Defiant Health Radio with Dr. William Davis
Defiant Health Radio with Dr. William Davis
How NOT to have atrial fibrillation
Atrial fibrillation, or A fib for short, is the most common heart rhythm issue that plagues people. About 30% of people will experience this rhythm disorder at some time in their lives, an issue that becomes more and more likely as we age.
The rhythm is typically experienced as the sudden onset of breathlessness and lightheadedness, and sometimes chest pain, even while you are sitting or relaxing. This is because, with A fib, the heart rate is typically in the range of 150-220 beats per minute, way above the normal resting heart rate of 60-70 beats per minute. It’s the result of chaotic electrical signals originating from the atria of the heart, the normally thin-walled sacks at the top of the heart on the right and left side, i.e., the right and left atria. Beyond the symptoms of breathlessness and lightheadedness, A fib puts you at risk for stroke—not mini-strokes, but large catastrophic strokes. This is because there is a passive sack or appendage attached to the side of the left atrium called the left atrial appendage. Because during a bout of A fib, the atria stop their normal contractions in synchrony with the powerful ventricles, the main pumping chambers of the heart, blood stasis or standstill occurs, allowing the formation of blood clots in the left atrial appendage. Should the blood clot fragment or dislodge, it can go to your brain, resulting in a catastrophic stroke. This is why, in conventional cardiac care, blood thinners are administered almost immediately with the onset of A. fib.
The management of this abnormal heart rhythm is fraught with difficulties and complications: toxic pharmaceuticals, procedures such as DC cardioversion in which a large and painful electrical shock is delivered with paddles to your chest, and others. So it is a good idea to take steps to avoid ever having this abnormal heart rhythm. Conventional advice typically includes achieving such things as controlling blood sugar and blood pressure with prescription drugs, or losing excess weight. But this leaves out some hugely important strategies that you can readily adopt that reduce your potential for experiencing A fib, as well as numerous other health problems. So that is the topic we consider here in this episode of the Defiant Health podcast.
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Atrial fibrillation, or AFib for short, is the most common heart rhythm issue that plagues modern people. About 30% of people will experience this rhythm disorder at some time in their lives, an issue that becomes more and more likely as we age. The rhythm is typically experienced as the sudden onset of breathlessness and lightheadedness, and sometimes chest pain, even while you're sitting or relaxing. This is because, with AFib, the heart rate is typically in the range of 150 to 220 beats per minute, way above the normal resting heart rate of 60 to 70 beats per minute. It's the result of chaotic electrical signals originating from the atria of the heart, the normally thin-walled sacs at the top of the heart, on the right and left side, that is, the right and left atria. Beyond the symptoms of breathlessness and lightheadedness, afib puts you at risk for stroke Not many strokes, but large, catastrophic strokes. This is because there is a passive sac or appendage attached to the side of the left atrium, called the left atrial appendage. Because during a bout of AFib, the atria stop their normal contractions in synchrony with the powerful ventricles, the main pumping chambers of the heart, blood stasis or standstill occurs, allowing the formation of blood clots in the left atrial appendage. Should the blood clot, fragment or dislodge, it can go to your brain, resulting in a catastrophic stroke. This is why, in conventional cardiac care, blood thinners are administered almost immediately with the onset of AFib. The management of this abnormal heart rhythm is fraught with difficulties and complications, toxic pharmaceuticals, procedures such as DC cardioversion in which a large and painful electrical shock is delivered with paddles to your chest and other strategies. So it's a good idea to take steps to avoid ever having this abnormal heart rhythm. Conventional advice typically includes achieving such things as controlling blood sugar and blood pressure with prescription drugs or losing excess weight, but this leaves out some hugely important strategies that you can readily adopt that reduce your potential for experiencing AFib, as well as numerous other health conditions. So that is the topic we consider here in this episode of the Defiant Health Podcast, and later in the podcast let's talk about Defiant Health's sponsors Paleo Valley, our preferred provider for many excellent organic and grass-fed food products, and BiotiQuest, my number one choice for probiotics that are scientifically formulated, unlike most of the other commercial probiotic products available today. I'd also like to make you aware of a new source for our favorite microbe of all, lactobacillus roteri, and a skin formulation I designed that improves skin from the inside out.
