Cholesterol madness

[kcowan]

In Feb, I had some lower back pain and decided to stop the statins, so in May, when I had my annual tests, the LDL had risen to 3.93 from 0.66 so I am back on them and getting the lower back investigated.

[athena53]

Quote:

Originally Posted by RAE So I'm assuming your experience with requestatest.com was pretty good?

Flawless. They even faxed the results to my doc (and she got them) when I gave the the appropriate authorizations. I love my doc but the lab she uses could never find her orders in the computer so if I didn't have a hard copy I'd have to wait (while fasting!) till her office opened at 9 AM. They also manage to code things in ways that make Medicare reject them as "not medically necessary".

Not great that I have to pay out of pocket but the convenience is worth it. A woman working at the LabCorp office where I was tested said her husband had used RequestaTest to monitor his cholesterol levels when they didn't have insurance.

[FI FELLOW]

I have been seeing a cardiologist for 20 years, since my aortic valve replacement with a mechanical valve at age 39 (congenital defect). He says that since patients have been using statins he has seen replacement heart valves last virtually forever, with little buildup of deposits as happened previously. He's a huge believer in statins for that reason.

[yakers]

Quote:

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

+a very large number

[Badger]

The vast majority of doctors have much less academic exposure to diet and nutrition than you would receive in a one semester introductory nutrition class. Medical school is extremely lacking in that realm of medicine. It is well documented that about 71% of the US population is overweight that includes the $40% of the population that are obese. I would first look at the physical condition of my doctor before listening to their recommendations. For some reason so many doctors choose to ignore the research described by the CDC, AMA, JAMA, Lancet, The New England Journal of Medicine, etc. and like to prescribe pharmaceuticals instead.

The US diet and eating habits have changed considerably in the past 50+ years to a great deal of processed simple sugars, fat, excessive amounts meat, and processed fast food with less whole grains, vegetables and fruit. The other part of the equation is there is also a large part of the population that is sedentary.


Cheers!

[sengsational]

For those doing self pay testing, a little story that caught me off guard:


My PCP order a test and that was a bit screwed up with respect to insurance, so wasn't paid yet. The test came back for $85 without insurance and once run through insurance it was $7.29, or something like that.



Anyway, I walked into LabCorp with the new out of pocket test order that was already pre-paid and the lab refused to do the test. Refused to do any new testing until the account was zero. I'm not sure how much competition there is in lab testing, but is seems like LabCorp is the only option.

[audreyh1]

Quote:

Originally Posted by sengsational For those doing self pay testing, a little story that caught me off guard: My PCP order a test and that was a bit screwed up with respect to insurance, so wasn't paid yet. The test came back for $85 without insurance and once run through insurance it was $7.29, or something like that. Anyway, I walked into LabCorp with the new out of pocket test order that was already pre-paid and the lab refused to do the test. Refused to do any new testing until the account was zero. I'm not sure how much competition there is in lab testing, but is seems like LabCorp is the only option.

Quest Diagnostics could be another option?

[John Galt III]

You guys doing the self pay blood testing: Do you need a prescription from a doctor?

[donheff]

Quote:

Originally Posted by John Galt III You guys doing the self pay blood testing: Do you need a prescription from a doctor?

I did one a few years back with no prescription.

[audreyh1]

Quote:

Originally Posted by John Galt III You guys doing the self pay blood testing: Do you need a prescription from a doctor?

The internet sites have a doctor ordering the test for you.

However, the grocery store just does the test.

[zinger1457]

Quote:

Originally Posted by John Galt III You guys doing the self pay blood testing: Do you need a prescription from a doctor?

Not sure if it varies by state but Arizona no longer requires a doctors prescription for most blood test, it was changed 3-4 years ago as I recall.

[braumeister]

Quote:

Originally Posted by sengsational I'm not sure how much competition there is in lab testing, but is seems like LabCorp is the only option.

Requestatest lets you choose where to get the tests done: LabCorp or Quest Diagnostics. Whichever is more convenient for you.

And no, a prescription is not necessary.

[timo2]

Quote:

Originally Posted by braumeister Had my semiannual checkup today and we went through the usual pointless conversation: "I'd really like to see you on a statin" "Not a chance" "OK, next topic ..." As some here may remember, I'm an extreme skeptic about statins and the cholesterol hypothesis in general. My total cholesterol and LDL levels have always been high, but my HDL and triglyceride levels are outstanding, which is all I care about. Anyway, the doc brought up a new one this morning, with a wink since he knew what my reaction would be. It seems that some prominent cardiologists are going far beyond the standard LDL goal of 100 or less, and now want your LDL level to be less than your age. Why? Because they have new drugs that can bring it down that low.

