Have you lowered cholesterol without statins?

[Yarnstormer]

Have any of you had a spike in ldl when you were losing weight? I’ve been dieting - lost 12 lbs and my ldl was quite increased. I’ve read that weight loss can temporarily raise ldl wonder if that is true.

 

[Helen]

So, for those worried about CVD, you might want to ask your doctor to order the advanced LDL test, so you can determine the breakdown of LDL particle sizes. It's not an expensive test, but very few doctors will routinely order it, unless you as for it. Here is one link that describes the test (this test actually gives more information than just particle sizes):

NMR LipoProfile | Blood Test | Life Extension

My doctor continually tried to get me to take statins. I finally asked her what particle size my LDL was and she blushed when she said she didn't know. She ordered the test and I have mostly large particles.

I was kind of bummed she would recommend statins before ordering the test.

 

[RAE]

My doctor continually tried to get me to take statins. I finally asked her what particle size my LDL was and she blushed when she said she didn't know. She ordered the test and I have mostly large particles.

I was kind of bummed she would recommend statins before ordering the test.

Unfortunately, this is all too common. My doctor did the same thing.

 

[mamadogmamacat]

At the risk of being snarked yet again for expressing gratitude, here goes. Thanks to the recent posters especially as your comments give me more items to discuss with my Dr should she ever try to push statins again. I do hope my new diet and the wgt I am losing will keep my numbers down anyway, but the info is useful too of course. Hope it is for others as well. Still wish i knew more before I accepted statins for those six weeks that changed my life for the worse. better late than never of course.

 

[Amethyst]

Thank you to those who've pointed up the large vs. small LDL particles issue, as my LDL is stubbornly high, although HDL is also high. Particle size is not on the standard "lipid panel" that I get every year.

I'll mention it at my yearly physical next summer.

 

[Free_at_49]

Do a calcium score before agreeing to take statins. My score was 0 (zero) so there's no need for drugs even if my cholesterol is high. Cholesterol by itself is not a disease, 260 may be normal & harmless for you.

 

[I was misinformed]

By the way, the LDL number you get when they do your blood test is not all that useful, because it does not distinguish between different LDL particle sizes. This is important. The small, dense LDL particles are dangerous since they contribute to plaque formation in the arterial wall. Ideally, one would want their results to show mostly large, buoyant LDL particles, which do not typically cross the arterial wall, so do not cause plaque formation. Small, dense particles are also closely associated with insulin resistance and an increased risk of developing type 2 diabetes.

So, for those worried about CVD, you might want to ask your doctor to order the advanced LDL test, so you can determine the breakdown of LDL particle sizes. It's not an expensive test, but very few doctors will routinely order it, unless you as for it. Here is one link that describes the test (this test actually gives more information than just particle sizes):

NMR LipoProfile | Blood Test | Life Extension

A recent article in Science reviews this issue

Is it time to retire cholesterol tests? | Science | AAAS

The discussion of how the research results can be incorporated
into clinical practice by “the poor frontline doctor” is a bit surprising,
with at least one expert expressing concern about burdening docs
with “too much information”.

 

[harley]

That was an interesting article, although non-conclusive. It did make good points about how little cholesterol numbers seem to have to do with actual heart disease instances.

One interesting quote I saw was

Although cholesterol-lowering statins are cheap, Sniderman notes that newer drugs given when statins aren't enough, such as the PCSK9 inhibitors, can cost tens of thousands of dollars per year.

I remember reading a blog entry from Dr. Malcom Kendrick a year or two ago. He was talking about how statin drugs are going off patent and becoming less of a money maker. He said he would be willing to bet that we'd soon be seeing articles saying that statins aren't really as useful as they've been said to be, and that people really now need to be on the new and expensive PSCK9 Inhibitors. I haven't seen that happening in large scale yet, but I wouldn't be surprised.

It would be nice if the ApoB test would give a better indication of liklihood of heart disease. Stay tuned, I guess.

 

[plsprius]

Good article, and good to see that science is progressing. In time, diagnosis and treatment will be even better.

Still, the takeaway for me is this quote:

Still, even apoB advocates admit that LDL cholesterol's track record is pretty good. About 85% of the time, it provides an accurate indication of a patient's likelihood of developing cardiovascular disease, Ference says. But that means it's wrong 15% of the time, he adds.