William Davis, MD:So what exactly is atrial fibrillation? So what exactly is atrial fibrillation? Well, there are four chambers of the heart. There are two atria, a right atrium and a left atrium. These are low-pressure sacs that sit on the top of the heart. Then there are the higher-pressure ventricles the very high-pressure left ventricle that does most of the work of pumping blood to the rest of your body, and the low-pressure right ventricle that pumps to your lungs. And these chambers contract in synchrony. That is a specific order, so that blood is pumped forward into the lungs by the right ventricle, into the rest of the body, out of the aorta on the left ventricle side. Now, this all occurs in a very predictable fashion, but sometimes something disturbs the rhythm, the conduction and also the rhythm generation. So normal rhythm is generated in a little piece of tissue called the sinoatrial node in the right atrium, and so when you have a normal rhythm, we call it sinus rhythm that comes from the sinoatrial node. Well, over the years, many people develop atrial fibrosis, that is, replacement of atrial muscle tissue with fibrous tissue, which thereby allows chaotic generation and conduction of rhythm, and that's when you have atrial fibrillation.
William Davis, MD:Typical way of experiencing atrial fibrillation You're sitting, minding your own business, watching TV or sitting outside, just having a glass of iced tea or something, and you feel your heart rate racing Typically 150, sometimes as fast as 220 beats per minute, much faster than the usual 60 to 70 beats per minute. Most people experience this as the sudden onset of breathlessness Severe breathlessness, can't catch your breath, lightheadedness and sometimes chest pain, especially if you have some measure of coronary disease, because that rapid pumping prevents your heart's arteries from filling properly with blood and you can feel chest pain. So this is an emergency. You need to go to the emergency room or an urgent care where they can take steps to stop it. You know I'm not a big fan of the medical system, as you know, but there's a time and place when you do need these kinds of things and then several things happen. They put you in a bed, of course, put an IV in and they try to slow the heart rate down. That's the first thing they do. There's a series of drugs you can give that, over hours, slows the heart rate. These are drugs like digoxin and beta blockers like metoprolol and others, and calcium blockers all meant to slow the generation and the conduction of this excessively rapid heartbeat, and that alone makes you feel better when you get your heart rate again below 100 beats per minute. They also anticoagulate you, because one of the problems, one of the most catastrophic problems that develops with atrial fibrillation is when the atria are fibrillating, that is, they're no longer contracting, they're quivering or not even moving at all.
William Davis, MD:Well, there's an area on the left atrium, so the rhythm is generated in the right atrium, but there's an area on the left atrium. It's called the left atrial appendage. It looks like a little ear on the side of the left atrium and when the right and left atria are no longer contracting and ejecting blood, there's blood stasis and blood coagulates or clots. When it's static, when it's not moving, and blood clots can form in that left atrial appendage. And those blood clots can fragment or dislodge and go to your brain and these tend to be large, catastrophic strokes.
William Davis, MD:You've probably heard of mini strokes. Those often come from someplace else, typically the thoracic aorta, atherosclerosis that fragments in the thoracic aorta. This kind of stroke that comes from the left atrial appendage tend to be much larger because these clots are very large it can be a centimeter in diameter or so and they go to the brain and they cause catastrophic strokes that are sometimes fatal or sometimes involve major incapacity, like losing the capacity for speech or movement of the left side of the body or other major impairments. So you don't want a stroke from atrial fibrillation. So for that reason, most of the time you're anticoagulated right away with intravenous drugs and then over time switched over to oral drugs so that the blood clot if a blood clot had formed has time to dissolve over several weeks to months.
