And I wish Pam and her loved one the very best.
Scott:
I wanted to get off a quick reply, mainly to gloat at my success at baiting you. 🙂
Seriously. I know who you are from comments here and elsewhere, I know you're a wealth, and so….
I'm fixing dinner for friends but can't wait to get more into this. Trust me: your post is not only welcome, but was backed in the cake.
Scott Miller,
We all know who u r…!!
I just wanted to thank you personally for your posts at theheart.org (and heartscanblog) and trying to affect the cardio idiots there.
You r a gem. Your optimism is quite infectious 🙂
And thanks for your supplement post here *ha* it's good you're here and your dad is so SO very LUCKY — I agree with EACH AND EVERY SUPPLEMENT and 'thought' that you've articulately expressed. I take these supplements prn as well (I'm ~37 and will make to 137 as my LAME genes can hopefully take me). How you became aware of health at such a young age doesn't cease to amaze me. I guess immortality can have early seeds.
-G
I just wanted to echo Scott Miller's recommendation for Magnesium supplementation. I have had heart palpitations my entire life and I have suffered from mild migraines for years. I had a doctor suggest I try a chelated form of magnesium in a 400mg daily dose. The result is that I now hardly ever get the palpitations and I have not had a migraine since I started to supplement. It's really quite amazing.
Dr. Larry McCleary, a neurosurgeon, wrote "The Brain Trust Program" and discusses why magnesium makes sense for migraines. Actually, the book is full of recommendations for supplementation from a brain health standpoint. He includes diet recommendations as well that aren't strictly Paleo, but he's on the right track for sure. It's a super easy read, you can finish the book in an evening. Highly recommended. He's a friend of the good Doctor Eades so that's also reason enough to check it out.
…Also, I began at about 35% BF and the little electronic thingy (that you clasp with both hands) now reads between 16-17%). So, closing in. I will get there.
I think they add the culture later, after pasteurization, and the K2 is produced by the bacteria during that fermentation process. So, in terms of K2, pasteurization probably doesn't matter.
Richard, there is a businessman on the web who plagiarizes the stuff Art DeVany and others write in the area of palaeo nutrition and exercise and then sells it off for profit with his own copyright.
You may already know who he is. That's not what's important for this topic. What is relevant is that for the supplements he recommends, he generally lists the natural sources of these chemicals, so people can make their own choices about supplementation through pharmaceuticals, supplementation through healthy food and activity regimes or a combination.
What can you suggest about the sources our Palaeolithic ancestors had for vitamin D (3), Omega-3s (I think we all know the answer to that one), vitamin K2, menatetrenone (MK-4)?
As to other supplements, there are soils which are either deficient in certain minerals or else the minerals, though present, are locked up in very stable compounds because the soil microbes (bacteria and fungi) have been disabled through aridification or other degradation. Soils in parts of China are, effectively, deficient in iodine. Soils in Australia ("the oldest continent") have lost a lot of their selenium. It's no good Chinese using USDA data to find out how much iodine is present in foods grown in parts of their country, nor should Australians assume that USDA data on the selenium content of beef applies to meat from animals grown in Australia.
So I'd suggest that mineral supplementation based on the nutritional content of the food we actually eat (not national averages) is a subject that could do with more exploration.
I want to add a small but key point, related to Keith's comment: Humans are designed as if by the lowest bidder, with serious sub-optimal systems that require specific inputs, otherwise a cascade of problematic chain reactions take place, often causing visible warning symptoms (headaches, eczema), and often not (sudden heart attack). These inputs include vitamins, minerals, water, sunlight, air, amino acids, fats and probably others. (Note that carbs doesn't appear to be a necessary input.)
But, back to my main point… We are not optimally engineered via evolution, which is a key reason seemingly small changes in inputs (lack of sunshine, changes in diet over the last 100 years) have dramatically worsened the health of "advanced civilization."
The paleo diet is perhaps the best *natural* diet for ensuring the ongoing perpetuation of our species, but one must ask the obvious question: Can science create an even better diet, perhaps building upon the paleo diet? And how would this diet be better?
One way is to provide optimal, science-proven inputs, versus inputs at levels that are merely good enough to ensure the survival of our species.
It turns out there are numerous supplements that provide improved levels of health at higher-than-paleo quantities. It also turns out that there are other natural and non-natural substances than have a profound net positive benefit on human health. One of the ones making news in the last three years is resveratrol. But there are literally several dozen others, and you cannot get these at optimal levels relying on diet alone.