 

[Lsbcal]

In my case the moderately high cholesterol test numbers led to a CT Heart Scan test that was surprising. Without the cholesterol test we wouldn't have had a clue.

 

[harley]

Here's an interesting entry from Dr. Malcolm Kendrick's blog about CVD. He's been writing for months about all sorts of things that go into developing vs. avoiding CVD, and this post pulls some of it together. It's somewhat eye opening (to me at least). I'm not surprised about his comments on statins:

For example, even if you believe that statins are effective in reducing CVD risk, when you look at the clinical trial data – assuming you believe it, one hundred per-cent – the average increase in life expectancy is around four days, if you take a statin for five years.

He also says that the standard advice about not smoking and do exercise is correct and extremely valuable. But I found this part very interesting too.

My next big-ticket item, however, is not conventional at all. It is sunshine. If there is one piece of mainstream medical advice that I would vote as the single most damaging, it would be the current, ever more hysterical, advice to avoid the sun.

It's an interesting, if sometimes very heavy, read. Just thought I'd throw it out there in case anyone is interested.

 

[RAE]

Here's an interesting entry from Dr. Malcolm Kendrick's blog about CVD. He's been writing for months about all sorts of things that go into developing vs. avoiding CVD, and this post pulls some of it together.

Yes, I'm convinced that avoiding the sun is a big mistake. Sun exposure is beneficial in many, many ways - including reducing CVD risk and blood pressure control, among others. Here is an article from a few years ago that summarizes some of the benefits of sun exposure:

https://chriskresser.com/does-avoiding-the-sun-shorten-your-lifespan/

Also, using sunscreen is generally not a good idea, as the article points out. The best approach is to just control the amount of time you are out in the sun (some is good, but getting a sunburn is obviously too much).

 

[Amethyst]

I remember what my mother's skin looked like when she was the age I am now. Frankly, I am glad I used sunscreen, starting the moment it was available to me in my late teens. I spend tons of time outside, always have, and like my mother I burn easily (Irish).

 

[Lsbcal]

I remember what my mother's skin looked like when she was the age I am now. Frankly, I am glad I used sunscreen, starting the moment it was available to me in my late teens. I spend tons of time outside, always have, and like my mother I burn easily (Irish).

When I go out to exercise or garden now, I put on sunscreen on face, neck, ears, arms. I'm not light skinned but DW had some mild skin cancer that was removed. I read about this stuff and decided I had to change my ways.

BTW, I just read that clouds can reduce exposure BUT if they are partial clouds you can get magnified exposure (by about 25%). Weird and not fully understood.

 

[tmm99]

Is there a higher incidence of CVD's in countries where they don't get as much sunlight, or it's so cold that they don't get out much?

 

[Winemaker]

^ Well, is the Mediterranean diet good for the Mediterranean people or is it the sunshine? I might have to stop drinking red wine.

 

[PatrickA5]

Here's an interesting entry from Dr. Malcolm Kendrick's blog about CVD. He's been writing for months about all sorts of things that go into developing vs. avoiding CVD, and this post pulls some of it together. It's somewhat eye opening (to me at least). I'm not surprised about his comments on statins: He also says that the standard advice about not smoking and do exercise is correct and extremely valuable. But I found this part very interesting too. It's an interesting, if sometimes very heavy, read. Just thought I'd throw it out there in case anyone is interested.

Another doctor selling books. If we can get one of the big groups (such as American Heart Association) to agree that taking statins for 5 years will (on average) give me another 4 days to live, then I'll stop taking my statins tomorrow. Until then, I guess I'll stick with the thousands of other doctors (that aren't selling books) who recommend statins, including my PCP and Cardiologist.

 

[flintnational]

Another doctor selling books. If we can get one of the big groups (such as American Heart Association) to agree that taking statins for 5 years will (on average) give me another 4 days to live, then I'll stop taking my statins tomorrow. Until then, I guess I'll stick with the thousands of other doctors (that aren't selling books) who recommend statins, including my PCP and Cardiologist.

Kendrick was quoting this study published in BMJ Open (A British Medical Journal publication).