William Davis, MD:Now there's also drugs introduced to try to convert the rhythm back, to try to stop this chaotic rhythm in the atria and convert it back to a normal sinus rhythm. These are unusual drugs you likely never heard of, like Sotolol and amiodarone and many others. These tend to be very toxic drugs but they're useful for helping nudge the heart back in a normal sinus rhythm. So you can imagine there's a lot of moving parts here and then, after all that is done, there's there's other issues like should you be what's called cardioverted, that is, a large current passed through your heart to break the rhythm and restore normal rhythm. There's also ablation, that is, the areas in the atria that are responsible for generating this chaotic rhythm. Usually several of them are essentially burned out. They're mapped out and burned out and that works most of the time, not all the time. And there's some other procedures, like they can put a blocking device in your left atrial appendage so that blood clots can't form and that avoids the use or the need for anticoagulants long-term.
William Davis, MD:Now, typically somebody goes to the hospital for the first time, has all these things introduced and then goes home, has to come back for conversion of the rhythm there are many variations on this theme, but that's pretty much what they do and then maybe you get normal rhythm back and then it comes back three months later. Go back to the hospital for a few days, they convert it again, a few months later it comes back. In other words, this is a revolving door. In and out of the hospital is the most typical experience Once in a while. Someone will have one bout and never have another recurrence for many years, but that's uncommon. Much more common is to have multiple recurrences over the years.
William Davis, MD:A lot of aggravation, a lot of medications right Medications for anticoagulation, medications to slow the heart rate during a recurrence, medications to inhibit the return of the rhythm, the antiarrhythmic agents and others. So you can imagine it's costly. It's a real hassle, eats up a lot of your time and energy. It's going back and forth to the hospital and to the doctor, so it really pays to take steps to not have atrial fibrillation. So there's a number of discrete, identifiable ways that get you to the atrial fibrosis that allows. Well, there are very common causes like high blood pressure, and high blood glucose is a real powerful one. Type 2 diabetics are much more likely at least threefold more likely to have atrial fibrillation.
William Davis, MD:Inflammatory phenomena, as often comes from people who have a lot of abdominal fat, people who have excessive abdominal fat. That's a major source for both inflammatory mediators and other factors that cause atrial fibrosis. Cigarette smoking, of course, but we know that no one should be smoking cigarettes. The point is, all those things high blood glucose, type 2 diabetes, inflammation, excessive abdominal fat all those factors are easily addressed. Unfortunately, in conventional circles, what they do is give you blood pressure medication and blood sugar reducing medication and anti-inflammatory, in other words, drugs that introduce problems, often significant problems of their own. So what we do instead is address the factors that allow high blood pressure, high blood glucose, inflammation to emerge. So we take such steps as removing the foods, wheat, grains and sugars that cause weight gain, high blood glucose, insulin resistance, etc.
William Davis, MD:Then we replace or restore the common nutrient deficiencies that most modern people share because of the way we live our lives. We don't get magnesium from drinking water because it's filtered out. We don't get vitamin D because we live our lives indoors, we wear clothing outside, and we lose the capacity to activate vitamin D in the skin as we get older, especially after age 40. Many of us don't get iodine because we don't eat thyroid glands of animals. We can't get enough shellfish or seafood because of the contamination with mercury and cadmium. And then, lastly, omega-3 fatty acids. Likewise, we can't eat all the fish we want because it's contaminated with mercury. We can't eat all the shellfish we want it's contaminated with cadmium. So we'll replace those four and those four things combined act together synergistically to minimize insulin resistance, the factor that drives high blood sugar, diabetes, heart disease risk, abdominal fat, and minimize inflammation. So just those basic steps have taken you many, many, many steps closer to not having atrial fibrosis and thereby atrial fibrillation. Now another very important factor that leads to atrial fibrosis that's becoming clearer and clearer with recent science is the idea that dysbiosis in the colon, or small intestinal bacterial overgrowth we say SIBO, s-i-b-o in the small intestine and thereby the endotoxemia that results, are major drivers of atrial fibrosis and thereby atrial fibrillation. Let's pause for a moment to tell you something about Defiant Health's sponsors, and when we come back let's take that idea further of how dysbiosis, sibo and endotoxemia can be major drivers of atrial fibrosis and thereby atrial fibrillation.
