Cholesterol madness

[audreyh1]

My triglycerides is down to 70. I suspect it is largely due to my intermittent fasting diet (shed 10% of my weight). I was also hoping it'd (diet + reduced weight) lower my cholesterol. It only improved by little, not enough to know if the diet did anything.

I had actually been doing the intermittent fasting for at least 6 months - the 16 or 14 hour fasting period each day. It did not help with weight loss - I gained a little. It did solve my main target problem, a settled tummy overnight and actually getting hunger pangs again. It seemed like my digestion had slowed and my tummy never felt empty. IF plus probiotics seemed to rectify that.

 

[FIRE'd@51]

Doc is having me target 20g carbs

20g carbs per meal or per day?

 

[audreyh1]

20g carbs per meal or per day?

For the whole day.

For a ketogenic diet, 20, 30 to 50 carbs per day are the usually recommended limits to maintain ketosis. Sorry I didn’t make that clear.

 

[ER Eddie]

David Diamond is good on the LDL question. I saw him mentioned earlier in the thread. Here's an article I have bookmarked:

LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature.
https://www.ncbi.nlm.nih.gov/pubmed/30198808

Some of his videos on Youtube are really good, too. I especially appreciate his dissection of the "relative risk ratios," which can be a very misleading way of presenting data.

https://youtu.be/yX1vBA9bLNk?t=2213

This stuff is disturbing.

 

[donheff]

First my bona fides: I used a LCHF diet to lose 35 pounds and at the same time stopped statins but still dropped my triglycerides, raised HDL, and only modestly raised LDL. I read all this stuff and as a result I am a statin skeptic. But, I wouldn't drop my doctor for cautioning that statins are still recommended for people who are at the prescribed risk levels. Most experts and researchers are thoroughly familiar with the studies but are still on the statin bandwagon. Doctors struggle with the conflicting evidence just as we do. I don't fault them for advising patients what the community consensus recommends as long as they are respectful of your wishes. I would be just as uncomfortable with a doctor who told me that the matter is settled and statins are poison as with a doctor who told me I am a fool for refusing them.

 

[athena53]

TT, yes that [studies all done on men] was something I wish I had known and fully researched prior to my six week long statin joint destroying disaster.

I'm also female and was prescribed statins a few years ago. I ended up with bad tendonitis; I got elbow pains just trying to raise a spoon to my mouth. I thought about what had changed in the previous 6 months since the pains had started- yeah, that was when I started the statins. I did some research and threw them out. Fortunately, I'm mostly recovered; the pains come back only when I really stress those joints. A couple of years later I had bloodwork done again and the doc's office called: "Your triglycerides are high so the doc is prescribing Prevastatin"- the same stuff that did me in before, and I'd told him that! Haven't seen him since.

I still get regular bloodwork and use my gyno as my PCP. Total cholesterol not great (247) but that's partly because HDL ("good cholesterol") is 110 and anything over 60 is good! Triglycerides/HDL is 0.6.

I'm hoping to find a new PCP who's focused on healthy living and prevention rather than writing prescriptions.

 

[ivinsfan]

First my bona fides: I used a LCHF diet to lose 35 pounds and at the same time stopped statins but still dropped my triglycerides, raised HDL, and only modestly raised LDL. I read all this stuff and as a result I am a statin skeptic. But, I wouldn't drop my doctor for cautioning that statins are still recommended for people who are at the prescribed risk levels. Most experts and researchers are thoroughly familiar with the studies but are still on the statin bandwagon. Doctors struggle with the conflicting evidence just as we do. I don't fault them for advising patients what the community consensus recommends as long as they are respectful of your wishes. I would be just as uncomfortable with a doctor who told me that the matter is settled and statins are poison as with a doctor who told me I am a fool for refusing them.

Really isn't part of their oath ,"first do no harm"?...in fact most MD's hand statins out like candy. I was getting my haircut when my hairdresser who I've known for over 35 years took a call from her doctor's office. Your numbers are "a little high" I'm writing you a statin RX.. her answer OK, send it to Walmart. They don't call the general public sheeple for no reason.