Frankly, I don't think you can get nearly enough K2 from diet alone, for example. I make sure I get MK-4 (15m daily) and MK-7 (1mg daily) from supplements. Yes, a paleo diet might get you a decent quantity of K2, but not at levels shown to reverse arterial plaque in studies–the level I come closer to taking.
It's our birthright to live to 90. What we eat, and how we live, can subtract or add to that average. Eating a poor diet can subtract 55 years. I'm personally shooting for 100+. It's not a dream. Most of us can make it. We just need to try.
Scott, I agree that we are "not optimally engineered via evolution". However, evolution provided a lab which produced, over three million years or so, a solution tested against all environmental and social influences – and their interactions – that "works".
Can science create an even better diet, you ask. Well, it's theoretically possible, but extraordinarily unlikely.
I eat red grapes (and chew their pips) and drink a red wine once a week or so. But I wouldn’t touch a resveratrol supplement. It’s my guess resveratrol supplements would be just like anti-oxidant supplements: having a different effect in the body whether taken as part of a natural diet when the consuming body is fit and active in a Palaeolithic way or as a pill by a couch potato body experiencing 21st century stresses etc.
I don't see longevity as particularly to be aimed for, though it appears to be the implied metric used to demonstrate the virtues of this diet / that lifestyle / the other fitness regime. I have seen far too many feeble (really feeble) people approaching 100 to want such a fate. I'm 60 now and have "rude good health" and I look forward to continuing through to 75. After that, I expect a more rapid decline, but if I still haven't been prescribed meds, I can exert myself vigorously to do everything I need to do, while my brain does not succumb to enfeeblement and while the friends and family I cherish also value me, I'll continue happily as I am. As we say over here “I wouldn’t be dead for quids”!
The dosage for melatonin varies between people a lot, and for some people they do not need even 1mg. Generally, the older you are, the more you need. I take 3mg. There's a lot of research on this hormone, especially as it relates to protecting the brain. A primer:
https://web.archive.org/web/20100103045327/http://antiaging-systems.com/extract/melatoninmiracle.htm
Note: This is one of dozens of key molecules you cannot get from diet. In fact, all hormones, such as DHEA and others, fall into this bucket. I personally supplement with hGH, testosterone, DHEA, melatonin, natural thyroid, and progesterone. While all of my levels are normal for my age (47), through supplementation I keep them in the range of a 28-yr-old. This is where I plan to keep them my entire life. It's simply impossible to keep our hormones at this 28-yr-old level without supplementation because of our body's natural age-related decay (especially via the chronic damage done via glycation and accumulated mitochondrial DNA damage, reducing cellular energy and function).
BTW, I take several supplements that reduce glycation damage that cannot by found in foods. But this is getting into more advanced areas of supplementation. I even take the one substance currently known that undoes "advanced glycation end-products" (look it up on wikipedia), ALT-711 (unavailable to the public). When I started taking this several years ago within a few weeks my blood pressure went down several points, and the muscles in my legs became a little more flexible (I have several black belts to I'm fully dialed in on flexibility issues). Basically, glycation causes hardening of all organs, including wrinkles in our skin, and the hardening of the lens within our eyes. It's an inescapable result of aging. So reducing and reversing it is one of my primary supplementation goals.
Keith:
I'm actually not aware of who this is. Could you email and let me know so that I can keep an eye out, for my own sake and that of others?
As to sources, well, I don't think there are many for D, and that's likely because we evolved out in the sun and had no need to get D from food. As for MK-4, see here:
Liver, pastured eggs, pastured dairy, fish eggs seem to be the best sources. I think there's some in marrow, too.
The soil issue is something that I have not taken any time to look into. Since the vast majority of my diet is carnivory, I think it may be a minor issue for me.
Scott:
Have been wanting to get a reply out on this for days. First, thank you for posting this. It's great info. Though I didn't include it, I sure do use lots of coconut oil (and full fat milk) myself as well.
A question on the EPA/DHA. You say two grams, but though I take 3 grams of salmon oil and 2 of CLO for a total of 5 grams, the omega 3 content is only 1605 mg, 1335 of which is EPA (720mg) and DHA (615 mg). Does that sound about right?
Also, I noticed on another comment that you indicated you take 15mg per day of MK-4, and here it's 5, so did you forget a 1, or accidentally add a 1?
Finally, do you have any decent single source of info that covers all or most of these, and perhaps others?
Richard, while I recommend 5mg to most people (Carlson makes a good 5mg gelcap), I do in fact take 15mg (of MK-4) because I've read enough research to believe that [1] there's extra benefit to be had, [2] at no additional risk.