William Davis, MD:The Defiant Health podcast is sponsored by Paleo Valley makers of delicious grass-fed beef sticks, healthy snack bars and other products. We're very picky around here and insist that any product we consider contains no junk ingredients like carrageenan, carboxymethylcellulose, sucralose or added sugars, and, of course, no gluten nor grains. One of the habits I urge everyone to get into is to include several servings of fermented foods every day in your diet, part of an effort to cultivate a healthy gastrointestinal microbiome. Unlike nearly all other meat sticks available, paleo Valley grass-fed beef, pork and chicken sticks are naturally fermented, meaning they contain probiotic bacterial species. Paleo Valley has also launched a number of interesting new products, including extra virgin olive oil, spice mixes, organic coffee, strawberry lemonade, super greens and essential electrolytes in a variety of flavors, and if you haven't already tried it, you've got to try their chocolate-flavored bone broth protein that makes delicious hot chocolate and brownies. See the recipes for the brownies in my drdavisinfinitehealthcom blog. Listeners to the Defiant Health podcast receive a 15% discount by going to paleovalleycom.
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William Davis, MD:Now let's get back to our discussion. So think about that that atrial fibrillation, atrial fibrosis a process in the heart, of course can get its start in the gastrointestinal system, specifically an increase in permeability of the intestinal wall and the entry of bacterial breakdown products into the bloodstream, which is extremely inflammatory. So what causes the intestines to be excessively permeable? Well, there's a number of things unique to modern life into the bloodstream, which is extremely inflammatory. So what causes the intestines to be excessively permeable? Well, there's a number of things unique to modern life Exposure to emulsifying agents.
William Davis, MD:These are agents such as carrageenan, polysorbate 80, carboxymethylcellulose and others. These are additives to food to mix them or to keep them mixed. Things like peanut butter ice cream is especially bad, typically with three or four different emulsifying agents all at once. So take a look at your processed foods. You want foods that do not contain these emulsifying agents. Good rule of thumb eat only foods that don't have a label, don't have an ingredient list, real foods like eggs or pork or an avocado. That way you know. No one added something like an emulsifying agent.
William Davis, MD:The bowel prep of Miralax, typically used before a colonoscopy, is a massive disruptor of the intestinal mucus barrier and thereby allows unhealthy microbes to proliferate, actually inflame the intestinal wall and allow the entry of breakdown products from bacteria enter the bloodstream. So a very bad practice is to use Miralax as a prep for a colonoscopy. Should that happen, you should insist on an alternative. A very common alternative is to use magnesium in some form. Magnesium preparations like magnesium citrate are osmotic agents. They pull water into the gastrointestinal tract and it's a very benign way. Now, nobel prep is a pleasant process. It is very unpleasant because you have lots of diarrhea. But an easy and benign way to do it is with magnesium. You just have to use more than the usual dose to encourage that osmotic effect, the entry of water into the gastrointestinal tract, to clear it out of stools so the gastroenterologist can see with his colonoscope. Nonsteroidal anti-inflammatory agents these are drugs like ibuprofen and naproxen. These are massive disruptors of the intestinal mucus barrier and they cause ulceration in the small intestine and increase intestinal permeability in the small intestine. So that increases the intestinal permeability that allows breakdown products entry into the bloodstream.
William Davis, MD:Chlorinated drinking water is a likely disruptor of the gastrointestinal lining because it dissolves the mucus barrier. So we drink only filtered water or other sources of water that are not chlorinated or, even worse, chloraminated that is made sterile with the use of chloramine rather than chlorine. Chlorine is relatively short-lived, chloramine is relatively long-lived. You can't even boil it off. It takes a minimum of three days of boiling to even start to remove the chloramine is relatively long-lived. You can't even boil it off. It takes a minimum of three days of boiling to even start to remove the chloramine. So we drink. We filter our drinking water.