DW has high LDL but really high HDL. When she is approached like this, she says 'I thought it was the ratio of the values that was important, not the absolute value'. and they stop then, because that is also in the medical literature.

[sengsational]

Quote:

Originally Posted by braumeister Requestatest lets you choose where to get the tests done: LabCorp or Quest Diagnostics. Whichever is more convenient for you. And no, a prescription is not necessary.

That's then a plus for requestatest since I don't recall LEF offering an option to select a different place.

[braumeister]

A couple more indications of how extreme this stuff can get:

The new drug achieving astounding results in lowering LDL levels is called alirocumab, so something you could look up if you're interested. The research was sponsored by the company making the drug, of course. And the reason some cardiologists are so excited about it is that "the average LDL of a newborn is 35" so that ought to be the goal for everyone.

The other thing I read recently (but not new) is you can now go in (every two weeks for the rest of your life) for "LDL Apheresis" to remove the LDL from your blood, similar to how dialysis works.

Don't want to take a statin? They've got you covered.

[donheff]

Why would we assume stats for babies would be the target for adults?

[youbet]

Quote:

Originally Posted by kcowan In Feb, I had some lower back pain and decided to stop the statins, so in May, when I had my annual tests, the LDL had risen to 3.93 from 0.66 so I am back on them and getting the lower back investigated.

Smart move getting the lower back investigated. I too was having lower back pain with symptoms of sciatica. I really wanted to blame the low dose steroid (5mg/day Atorvastin) I've been taking for years but after working with a physical therapist, we discovered my core body strength was poor. Fixing that required a LOT of work (for a guy who definitely isn't a gym rat) but the results have been great. At almost 72 yo, I'm back to joining DW on multi-mile walks without lower back pain stopping the fun and am enjoying much improved flexibility and mobility.

I'm OK with taking Atorvastatin in this very low dose. All my numbers are good and I have no discernable side effects. I've developed a "why rock the boat" attitude about it I guess. The only real pita is needing to use a pill cutter to half the 10mg pills to 5 mg since 10mg is as low dose as they come.

[youbet]

Quote:

Originally Posted by Badger The vast majority of doctors have much less academic exposure to diet and nutrition than you would receive in a one semester introductory nutrition class. Medical school is extremely lacking in that realm of medicine. It is well documented that about 71% of the US population is overweight that includes the $40% of the population that are obese. I would first look at the physical condition of my doctor before listening to their recommendations. For some reason so many doctors choose to ignore the research described by the CDC, AMA, JAMA, Lancet, The New England Journal of Medicine, etc. and like to prescribe pharmaceuticals instead. The US diet and eating habits have changed considerably in the past 50+ years to a great deal of processed simple sugars, fat, excessive amounts meat, and processed fast food with less whole grains, vegetables and fruit. The other part of the equation is there is also a large part of the population that is sedentary.

My PCP is a DO instead of the traditional MD and I've been quite pleased with him for the 30+ years I've been under his care. He's part of an independent practice unattached to any of the big area medical conglomerates.

I do see MD specialists from time to time (urologist, cardiologist, dermatologist) but count on the DO for routine check-ups, incidental minor treatments and solid lifestyle advise. He's definitely a diet and exercise guy.

When he and I decided that I really needed to lose some weight, he did refer me to a dietician (covered by a Medicare program). He and the dietician both are in the camp that a basic healthy diet (by historical standards) is the way to go rather than one that emphasizes extremes in carb/fat/protein ratios. So, working with the dietician and using "myfitnesspal" (free version), I tweaked carbs down and protein up a bit and counted total calories while doing some exercise. I slowly lost 70 lbs over about two years and am successfully holding steady now. We're thinking that perhaps another 10 lbs might be helpful and I'll use the same slow, steady and no extremes to do that.

DO Doc happily took me off BP meds after the weight loss and left the 5mg daily of Atorvastatin up to me.

[threegoofs]

Quote:

Originally Posted by sengsational Any doctor that prescribes a statin based on calculated LDL or without running the Apo B blood test should be fired.

Wrong.

Statins should be prescribed to high risk individuals irregardless of cholesterol levels.

Statins work. Extremely well.

And when I say work, I mean they work in reducing cardiovascular events and death, their effect upon cholesterol is secondary.

[yakers]

Quote:

Originally Posted by threegoofs Wrong. Statins should be prescribed to high risk individuals irregardless of cholesterol levels. Statins work. Extremely well. And when I say work, I mean they work in reducing cardiovascular events and death, their effect upon cholesterol is secondary.

That is what my cardiologist said. I wanted to come off statins, I have low LDL, and triglicerides and good HDL, good BMI, controling my blood sugar well through LCHF. But she said the anti inflammation properties are important for me, I had two ablation procedures. We compromised and I reduced the dose 50% but continue to take a statin. Have not had any negative side effects.