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View Poll Results: Tell us about your LDL measurements and statin use
Thought there was only one LDL measurement, using statin. 24 20.87%
Thought there was only one LDL measurement, not using statin. 25 21.74%
Heard about LDL particle size, never had an LDL-P test, using statin. 14 12.17%
Heard about LDL particle size, never had an LDL-P test, not using statin. 30 26.09%
Had an LDL-P test, using statin. 9 7.83%
Had an LDL-P test, not using statin. 13 11.30%
Voters: 115. You may not vote on this poll

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Old 01-29-2014, 02:04 PM   #141
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Very true. This is the saddest part, really. For many years, doctors were told to just focus, tunnel-vision style, on the LDL number. I'm convinced this was because statins were incredibly profitable and their only real effect was to lower LDL. So many pharma reps pushed partial information to the docs, who were too busy to look into the matter deeply.

Many, if not most doctors are now much better informed, but there is still plenty of misinformation circulating in both the medical community and the public. We each have to do our own investigating and do what seems best.
I went around and around with my doctor on the LDL number (mine was up to 199 a few years ago). I pointed out that I had no other indicators for heart attacks except for a high LDL and that my ratios were good. The next year we had the same conversation and I pointed out that my neurosurgeon viewed my angiogram (for a brain aneurysm procedure) and said my arteries looked better than more than 95% of his patients. The next year we had the same discussion again and I asked her what type of LDL particles I had and she blushed and said I hadn't been tested for that. I had the test and I have the larger (supposedly) less damaging LDL particles.

That doctor resigned and I have a new doctor. The first thing she said was, "why aren't you on statins?".

These doctors all just look at the LDL number and recommend a statin based on that.

I agree with the other poster that said many doctors haven't done their own research on cholesterol.
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Old 01-30-2014, 05:23 AM   #142
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My doctor wants to do the Berkley test, to see if I have the artery clogging ldl or the digestible ones. Not sure insurance will pay for but will check. Some people clog and some don't. This test will be important for my wife who cannot take statins.

Extreme exercising and diet have not reduced my chol. Tread mill did help some, hips just wear out.
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Old 01-30-2014, 08:02 AM   #143
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No idea what the Berkley test is, but you can get the particle size information from the NMR Lipoprofile test. I went to my local Labcorp facility last year and got it done for $99 as I recall. Several months later, I saw my doc for my annual physical and (much to my surprise) he included it with my bloodwork, so I had two sets of results (very similar). Medicare paid for the one with my checkup.
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Old 01-30-2014, 09:51 AM   #144
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No idea what the Berkley test is, but you can get the particle size information from the NMR Lipoprofile test. I went to my local Labcorp facility last year and got it done for $99 as I recall. Several months later, I saw my doc for my annual physical and (much to my surprise) he included it with my bloodwork, so I had two sets of results (very similar). Medicare paid for the one with my checkup.
My doc said he was thinking of switching to the Spectracell Lipoprotein Particle Profile test. I think it has a little more information than the NMR and I think it was going to cost $40 if insurance didn't fully cover it. He seems to negotiate special prices with the labs, so YMMV.

Cleveland HeartLab (.com) was another place he liked, perhaps the lab of choice, but also more expensive for now. There's lots of the latest info on their website.

Our Science | Cleveland HeartLab, Inc.

"In fact, nearly 50% of all heart attacks and strokes occur in patients with ‘normal’ cholesterol levels. Recent evidence goes beyond lipids to suggest that inflammation within the artery wall is the primary contributor to this residual risk for heart attack and stroke."
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Old 02-10-2014, 01:51 PM   #145
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Old 02-10-2014, 02:47 PM   #146
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Just had a very in-depth analysis of my blood by a company called WellnessFX last week. My blood was drawn at Quest Diagnostics and in 3 days I knew more about my health than I've ever learned from my doc.

It was $199 (which insurance didn't pay) but it included analysis that my doctor has never even suggested. My cholesterol is consistently a bit above 200 but finally learned that I have more of the fluffy good type of LDL and fewer of the bad sticky kind. The $199 version of the test also tests for C reactive proteins which is the body's internal inflammation. Was happy to learn that even though I've had a terrible diet over the last several months my internal inflammation is in the lower end of low risk.