I personally take numerous marine lipids:
o 4 of the LEP caps daily
o 4 krill oil caps daily
o 1 seal oil cap (has the rare DPA, an omega-3 found in early human breast milk)
o i Fucoidan daily:
I've probably spend no less than 2-3 hours each day researching the topics of health and fitness, and have been doing this for 10 years. For supplements alone, I just don't know of a single great source–like Cordain's version of the Paleo Diet, I've not found any single source that I fully agree with. My personal knowledge is a best-fit of ALL the books, articles and opinions I've read, melding with all the the research I've read, filtered through the lens of evolution. I firmly believe in the phrase, "Nothing makes sense in biology except in the light of evolution." So this is always my touchstone.
I see that Stephan is quite resistant to supplements, and this may end up being his blind spot, despite his genius in the area of diet.
I fully embrace any tactic that adds quality of life, and adds longevity of life.
I've said many times in other forums (I'm a long-time poster on ImmInst.org, in the nutrition and supplement forums) that the older we are, the more chances we must take. Therefore, at 47, I probably take several supplements I wouldn't necessarily recommend to someone half my age. My goal is to live long enough to live 100's years, via projects I've invested in, like http://www.sens.org. So, if I was younger, I might not take 300mg a day of resveratrol. But, at my age, I need to take a few cautious risks. I also monitor over 125 blood markers every 9-12 months to catch anything that might be out-of-whack before it gets out-of-hand. So far, my cognitive function (I take a lot of very safe nootropics) and every other measurable marker indicates I'm much much younger than my age. I can do anything I could do in my mid-20's, and at nearly 48 I just do not feel anywhere close to being on a downhill slide. I'll be in significantly better shape than Art when I'm his age if this keeps up.
Most likely, one of three things will kill most of us who die a "natural death": heart disease, cancer, brain disease. All three of these can be seriously reduced in odds by diet and supplements. Resveratrol, for example, is the ultimate anti-cancer chemical — worth billions if it could be patented by a pharmaceutical company. It blocks cancer in the five known ways that cancer can be defeated:
o boosts immunity, a primary natural defense versus cancer cells
o greatly reduces metastasis, the spreading of cancer through the body
o silences 100's of gene-controlled mechanisms that lead to cancer cell survival and growth
o reduces the fermentation within cancer cells that gives them their metabolic energy
o inhibits angiogenesis, the growth of blood vessels that feed growing tumors
1000's of people are taking resveratrol at amounts equal to 500 bottles of red wine daily, with no reported ill effects. This is at the same relative quality used by Dr. David Sinclair at his famous Harvard studies to show numerous pro-aging effects.
These are no Chinese herbs I'm taking — every supplement I take is backed by real science, and most have been in our food supply safely for 1000+ years, like olive oil polyphenols, blueberry polyphenols, and green tea polyphenols.
Anyway, I can write about this a lot more, but you get the idea.
Turns out, I'll be talking about health tomorrow, live, online:
http://www.imminst.org/forum/index.php?showtopic=28288
I was just at Vitamin Shop this afternoon. Wow, you must spend a fortune; but I get it.
I ended up getting the magnesium, niacin and melatonin, for now. I had already done some research on magnesium and niacin and had planned to try those. And, have heard a lot about melatonin over the years. You didn't mention dosage for that, they had 1, 3, and 5 mg, so I got the 3.
Hi Richard, what do you think of Vitamin D3 in liquid drop form vs gel caps? Carlson have a product with 2000IU per drop.
Eric:
I think it’s totally fine. I have the 1K drops myself which I occasionally add a drop or two to a dogfood mix that my two rat terriers will consume of the space of 3-4 days.
About the toxicity of vitamin A and D, the link to Guyenet’s blogs does not work, so I post here the link to the archive.org version of the post:
https://web.archive.org/web/20081203191727/http://wholehealthsource.blogspot.com/2008/11/is-vitamin-toxicity-concern.html
A relevant paragraph:
“Vitamin D strongly protects agains vitamin A toxicity and vice versa. As a matter of fact, “vitamin A toxicity” is almost certainly a relative deficiency of vitamin D. Vitamin D deficiency is also tightly correlated with low bone mineral density, osteoporosis and fracture risk. A high vitamin A intake requires vitamin D to balance it. The epidemiological studies showing an association between high-normal vitamin A intake and reduced bone health all sported populations that were moderately to severely vitamin D deficient on average. At optimal vitamin D levels, 40-70 ng/mL 25(OH)D, it would take a whopping dose of vitamin A to induce toxicity. You might get there if you eat nothing but beef liver for a week or two.”
Perhaps Guyenet does not stand for this anymore.