Cholesterol Drugs - what they're not telling you...

[tfudtuckerpucker]

DH went to the doctor last month for a tetanus shot. BP was elevated. A LOT, but DH cannot remember the #'s. Doctor put him on Lisinopril (20 mg) and ordered blood work. EKG and chest x-rays.

A week later, partial report arrives in the mail, saying his cholesterol was 310. That number was circled. DH goes back next month for more tests.

Diet and exercise should normally be the first focus. Even the Lipitor ads (reluctantly) say this. Your doctor may want to immediately jump to statins, but please do your homework. I suspect some doctors don't push patients for diet and exercise, because so many patients just want a pill to "make it go away".

 

[Letj]

Avoiding statins is all well and good if your cholesterol is caused by lifestyle choices. However, for a small number of people whose high cholesterol is caused by a genetic defect, statins is the only thing that would prevent early death from heart disease. It's fairly easy to reverse high cholesterol by switching to a plant based diet if it's not genetically based.

 

[Chuckanut]

Avoiding statins is all well and good if your cholesterol is caused by lifestyle choices. However, for a small number of people whose high cholesterol is caused by a genetic defect, statins is the only thing that would prevent early death from heart disease. It's fairly easy to reverse high cholesterol by switching to a plant based diet if it's not genetically based.

Good point. I am suspicious of drugs that have to be sold to me on TV, and the use of statistics that give the impression the benefits are a lot larger than they really are. But, modern medicine has done some real wonders with treating various diseases. My mother lived into her 90's thanks, in part, to blood pressure medicine that kept her BP at safe levels.

 

[Letj]

Good point. I am suspicious of drugs that have to be sold to me on TV, and the use of statistics that give the impression the benefits are a lot larger than they really are. But, modern medicine has done some real wonders with treating various diseases. My mother lived into her 90's thanks, in part, to blood pressure medicine that kept her BP at safe levels.

As you should be. BTW, it's prohibited by law in most of the developed world to advertise drug. I believe drug ads and all ads aimed at children should be illegal. Ads have an insidious way of corrupting and manipulating the mind and in my opinion is partly responsible for our drug culture and easy fix mindset as well as the obesity epidemic.

 

[Chuckanut]

As you should be. BTW, it's prohibited by law in most of the developed world to advertise drug. I believe drug ads and all ads aimed at children should be illegal. Ads have an insidious way of corrupting and manipulating the mind and in my opinion is partly responsible for our drug culture and easy fix mindset as well as the obesity epidemic.

All of these drug and surgery ads on TV depress me. I think I will talk to my doctor about Calmdumba.

 

[sengsational]

Avoiding statins is all well and good if your cholesterol is caused by lifestyle choices. However, for a small number of people whose high cholesterol is caused by a genetic defect, statins is the only thing that would prevent early death from heart disease. It's fairly easy to reverse high cholesterol by switching to a plant based diet if it's not genetically based.

It sounds as if you are under the impression that "cholesterol" is correlated with "early death". Not even what kind of cholesterol? Cholesterol is essential for health!! It serves an essential role in the body. There happens to be one type of particle that carries cholesterol that is suspected of promoting CVD, but that particle is usually not even measured. Google "framingham offspring study" and see for yourself that higher LDL-C is not a good predictor of CV 'events'!

 

[Letj]

It sounds as if you are under the impression that "cholesterol" is correlated with "early death". Not even what kind of cholesterol? Cholesterol is essential for health!! It serves an essential role in the body. There happens to be one type of particle that carries cholesterol that is suspected of promoting CVD, but that particle is usually not even measured. Google "framingham offspring study" and see for yourself that higher LDL-C is not a good predictor of CV 'events'!

I know a family where many of the males experience early death from heart attacks and they all had or have one thing in common - high cholesterol in the 300 to 400 range.

 

[harley]

I know a family where many of the males experience early death from heart attacks and they all had or have one thing in common - high cholesterol in the 300 to 400 range.

And nothing else? Overweight, genetic predisposition, high blood pressure, smoking, alcohol use, coronary artery disease, etc?