Also, you can pay about $40 to have one of their nutritionists or MDs review the results with you and make recommendations. It's a 20 minute consultation. I chose to do this since most docs have had only one class on nutrition (!) and one class on genetics so they're not really up on how to use food as medicine.

If you're interested in looking into them the link is here: http://wwws.wellnessfx.com
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Old 02-11-2014, 05:15 AM   #147
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I want to throw this in the discussion, extreme work outs 6 times per week and a very low fat diet, did nothing for my chol level. Statins did. So as soon as I had a lipid panel the Dr. would recommend exercise. Works for some but not for me. Also some of my friends were on the all meat diet and there chol was lower on a high fat diet.
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Old 02-11-2014, 09:13 AM   #148
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I want to throw this in the discussion, extreme work outs 6 times per week and a very low fat diet, did nothing for my chol level. Statins did. So as soon as I had a lipid panel the Dr. would recommend exercise. Works for some but not for me. Also some of my friends were on the all meat diet and there chol was lower on a high fat diet.
From what I've read, the 'extreme' part of your workout could have been part of the problem. The body produces massive amounts of cortisol when one exercises to extreme. Cortisol causes inflammation in the body which then messes up all kinds on internal functions.

You might want to try moderate exercise with a lower carb, higher fat diet to see if that would work. I'm experimenting now with a ratio of carbs/protein/fat of 20/40/40 and have cut out all alcohol which burns like sugars to see how much I can influence my cholesterol numbers.
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Old 02-11-2014, 10:29 AM   #149
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Also some of my friends were on the all meat diet and there chol was lower on a high fat diet.
Probably because on such a diet (not that I recommend an all meat diet) they cut out the highly refined carbs and added sugars. Those seem to be worse for us than old fashioned, natural fats found in real food. Of course, we are all different, so what works for one person may not work for others.
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Old 02-11-2014, 11:11 AM   #150
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Glad I found this discussion. DH's new endocrinologist has been pressuring him to get on statins. A type I (insulin dependent) diabetic for 40+ years, he low carbs and has been told he is one of the healthiest long term diabetics his doctor has seen. But there is this study, see, and we want you to take statins to prevent issues. I have to wonder, given the positive impact of low carbing on cardiac health, how linearly you can extrapolate the study results done on people probably eating a conventional diet to one eating low carb? Do these studies actually apply to a low carber?

His total cholesterol is moderately high, lipids low, c-reactive protein great, but because he also has mildly high blood pressure (140/80) they want to throw him on meds. I have heard so much of the negatives of statins, that I have gotten him to question the wisdom of going on them.

I wish I could say he was a FABULOUS low carber, but with the pressures of the job, he has been over doing it to some extent. When he quits in 18 months at 55, no longer eating out with customers or having hoagies at meetings, the low carb will be much more controlled. Is it better to go on the statins for those 18 months and then get off them when his diet is more controllable? A crystal ball would be nice.

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Old 02-11-2014, 11:18 AM   #151
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Probably because on such a diet (not that I recommend an all meat diet) they cut out the highly refined carbs and added sugars. Those seem to be worse for us than old fashioned, natural fats found in real food. Of course, we are all different, so what works for one person may not work for others.
Low Carb is about lowering your exposure to high glycemic index foods that raise your blood sugars quickly, requiring large amounts of insulin use, which can also impact your body's manufacturing of cholesterol. You count "net" carbs, which is the carb count minus the indigestible fiber. Different people require different levels of carbs taking into account their body and goals. So sure, I can have a cheese burger, but instead of a bun and fries, I have it chopped up on top of a wonderful large salad with my spicy guacamole dressing. Or if we have steak, it is with a side of mashed cauliflower and a side of broccoli. LOTS of low glycemic veggies with this way of eating.