William Davis, MD:The gliadin protein of wheat is a massive cause of increased intestinal permeability. You may recall that the original research that identified gliadin as a factor that increases intestinal permeability came from Dr Alessio Fasano's work while he was at University of Maryland, now at Harvard, and he was looking to find another factor that causes an increase in intestinal permeability and he wanted to find something that mimicked the effects of cholera toxin. So if you've ever seen cholera, it's a horrible, horrible disease. This often happens in third world countries or where there's war and fecal contamination of drinking water and people develop incessant, endless diarrhea so bad they often cut a hole in the gurney so that diarrhea can pour out into a pan because they can't keep up with the diarrhea and most people die of dehydration. They can't keep up with the fluid needs of the incessant diarrhea. Well, cholera toxin causes that. It causes unrestricted entry of water into the intestines. Well, the gliadin protein was the only thing he could find that mimicked the effect of cholera toxin, except it didn't allow water to enter the intestines. It allowed other things like breakdown products of food or bacteria to enter the intestines. It allowed other things like breakdown products of food or bacteria to enter the bloodstream and lymph. That, by the way, was also found to be by Dr Fasano's work and his team to be the initiating factor in many, if not most, forms of autoimmune diseases, because entry of those foreign products fools your immune response into attacking organs that resemble those foreign factors.
William Davis, MD:But the real problem in the vast majority of people. So those things you can fix right. You can try to avoid having a bowel prep with Miralax. You can avoid processed foods that have emulsifying agents in them and choose whole foods instead. You can avoid the use of non-steroidal agents. You can filter your drinking water, so all relatively easy to remedy and all those things help you reduce or minimize abnormal intestinal permeability. And, of course, going wheat and grain-free to avoid the gliadin protein and the related proteins of other grains such as the secalin and rye, the hordean and barley, the zean and corn are also provokers of increased intestinal permeability.
William Davis, MD:But a real common cause, and a very potent cause of increased intestinal permeability and thereby entry of breakdown products of bacteria into the bloodstream is the overgrowth of fecal microbes, so-called gram-negative enteric or fecal microbes. This is a situation where, because of our exposure to antibiotics and other factors, fecal microbes have been allowed to over-proliferate in the colon and then ascend into the 24 feet of small intestine. And the small intestine is simply not equipped to deal with trillions of fecal microbes, because the small intestine is supposed to have a very low count of bacteria and is meant to be very permeable because that's where we absorb most amino acids, fatty acids, vitamins and minerals. So the small intestine is meant to be very permeable. But when the small intestine is infested by trillions of fecal microbes that live and die in short order, they only live for a few hours. When they die, they shed their components, only live for a few hours. When they die they shed their components, especially a component of their cell wall called endotoxin.
William Davis, MD:And that endotoxin is able to enter the lymph and the bloodstream through the permeable small intestine. And when that happens, when endotoxin occurs at high levels in the bloodstream, that's called endotoxemia. Endotoxemia is a situation where there's 200 to 400% increase in the level of this endotoxin. That's probably a marked underestimation because the method used to measure endotoxemia only only identifies some of the forms of endotoxin. That is, the endotoxin of different species may differ and are not all identified by the method used. So, for instance, the endotoxin of E coli may differ from the endotoxin of citrobacter campylobacter or pseudomonas. And so, except that any measure of endotoxemia in studies it's not available clinically, it's only something used in clinical studies underestimates the degree of endotoxemia. So endotoxemia is likely much worse than it appears.