Correlation does not imply causation. Cholesterol probably does have something to do with heart disease, but I've done a lot of reading on the topic (brother died of a heart attack at 42, cholesterol level was well below 200) and I don't think they've got good handle on the cause yet. And it's easy to throw pills at a condition, but it's hard to prove that using the pills has ever extended anyone's life.

It's similar to when I was diagnosed with diabetes. My doctor tried to put me on pills, and barely mentioned lifestyle changes. Just like patients, doctors sometimes take the easy way out.

 

[razztazz]

People with familial hypercholesterolemia (cholesterol over 400) have, in some studies not all, been shown to a heart attack rate a whole whopping (meaningless) 6% higher than the gen pop. (Malcolm Kendricks MD et al) And that was not correcting for any other factors. Cholesterol is pretty worthless for indicating anything except the patient is about to have his pocket picked.

 

[Letj]

Not necessarily disagreeing but I do want to point out that I happen to know well at least one of the individual practically all his life. He's never smoked, drank nor had a bad diet. In fact, he was an athlete for much if his youth. He started his cholesterol regimen in his 30s and is now 51. When he started, his doctor told him that with such high cholesterol levels, he must already have some build up in his arteries. Sure enough, after a recent heart scan, he was told that he has moderate arterial blockage. Not exactly sure what this means for him.

 

[imoldernu]

When it comes to personal health, I think that we tend to obsess over the concept of "normal", and the idea that if we do everything ""right", then we should live a long happy life... and... if we can do it without resorting to unnatural chemical substances, we should be even healthier.
That's a little hard to take for those who have physical anomolies that are out of the normal range and are advised that they can be cured with exercise or diet.
The frustration of not being able to control cholesterol, triglycerides or weight with lifestyle changes sometimes leads to a feeling of failure and a loss of self esteem, especially with younger people.

As to drugs, studies, and "what they're not telling you... a simple internet search will bring up a "proof" for whatever the current health fad might be. All of the theories are backed with scientific truths to suit the predilection of the source.
Alternate medicine... Homeopathy, Ayurveda, Chiropractic and Acupuncture, and natural alternatives to drug remedies all have strong adherents, many of whom are absolutely certain that they have discovered the holy grail of eternal life.

Coming from an era when "drugs" and were limited to aspirin, milk of magnesia, Cuticura, Dristan and Tums, ... I see the growth of the pharmaceutical industry as being the single, most amazing evolutionary event since the invention of printing.

Practical thought?... Do whatever works. Try whatever sounds good and logical, watch for side effects, and keep an open mind. This curmudgeon lived through the "discovery" of cholesterol and the first tests of cholesterol level... went through 6 different 'statin drugs with limited results... original cholesterol at 380, and when triglycerides became de rigueur... off the scale at 1000+. Lipitor worked but resulted in severe muscle ache and muscle loss. Finally, a few years ago, settled on fenofibrate, which brought the readings down to borderline high. Total Cholesterol 200, Triglycerides 240.

With all of that, I am not sure that any of this is good, bad, or indifferent. Overall health is pretty good... no serious health problems (except for normal age related arthritis, some neuropathy, and slow onset of some kind of dementia.) DW thinks my early days as an athlete helped. And so we continue... doing whatever seems right or logical, and trying to figure out who to believe. So far, so good.

 

[Chuckanut]

He's never smoked, drank nor had a bad diet. In fact, he was an athlete for much if his youth.

Interesting. Like my mother and her blood pressure medicine your friend seems to be somebody at significant risk who will benefit from the statin. I hope it helps him.

I am guessing that he did not need an advertisement to get get him to ask his doctor about the statin. In fact, I will bet that his doctor, after reviewing his and his family's medical history, recommended it. What a radical thought!

I like that kind of medicine, a sharp shooter approach. What many people are skeptical of, IMHO, is the shotgun approach. "Let's give a large number of people this medicine, though they have no diagnosed disease, in the hope that it will prevent one or two percent of them from getting sick. We'll worry about the side effects later."

