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

[donheff]

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Originally Posted by sengsational 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]

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Originally Posted by Chuckanut 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]

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Originally Posted by ohyes 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...t-healthy.html

[Chuckanut]

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Originally Posted by pb4uski True, but the Lifestyle Lift ads are really creepy to me.

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

[razztazz]

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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]

Quote:

Originally Posted by razztazz 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]

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Originally Posted by DFW_M5 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.

[donheff]

Quote:

Originally Posted by UtahSkier 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.

SInce it isn't yet accepted medical practice I assume many, if not most, insurance companies will not pay for an extended lipid panel. I am also surprised that most PCPs won't run it. If you are in or near a big city you can get the test done yourself on your dime. I plan to ask next time I go, explaining that I want the data for my own information and am willing to pay incremental costs..

[Animorph]

My PCP brought it up, after I'd been reading about it. I had to pay a extra due to no insurance coverage on it. It was mostly good news, but still not perfect. And obviously doesn't pin anything down completely. But it keeps me off statins a for now.

[sengsational]

Quote:

Originally Posted by razztazz 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.

It seems as if getting the test done requires a doctor, so you could just try something like NMR LipoProfile a Cholesterol and Lipid Blood Test (not saying that one is optimal, or that you should use it, just saying that if you find ways to "buy the LDL-P test online", you will often get an option to find a lipidologist (doctor that knows something about the current science).

[razztazz]

Oh, the TEST is not a problem. I can get just about any test I want at a private lab for cash-on-the-barrel-head. In fact I have had several health-assessing tests done completely off the books and away from the insurance and my regular doctor because I do not trust any doctor to give a real hoot about my health. None of them have ever indicated any such tendency.

ALL they ever want to talk about or test for is cholesterol then give some whimsical schpiel about "risk" that a 3rd grader could see through.

That's why I ask where can I find a Doctor like that. ie one who isn't suffering from "Doctor induced hysterical hyperlipidemia."

[haha]

Quote:

Originally Posted by razztazz Oh, the TEST is not a problem. I can get just about any test I want at a private lab for cash-on-the-barrel-head. In fact I have had several health-assessing tests done completely off the books and away from the insurance and my regular doctor because I do not trust any doctor to give a real hoot about my health. None of them have ever indicated any such tendency. ALL they ever want to talk about or test for is cholesterol then give some whimsical schpiel about "risk" that a 3rd grader could see through. That's why I ask where can I find a Doctor like that. ie one who isn't suffering from "Doctor induced hysterical hyperlipidemia."

You don't say where you live, or at least I did not catch this. These doctors are around, but they are clearly a minority. My doctor suggested the NMR particle tests to me, and I had asked him if he thought I should take statins and he said no.

So these doctors exist.

Ha

[Elbata]

I will be recommending the opposite of what most are recommending on this thread. You can look these 2 doctors up on the internet and then decide for yourself:

Dr Caldwell Esselstyn==How to Reverse and Prevent Heart Disease
Dr T Colin Campbell==The China Study

[Sue]

I also would recommend reading these books (The China Study and How to Prevent and Reverse Heart Disease).

Both books are based on solid epidemiological and long-term clinical studies. Although the books approach the concept of what is a healthy diet from different perspectives, they come up with the same conclusion.

[braumeister]

Actually, the China study has been thoroughly discredited so many times it is no longer even mentioned seriously in most places.

A quick web search for terms like "china study debunked" will yield a plethora of references.

[razztazz]

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You don't say where you live, or at least I did not catch this. These doctors are around, but they are clearly a minority.

The Greater Omaha Nebraska area

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I had asked him if he thought I should take statins and he said no.

Better keep that DR/patient confidentiality. Anybody else finds this out and he'll get "Serpico'd"

[ohyes]

The more I read, the more I wonder. When it was simply curiosity about eating healthily, it didn't feel so crucial. Neither DH nor i had high bp or cholesterol (that we knew of). Tests were always in the good range. Now, i feel huge motivation and responsibility to find the BEST way of eating.

Fuhrman, Esselstyn, McDougall, etc. disagree on some things, but i didn't find it confusing a year or so ago. Go plant based. Okay. A good friend (who has had two heart attacks by age 56) tried to tell me that the China Study was totally flawed, but I never followed up on learning more about that. Guess I will, now.

One thing that I keep coming back to is WHY is plant based after heart disease is evident so recommended? Seems like the Ornish diet and strictly vegan is what lots of people go to after a heart attack or is that just my imagination?

Have the New Atkins book ordered, along with the Carlson Super DHA (Thanks for that recommendation). The discussion confuses me, but it has also given me plenty of good leads.

Eco-Atkins sounds interesting. Just learned about it this week. The link is to abcnews.com, a report on a study of 44 participants/good results.

Also, just a couple weeks before DH's cholesterol test results came back (ugh), I had started us on the G-BOMBS that Fuhrman recommends...making sure we get Greens, Beans, Onions, Mushrooms, Berries, Seeds or nuts every day. A couple days ago, i have added a rule: no bread, potatoes or pasta.

I'll keep reading/learning. Thanks again.