 

[audreyh1]

I'm also female and was prescribed statins a few years ago. I ended up with bad tendonitis; I got elbow pains just trying to raise a spoon to my mouth. I thought about what had changed in the previous 6 months since the pains had started- yeah, that was when I started the statins. I did some research and threw them out. Fortunately, I'm mostly recovered; the pains come back only when I really stress those joints. A couple of years later I had bloodwork done again and the doc's office called: "Your triglycerides are high so the doc is prescribing Prevastatin"- the same stuff that did me in before, and I'd told him that! Haven't seen him since.

I still get regular bloodwork and use my gyno as my PCP. Total cholesterol not great (247) but that's partly because HDL ("good cholesterol") is 110 and anything over 60 is good! Triglycerides/HDL is 0.6.

I'm hoping to find a new PCP who's focused on healthy living and prevention rather than writing prescriptions.

OMG! HDL of 110 is fantastic!

 

[audreyh1]

Really isn't part of their oath ,"first do no harm"?...in fact most MD's hand statins out like candy. I was getting my haircut when my hairdresser who I've known for over 35 years took a call from her doctor's office. Your numbers are "a little high" I'm writing you a statin RX.. her answer OK, send it to Walmart. They don't call the general public sheeple for no reason.

Yes, that is what really infuriates me at times.

 

[ShokWaveRider]

My doctor uses the Framingham Risk Score for statins. I have HBP and a Pacemaker for an Electrical issue (Not a Blockage or Plaque related issue, in fact many tests have shown my arteries to be clear). He put me on a Statin and it actually lowered my HDL. I must admit I only take them when I feel like it and do not refill the prescriptions regularly. I am not a fan of statins either. Without them my Cholesterol is high 270, but my overall ratios are not bad. TRI=104 (<150) LDL=175 (H <100) HDL=72 (>40).

HDL went down to 69 with statins. LDL to 109 TRIs went up too one time to 110 and another to 181, but I think the 181 was an anomaly as they have never been that high.

Pre Statin as seen above was TCOL=270, HDL=72, LDL=175 and TRI=104

 

[RAE]

My triglycerides is down to 70. I suspect it is largely due to my intermittent fasting diet (shed 10% of my weight). I was also hoping it'd (diet + reduced weight) lower my cholesterol. It only improved by little, not enough to know if the diet did anything.

If your triglycerides are at 70, and your HDL is good, you are in great shape - don't worry about total cholesterol. In fact, people whose cholesterol is on the high side (according to mainstream medicine, anyway) actually live LONGER than those with lower cholesterol. Most doctors won't tell you this, but it is true. Also, statins may lower cholesterol, but they do nothing to reduce all-cause mortality. It irks me that a lot of doctors will congratulate their patients on lowering their cholesterol levels (as a result of the statin drug they are on), when the reality is that that lower cholesterol will almost certainly NOT make them any healthier, or help them live longer. In fact, they are more likely to die sooner if their cholesterol is on the low side.

This article reviews some studies that reinforce what I have said above:

https://medium.com/the-mission/higher-cholesterol-is-associated-with-longer-life-b4090f28d96e

 

[audreyh1]

Interesting. Your doc is at least focused on the right thing (triglycerides), and not on LDL and cholesterol. And the fact that he prescribed a diet to help achieve lower triglycerides is pretty amazing to me......most doctors ignore diet, and talk only about available drugs to control various things.

I remember now: the Doc gave his opinion that the approach of targeting the triglycerides and using a LCHF diet will eventually become the standard of care in terms of managing heart disease risks.

I wonder how long that’s going to take.

 

[robnplunder]

If your triglycerides are at 70, and your HDL is good, you are in great shape - don't worry about total cholesterol.

HDL is slightly worse than normal, and total cholesterol is around 200. The ratio is in normal range and yet my doctor keeps suggesting drugs. I finally stop taking it after I started intermittent fasting. Whether it was the IF or not, my cholesterol has improved a little which I used as a premise to stop taking cholesterol drug.