William Davis, MD:But it's that increase intestinal permeability caused by the overgrowth of those fecal microbes or proteobacteria in the small intestine that allows the entry of endotoxin endotoxemia into the bloodstream. That is a major driver of atrial fibrosis and atrial fibrillation. So it's my view this work has to be extended further, but it's my view that SIBO and thereby endotoxemia, is going to prove to be the major driver of atrial fibrillation and that your efforts to prevent atrial fibrosis and thereby fibrillation are incomplete If all you do is just good things and diet and vitamin D and omega-3 fatty acids and iodine all the basic things we do. You've taken several steps forward in reducing your potential for atrial fibrillation, but your efforts are not complete unless you address bowel flora. Now recall that we do so in my programs by doing several things.
William Davis, MD:We make sure we consume lots of fermented foods. These are foods like sauerkraut that are fermented naturally, not sauerkraut and brine Kimchi vegetables you ferment on your kitchen counter. Kefir, real yogurts, not the stuff in the grocery store. Those are you want to include every day, several times per day. Curiously, they provide species like Leuconostoc mesenteroides and Pediococcus pentasatius. These are microbes that don't take up residence in the GI tract. So what good are they? Well, something happens when you consume these fermented foods with those non-colonizing microbes. As they pass through, they somehow provoke the proliferation of beneficial microbes that do take up residence. These are very beneficial microbes like Fecalobacterium and Acromantia and Ruminic Acacia Don't remember those names, but those are very important species that do many good things. They support the proliferation of other beneficial microbes. They produce beneficial metabolites such as butyric acid that mediates many of the wonderful effects of fermented foods and microbes like reduction of blood sugar and blood pressure and better sleep. So plenty of fermented foods, very important.
William Davis, MD:We re-implant keystone species, the two most important, lactobacillus rhoderi and Lactobacillus gasseri, and the reason for that is these are two microbes that are very unique in that while most microbes probiotic type species, colonize the colon, these two are known to uniquely colonize the small intestine where SIBO occurs, where they're known to produce bacteriocins, natural antibiotics effective in killing those invading fecal microbes. So we make a yogurt. It doesn't have to be dairy, it could be something else, but yogurt's the easiest. We make yogurt out of those two species and we consume half cup per day, typically for four weeks at the start and then intermittently, maybe three times a week, something like that, chronically, because we yet don't know how to make these things colonize the intestine permanently. So we rely on ongoing consumption to restore and maintain those microbes and this has been far more effective than I ever expected. So far, of over about 50 people who've done this, 90% have tested negative for hydrogen gas on the breath. That's how we test for SIBO, so that combination can be called SIBO yogurt.
William Davis, MD:See my recipes in the Super Gut book for SIBO yogurt. In that recipe I also added bacillus coagulans. That's optional. I'm not sure how much that adds, but you have the option of adding bacillus coagulans. But at the very least you want to do lactobacillus roteri and certainly at the beginning lactobacillus gasseri. Long-term you have a choice either roteri alone or roteri gasseri, both in combination.
William Davis, MD:Long-term, what you're doing is re-implanting those species to inhibit the colonization, the infestation of your 24 feet of small intestine with fecal microbes. Then we make sure we include lots of fibers and other related compounds. These are things. These are the fibers from legumes or other root vegetables, inulin powder that you can buy, galacto-oligosaccharides from black beans, white beans, hummus, chickpeas so see the list in my Super Gut book. Also, all throughout my blog, my drdavisinfinitehealthcom blog or williamdavismdcom blog, you'll see lists of prebiotic fibers and related compounds all the foods that you can consume that feed microbes and make them proliferate the beneficial microbes.
William Davis, MD:So, I believe, is my prediction that management of colonic dysbiosis, but even more so, small intestinal bacterial overgrowth and the increased intestinal permeability and endotoxemia, management of these issues will prove to be one of the most important revelations, one of the most revolutionary approaches to inhibiting, to reducing the likelihood of developing atrial fibrosis and thereby atrial fibrillation. Now, if you've learned something from this episode of the Defiant Health Podcast, I invite you to subscribe to your favorite podcast directory. Post a review, post a comment. Help us grow this movement of self-empowerment and health and freedom from the clutches of the healthcare system. Thanks for listening.