 

[okapi]

Red Yeast Rice worked for me.Used in Asian countries for years.Drug companies trying to get it banned in U.S. Dollar is the bottom line.Drug companies hate healthy folks cause they don"t make money off them.My changing to a more plant based eating lifestyle along with exercise helped also.

 

[ohyes]

DH had 1 month re-visit to dr. after cholesterol reading of 310. They took more blood, and dr. said this was "to get good, bad and ugly, but this is going to be ugly."

He gave us three months to get cholesterol down with diet/exercise. His advice: chicken or turkey, no oil, lots of veggies. Recommended red yeast rice, CQ-10, Niacin, fish oil (2 g/day- i have not figured out which one to purchase...any advice?). He said Niacin can cause flushing and take baby aspirin to counteract that. We had already purchased all of those, but cvs.com said do NOT take niacin with lisinopril, so we had held off. DH's dr. said there is no problem with mixing any of these with the BP med.

So, here we go....hope DH has marvelous results three months from now.

Funny thing is, DH gave up butter over a decade ago. Has avoided chicken skin, fried food, etc. This just kinda snuck (?) up...

 

[sengsational]

He gave us three months to get cholesterol down with diet/exercise. His advice: chicken or turkey, no oil, lots of veggies.

When you get a recommendation to cut back on fat in your diet, what you need to hear is "increase carbohydrates", because protein tends to be pretty stable. By default, unless you DO something, you're going to get refined carbohydrates, and your lipid profile will get WORSE!

If your doctor tells you this without getting an LDL particle count, I'd get a new doctor! Total cholesterol is NOT a good predictor of CVD. It's the particle count that's important, and the size of the particles. The best predictor we have now is LDL-P. If you are 1300 nmol/L, that's the 50th percentile (1000 is 20th percentile, and you can completely relax). But even 50th percentile (with no insulin resistance) should be no big deal. If I can have this figured out with an afternoon or two of reading pub-med, why is it that doctors can't order the particle count and interpret it?

 

[donheff]

When you get a recommendation to cut back on fat in your diet, what you need to hear is "increase carbohydrates", because protein tends to be pretty stable. By default, unless you DO something, you're going to get refined carbohydrates, and your lipid profile will get WORSE!

If your doctor tells you this without getting an LDL particle count, I'd get a new doctor! Total cholesterol is NOT a good predictor of CVD. It's the particle count that's important, and the size of the particles. The best predictor we have now is LDL-P. If you are 1300 nmol/L, that's the 50th percentile (1000 is 20th percentile, and you can completely relax). But even 50th percentile (with no insulin resistance) should be no big deal. If I can have this figured out with an afternoon or two of reading pub-med, why is it that doctors can't order the particle count and interpret it?

+1. He has three months. Try a serious low carb high fat diet. Log every meal to see what is going down the hatch. Go back to butter and chicken fat. Include the CQ10 and the other stuff. Then look and see if HDL isn't way up and triglycerides way down. If LDL is still high, check particle size. Something like The New Atkins for a New You will tell him how to start. If he is like me he may be able to add back some rice and potatoes later but to get started he needs low carb. If he is going to continue with low fat high carb he might as well start taking Lipitor now.

 

[harley]

I wouldn't worry about any interaction between lisinopril and Niacin. I've taken both for years with no problem. I'd be curious to see the link to cvs.com that says there's an interaction, since I couldn't find it. None of the pharmaceutical information sites I've checked mentions any significant interactions. The only mention I've seen is that both can lower blood pressure, which is a positive for me, not a negative. And he should just try the Niacin without the aspirin, see if the flush bothers him. I find it only a minor annoyance.

My doctor specifically recommends Super DHA fish oil. It's made by Carlsons. I just google it and order it from whoever has the best price. Not cheap, but she says the DHA is especially good for increasing the size of LDL particles, which is more important than lowering the LDL count. I haven't been able to find another fish oil with that amount of DHA.

As far as the no oil recommendations, I'm with sengsational and Don. He'd be much better off eating low carb, losing weight, and not worrying about the oils. Cholesterol from foods isn't a significant issue. It's the cholesterol produced inside the body that's the problem. Weight loss and exercise combined with a low refined carb diet will give him the numbers that will make his doctor happy.