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Old 02-11-2014, 11:27 AM   #152
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Low Carb is about lowering your exposure to high glycemic index foods that raise your blood sugars quickly, requiring large amounts of insulin use, which can also impact your body's manufacturing of cholesterol. You count "net" carbs, which is the carb count minus the indigestible fiber. Different people require different levels of carbs taking into account their body and goals. So sure, I can have a cheese burger, but instead of a bun and fries, I have it chopped up on top of a wonderful large salad with my spicy guacamole dressing. Or if we have steak, it is with a side of mashed cauliflower and a side of broccoli. LOTS of low glycemic veggies with this way of eating.

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I would love to see some lipid studies where the participants were all low carbers. There are some of us that have a high total cholesterol (that some docs want to treat with statins), but our ratios are off the charts 'good' and we show zero CV disease on imaging tests.
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Old 02-11-2014, 11:56 AM   #153
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Sorry if this is a repeat, but found it interesting.
World Renowned Heart Surgeon Speaks Out On What Really Causes Heart Disease | MyScienceAcademy
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Old 02-11-2014, 12:13 PM   #154
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"Let me repeat that: The injury and inflammation in our blood vessels is caused by the low fat diet recommended for years by mainstream medicine.

What are the biggest culprits of chronic inflammation? Quite simply, they are the overload of simple, highly processed carbohydrates (sugar, flourand all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods."

Which is why on our low carb diet, and taking supplements like turmeric which has been shown to be beneficial in reducing inflammation, I think it is too simplistic for DH's endocrinologist to say studies show statins to be great for diabetics!

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Old 02-11-2014, 12:56 PM   #155
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I think it is too simplistic for DH's endocrinologist to say studies show statins to be great for diabetics!
Absolutely correct!

Here's a study from last year that says pretty much the opposite:
Could Statins Raise Diabetes Risk? -- WebMD
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Old 02-11-2014, 01:17 PM   #156
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Absolutely correct!

Here's a study from last year that says pretty much the opposite:
Could Statins Raise Diabetes Risk? -- WebMD
That is not really what the article says. It does not address the hazards of taking statins for diabetics, but says that taking statins may increase your risk of getting diabetes if you don't already have it. There is also a danger of accepting someone's interpretation of a study unless you know their motivation and credentials. The person who wrote that synopsis lost any credibility with me when they wrote "People with type 2 diabetes have higher than normal blood sugar levels because their bodies don't make or properly use insulin." If your body doesn't make insulin, then you are a type I diabetic. Type 2's might still require insulin injections if their control is that bad, and they may evolve into a type 1 if they stress the insulin production so hard that they burn out it's ability to produce insulin, but at that point they are a type I insulin dependent.

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knowing way more about diabetes than she ever hoped to, but not enough about statins :-)
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Old 02-11-2014, 04:35 PM   #157
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Here's a tedious presentation for providers summarizing a bunch of studies from a few years ago:

http://www.dmhc.ca.gov/library/repor...are_112012.pdf

(Pay attention to slide #11)

The bottom line is that for prevention of MI in diabetics and people with a previous history of a coronary event, peripheral vascular disease, etc., the combination of a cheap, generic statin, a cheap, generic ACE-I drug (lisinopril, benazepril or some other "-pril") and cheap, generic aspirin is extraordinarily powerful for dropping (not eliminating) risk of a heart attack. People without those risk factors don't get much if any improvement with the same combo, though. The risks of the drugs are grossly exaggerated in the media. People who develop type 2 diabetes on statins already have signs indicating that they have the genetic pre-disposition to the problem anyway.
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Old 02-12-2014, 08:37 AM   #158
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Here's a tedious presentation for providers summarizing a bunch of studies from a few years ago:

http://www.dmhc.ca.gov/library/repor...are_112012.pdf

(Pay attention to slide #11)

The bottom line is that for prevention of MI in diabetics and people with a previous history of a coronary event, peripheral vascular disease, etc., the combination of a cheap, generic statin, a cheap, generic ACE-I drug (lisinopril, benazepril or some other "-pril") and cheap, generic aspirin is extraordinarily powerful for dropping (not eliminating) risk of a heart attack. People without those risk factors don't get much if any improvement with the same combo, though. The risks of the drugs are grossly exaggerated in the media. People who develop type 2 diabetes on statins already have signs indicating that they have the genetic pre-disposition to the problem anyway.
I did not find that slide show tedious at all, though it would have been helpful to be at the presentation as much information is missing from the slides. Thank you for the link. However, what I draw from it is the following:

-For a couple of decades, based on some "evidence" of uncertain nature, the general public has been over treated with statins with no significant benefit. Rush to prescribe a concern then, what about now?