 

[braumeister]

I remember now: the Doc gave his opinion that the approach of targeting the triglycerides and using a LCHF diet will eventually become the standard of care in terms of managing heart disease risks.

I wonder how long that’s going to take.

Your doctor is somewhat of an outlier, but a very smart person. Treat him well.

 

[BoodaGazelle]

I was on Crestor for quite a few years, because my Dr had pressured me. I finally lost weight (thereby going off Losartan), and decided to drop Crestor as well. I did a lot of research into the debate about cholesterol, and won’t go through all of that here. I would like to recommend a popularizing book, though, with the amusing title “Eat Bacon, Don’t Jog” by Grant Peterson.

He does a very good job of explaining why to eat LCHF diet, and how interval training is the best exercise.

 

[RAE]

Your doctor is somewhat of an outlier, but a very smart person. Treat him well.

+1, I agree. I wish I could find a doc like yours! Is he by chance a functional/integrative medicine MD, or just a traditionally-trained MD who is way ahead of the curve?
As for how long it will take for most docs to come around to start talking about diet/lifestyle to address chronic disease issues, rather than just pushing pills to treat symptoms - my guess is a long, long time. There is just too much money involved for the drug companies to change their ways. And there are other reasons for the inertia to continue also - this quote from a paper I just read pretty well sums it up:

"There are many reasons for resistance to a paradigm shift. Scientists are not as dispassionate, objective, and rational in processing information as computers. It is probably difficult for some authorities to reverse a long-held position and admit that their previous advice was incorrect. This may be especially true for clinicians who depend on their authority to encourage compliance with their recommendations, and who might fear that a change in a long held position will damage their credibility. The same may apply to prestigious institutions such as the American Heart Association (AHA) and National Heart, Lung, and Blood Institute (NHLBI), which are composed of numerous individual authorities. The imprimatur of these organizations helped entrench lipid theory. Of particular importance in this regard is the National Cholesterol Education Program (NCEP), a program of the NHLBI which has activities aimed at the public. In addition, busy clinicians may not feel they have time to spend on a new theory which may not stand the test of time, or enthusiasm for assimilating a new paradigm after working an 18-hour day. It is not surprising that the physicist Max Plank wrote "a new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5969815/

 

[davebarnes]

I do not understand "my doctor says".
I view the relationship as customer (me) and vendor (doc).
I expect to ignore 99% of what the vendor says to me.
I hate drugs.

 

[O2Bfree]

I recently had my cholesterol tested twice in close succession: Once at a screening at work in the morning after a very light breakfast; then again the next morning for my physical, after fasting for about 20 hours.

My cholesterol after fasting was actually a little higher, 243 vs. 236. HDL was higher, 83 vs. 69. Non-HDL was a little lower, 160 vs. 167. The screening at work didn't test for triglycerides, but the test from the doctor's lab after fasting showed 65.

My doctor uses the ASCVD risk score to measure risk, and mine is 1.7%. She's never suggested that I take statins. Based on what I've been reading lately, I probably wouldn't if she did.

 

[braumeister]

I got my current numbers from the blood test the other day.
HDL 79, Trig 76. Those are the only lipid numbers I care about and they're just fine (Trig/HDL ratio 1.0).

My new doc kept scratching his head and trying to find a way to justify recommending a statin, but he couldn't do it.
AAA ultrasound: fine (a very tiny amount of plaque)
Carotid ultrasound: same
Stress echocardiogram: same

So he says "Your pipes are essentially clear, so I'll back off. Whatever your lifestyle is, it's obviously working for you."x

What that lifestyle consists of is a mostly LCHF diet for the last eight years.

 

[audreyh1]

Your doctor is somewhat of an outlier, but a very smart person. Treat him well.

My doc is definitely smart and an outlier. He’s also maybe just a little nuts. He pushes some things aggressively that I don’t think deserve that approach. Other things like this, I am glad to have his guidance. It’s kind of a love-hate relationship, he’s very type A and probably doesn’t understand why other people are not.