 

[braumeister]

My doc used to give me that same sort of advice about diet, due to my high total cholesterol.
I tried his way (the conventional medical wisdom) for a couple of years, with no significant effect.

Then I learned about the science of low carb, high fat diets and went that way.

When I showed up at the doc with vastly improved numbers (high HDL, low trigycerides, etc.) and told him about my high fat, low carb, moderate protein intake, he just shook his head and said "Well, I can't explain it, but keep doing what you're doing."

After a couple more years of this, and greater availability of the relevant information, my doc is gradually coming around to my approach, simply because it's easy to see that it works. Long term, the science shows that it's likely to work for a variety of reasons, but even short term the results are pretty dramatic.

 

[ohyes]

Thanks for all this great input. Going to [-]make[/-] ask DH to read your responses. Am ordering the Atkins book from Amazon. Public library does not have it available or I'd grab it today.

If DH's #'s weren't so bad, I would most likely poo-pooh this information, as I have had us on an almost vegan way of eating for some time. Joel Furhman's advice made a lot of sense to me. HOWEVER, having a 60yo DH with some scary lab results can make one start to reconsider. Cuz it obviously ain't working.

Hopefully, the new blood test results will show the particle thing. I must read more about that and jot down notes before next doctor visit.

When I went back to cvs drug interaction site, it showed niacin + lisinopril as only a moderate alert. That had me scratching my head because I knew there had been a major one. So, i put all the stuff in again and it is niacin and red yeast rice that has the major possible interaction listed. My apologies.
CVS - Drug Interaction Checker

Thanks again for sharing all this information. Hearing it from real people that have BTDT is what i love/can use to help DH get back on the right track.

i hope, really hope.

 

[pb4uski]

All of these drug and surgery ads on TV depress me. I think I will talk to my doctor about Calmdumba.

True, but the Lifestyle Lift ads are really creepy to me.

 

[Chuckanut]

If DH's #'s weren't so bad, I would most likely poo-pooh this information, as I have had us on an almost vegan way of eating for some time. Joel Furhman's advice made a lot of sense to me. HOWEVER, having a 60yo DH with some scary lab results can make one start to reconsider. Cuz it obviously ain't working.
.

The trick is to find what works for you and DH and stick to it. Be objective and hard nosed about the results. Check out competing sources, including the credentials and if the person is selling something other than a book. Be careful. Fanatics are dangerous. People who make big $$s selling supplements, specially made Frankenfoods, and other things lose credibility in my mind. Be careful of healthful food claims. Remember at one time, IIRC, Cocoa Puffs had the American Heart Society seal of approval. http://blog.trackyourplaque.com/2010/04/is-cocoa-puffs-no-longer-heart-healthy.html

 

[Chuckanut]

True, but the Lifestyle Lift ads are really creepy to me.

I can do the same thing better and cheaper with PhotoShop plugins!

 

[razztazz]

If your doctor tells you this without getting an LDL particle count, I'd get a new doctor!

Where does one find doctors like this? Every Dr I've had in the last 20 years has practiced nothing but "Pop Science" strictly IAW what the "Man on the TV" says. Also they have been nothing but Pill Heads. What you always need is a new pill.

 

[eytonxav]

Where does one find doctors like this? Every Dr I've had in the last 20 years has practiced nothing but "Pop Science" strictly IAW what the "Man on the TV" says. Also they have been nothing but Pill Heads. What you always need is a new pill.

Honestly, I am not aware of many PCPs that are calling for these specific tests. I suspect 90% of the population might be out looking for new physicians otherwise. Perhaps the reason they do not is an insurance thing, as if this was well founded good medical practice, paid by insuraance, why would the Drs not want to call for such a test

 

[UtahSkier]

why would the Drs not want to call for such a test

I requested my DR to run the test and he resisted. He stated that he did not have official guidelines for acting on the information provided by the test. Since the test provided him no information to act upon, he had no need for the test.

In the end, he did run the test for me and provided no comment.