-From the slides, it appears as though the research is based on type2 diabetes, which is very different from type 1. DH's body simply doesn't make insulin anymore, which he must inject. For him it was an auto immune issue that occurred post infection as a kid. His body uses the injected insulin just fine, and is not insulin resistant as is the case with type 2.

-Beyond statins there are several ways to reduce MI risk, including ace inhibitors and aspirin, both of which he takes. Not covered by this slide show is low carb dieting, which has been shown to be heart healthy when done well, and taking other anti-inflammatory supplements such as fish oil and turmeric.

My conclusions, though no doubt imperfect:

-Cynically observe a need for the statin manufacturers to find another set of customers now that long term analysis of the one time ground breaking "evidence" has shown that the treatment with statins is ineffective for many.

-Wonder what the results will be down the road when the current conclusion that people with diabetes should take statins is analyzed and controlled for type of diabetes, alternative supplementation/meds, and lifestyle. Just how much do statins add? Is the combination with aspirin and ace inhibitor magical, or do the aspirin/ace combo pretty much cover it, particularly when combined with lifestyle/supplements?

-Believe that side effects of statins are actually more prevalent than reported. While anecdotal evidence is a much weaker approach to determining risk than a controlled study, there is an increasing amount of anecdotal evidence demonstrating that negative life effects, ones that doctors have not been told could be a result of statins, disappear when statins are removed from body.

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Old 02-12-2014, 10:45 AM   #159
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Probably because on such a diet (not that I recommend an all meat diet) they cut out the highly refined carbs and added sugars. Those seem to be worse for us than old fashioned, natural fats found in real food. Of course, we are all different, so what works for one person may not work for others.
that's what worked for me.
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Old 02-13-2014, 07:34 PM   #160
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-Beyond statins there are several ways to reduce MI risk, including ace inhibitors and aspirin, both of which he takes. Not covered by this slide show is low carb dieting, which has been shown to be heart healthy when done well, and taking other anti-inflammatory supplements such as fish oil and turmeric.

My conclusions, though no doubt imperfect:

-Cynically observe a need for the statin manufacturers to find another set of customers now that long term analysis of the one time ground breaking "evidence" has shown that the treatment with statins is ineffective for many.

-Wonder what the results will be down the road when the current conclusion that people with diabetes should take statins is analyzed and controlled for type of diabetes, alternative supplementation/meds, and lifestyle. Just how much do statins add? Is the combination with aspirin and ace inhibitor magical, or do the aspirin/ace combo pretty much cover it, particularly when combined with lifestyle/supplements?

-Believe that side effects of statins are actually more prevalent than reported. While anecdotal evidence is a much weaker approach to determining risk than a controlled study, there is an increasing amount of anecdotal evidence demonstrating that negative life effects, ones that doctors have not been told could be a result of statins, disappear when statins are removed from body.
In the UK NICE just recommended the expansion of statin use. The benefits far outweigh the risks:

BBC News - Guidelines call for more people to be put on statins

Although type 1 and type 2 DM are very different diseases, the complications that we see in smokers and people with either type of diabetes are micro- and macrovascular disease. Statins are an important tool in preventing those consequences.

Over the years all kinds of diets and supplements have been advocated for the prevention and treatment of heart disease. Lecithin, vitamin E, various B vitamins, cinnamon, hawthorn, fat-free, low-carb, etc. have all been advocated, however, none of them have really been shown to work. Statins, OTOH, have been shown to be quite powerful.

I don't think that we will see statins be discarded any time soon. I think it's more likely that the mechanism by which they work has a lot more to do with plaque stabilization on arterial walls rather than LDL lowering. I suspect that lower, fixed doses will be used. Since most of the drugs are now available as inexpensive generics, I can't think that anybody is going to get rich by cynically pushing them.
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