"Results 6 studies for primary prevention and 5 for secondary prevention with a follow-up between 2.0 and 6.1 years were identified. Death was postponed between −5 and 19 days in primary prevention trials and between −10 and 27 days in secondary prevention trials. The median postponement of death for primary and secondary prevention trials were 3.2 and 4.1 days, respectively."

 

[sengsational]

Another doctor selling books. If we can get one of the big groups (such as American Heart Association) to agree that taking statins for 5 years will (on average) give me another 4 days to live, then I'll stop taking my statins tomorrow. Until then, I guess I'll stick with the thousands of other doctors (that aren't selling books) who recommend statins, including my PCP and Cardiologist.

Another couple of doctors that take free lunches and other stuff from the pharmacy company reps. Everyone has their axe to grind.

 

[braumeister]

Wouldn't it be better if we all recognized that there is little chance of anyone's mind being changed here?

I keep seeing folks here trying to convince others to make changes, and it's just not going to happen in most cases, no matter how cogent the argument or how unassailable the data. We all have our confirmation bias regarding what we do for our own health.

It is easier for the world to accept a simple lie than a complex truth.

-- often attributed to Alexis de Tocqueville

 

[PatrickA5]

Another couple of doctors that take free lunches and other stuff from the pharmacy company reps. Everyone has their axe to grind.

Really? You think my doctors gives me bad advice on purpose because he gets a free lunch or the big pharma rep drops by with a few free trinkets? I guess that could be possible. He "seems" to care about my health, but I'll admit that most of my appointments are right after lunch.

I would be happy to stop my statins as soon as there is convincing evidence coming from a reputable organization. Who knows maybe these studies show convincing evidence and the AHA and mainstream doctors are just too stupid to figure it out. I suppose it's possible.

 

[Amethyst]

I am sure doctors vary in their "dependence" on pharma perks and incentives. Our internist seems very reluctant to prescribe anything without lots of evidence of need. My cholesterol is high (211,
233) and there is family history of heart disease, yet she points to high HDL and good lifestyle/weight as factors that outweigh the risks of statins.

Really? You think my doctors gives me bad advice on purpose because he gets a free lunch or the big pharma rep drops by with a few free trinkets? I guess that could be possible. He "seems" to care about my health, but I'll admit that most of my appointments are right after lunch.

I would be happy to stop my statins as soon as there is convincing evidence coming from a reputable organization. Who knows maybe these studies show convincing evidence and the AHA and mainstream doctors are just too stupid to figure it out. I suppose it's possible.

 

[razztazz]

None of my doctors ever gave a hoot about lifestyle factors.

One blood test. The end. Always Knee jerked to insist on drugs.

 

[harley]

Really? You think my doctors gives me bad advice on purpose because he gets a free lunch or the big pharma rep drops by with a few free trinkets? I guess that could be possible. He "seems" to care about my health, but I'll admit that most of my appointments are right after lunch.

I would be happy to stop my statins as soon as there is convincing evidence coming from a reputable organization. Who knows maybe these studies show convincing evidence and the AHA and mainstream doctors are just too stupid to figure it out. I suppose it's possible.

I'd never try to convince you or anyone else not to take statins if they want to. And I don't think doctors would knowingly give you bad advice based on a few perks. However, I also am pretty sure most doctors don't do any research, but just base their prescribing on advice from the AMA and the gov't. That advice is all based on doctor's who are selling books, or pharmaceutical companies selling drugs. The only reason I (me, no one else) like Dr. Kendrick's advice is that he stopped and looked at all of the data, not just the data that was cherry picked by the pharma. He has based his ideas off of research, and from what I've read it makes sense. So I pass on what I've learned in case anyone else wants to take a look and make their own decisions.

Don't forget, you're taking the advice of the people who have created the obesity and diabetes epidemics by recommending low fat high carb whole grain diets for the last 30 or 40 years. So it's not like they can't be wrong. They just have a very hard time admitting it. Just like most people.

 

[flintnational]

....... The only reason I (me, no one else) like Dr. Kendrick's advice is that he stopped and looked at all of the data.......

Harley, I was with you until I looked at the foods reccomened by the AHA. Man, you lost me. I am going over to the over side!

P.S. No more veggies for me.