 

[audreyh1]

+1, I agree. I wish I could find a doc like yours! Is he by chance a functional/integrative medicine MD, or just a traditionally-trained MD who is way ahead of the curve?
As for how long it will take for most docs to come around to start talking about diet/lifestyle to address chronic disease issues, rather than just pushing pills to treat symptoms - my guess is a long, long time. There is just too much money involved for the drug companies to change their ways. And there are other reasons for the inertia to continue also - this quote from a paper I just read pretty well sums it up:

"There are many reasons for resistance to a paradigm shift. Scientists are not as dispassionate, objective, and rational in processing information as computers. It is probably difficult for some authorities to reverse a long-held position and admit that their previous advice was incorrect. This may be especially true for clinicians who depend on their authority to encourage compliance with their recommendations, and who might fear that a change in a long held position will damage their credibility. The same may apply to prestigious institutions such as the American Heart Association (AHA) and National Heart, Lung, and Blood Institute (NHLBI), which are composed of numerous individual authorities. The imprimatur of these organizations helped entrench lipid theory. Of particular importance in this regard is the National Cholesterol Education Program (NCEP), a program of the NHLBI which has activities aimed at the public. In addition, busy clinicians may not feel they have time to spend on a new theory which may not stand the test of time, or enthusiasm for assimilating a new paradigm after working an 18-hour day. It is not surprising that the physicist Max Plank wrote "a new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5969815/

He’s a gynecologist, traditionally trained MD. I think he’s a bit of a functional medicine wannabe. He’s very motivated to be up on the latest on everything so yes, he’s usually way ahead on the curve. Like an endocrinologist, a gynecologist is very educated on hormones since that’s a lot of what he has to deal with, and many hormonal and gynecology issues are associated with overweight/obesity. He was trying to tackle my sub-clinical thyroid issues with newer theories like leaky gut. Over several years we tried many things, and nothing helped and one thing he really wanted to try turned out to be bad for me and had to seriously backpedal. Meanwhile my PCP (internal medicine) says just don’t worry about those thyroid antibody numbers as my thyroid is functioning OK and I don’t have symptoms.

 

[tominboise]

Please delete

 

[street]

Here are my results from last Dec. 2018. My overall Chol. is higher then it has been in the past years which it usualy runs about 215 to 224. Doc wanted me to start satins for the last 4 or 5 years but have not wanted to start them. I haven't been to him with these last results. My take on it is if I worked on my diet and watch what I eat I could most likely get all of these numbers a lot better and they are. I pretty much eat what I want and when, so I am in the processes of eating better and when I eat.

My plan is to eat better and not take the pills unless things get out of hand and I can't control them. I would rather die of a heart attack then die of dementia living a nursing home. I will stay fit as I can and try to control my chol. as natural as I can.


Cholesterol
233 mg/dL
100 - 199 mg/dL
Triglyceride
149 mg/dL
30 - 200 mg/dL
HDL
52 mg/dL
40 - 60 mg/dL
LDL Direct
161 mg/dL
65 - 159 mg/dL

 

[ER Eddie]

+1, I agree. I wish I could find a doc like yours! Is he by chance a functional/integrative medicine MD, or just a traditionally-trained MD who is way ahead of the curve?

Here's one place to look, although they don't have a lot of doctors listed (e.g., there are only two in my state).

https://www.dietdoctor.com/low-carb/doctors

 

[athena53]

As for how long it will take for most docs to come around to start talking about diet/lifestyle to address chronic disease issues, rather than just pushing pills to treat symptoms - my guess is a long, long time.

While I blame Big Pharma for continually coming up with studies that produce new "guidelines" recommending meds for ever-larger segments of the population, pills also seem to be the answer that a good deal of the population wants. There are many people who have cultural or emotional connections with eating. Some don't know how to prepare healthy food. Chronic pain or a stressful job, or even being at home full-time with small children can make it hard to work out regularly. And some people just like their chocolate, salt, beer, bacon, in excess and don't want to cut back. The docs can preach healthy lifestyles till they're blue in the face (and many do) but some patients just aren't interested.