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

[harley]

Quote:

Originally Posted by Texas Proud What level causes the flush How long does it last It might be something that I would try.... statins so far have not been tolerated by my body.... sometimes in a big way.... My doc is more concerned with my low HDL than my high normal LDL...

I take 500 mg twice/day. The niacin flush is when the niacin causes your blood vessels to dilate. It's sort of like a blush, except more extreme. Your face and shoulders get a little red, and it feels like a mild sunburn. It only lasts 10 minutes or so for me, although I've heard it's more extreme for others. It's a mild enough side effect for good enough gain that I don't mind the annoyance.

[wanaberetiree]

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Originally Posted by Brat My husband doubled his niacin about 4 months ago and occasionally gets flushed as well. One other side effect is that he has far fewer night time muscle cramps.

Be careful and check his uric acid to avoid gout.

[sengsational]

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Originally Posted by zedd Fact: statins lower blood cholesterol levels. Conjecture: Elevated blood cholesterol levels are a leading cause of heart disease and heart attack. There has never been a credible study linking elevated blood cholesterol levels to heart disease and heart attack. Prescribing statins to women is even more so dangerous. They are even talking about statins for children ... absolutely criminal. zedd

Agreed 100%

I'm not sure why, but generally people concentrate on "numbers" when those numbers do not correlate to health! LDL-C, which is what you get in a regular lipid panel, is just not correlated well with CVD, yet that's still the reason some people get a statin! Nuts! The ratio of your hips to waist is a better predictor of CVD than LDL-C! There's general agreement now that the mechanism that helps some people who use a statin is NOT reduction of LDL, but rather the "side effect" of a statin: reduction of inflamation. If your doctor prescribes a statin based on just an LDL-C reading, I'd get a new doctor!

[rgarling]

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Originally Posted by UtahSkier Just some personal observations here about LDL and diet. Both my brother and I dropped our LDL and triglycerides significantly when we reduced Fructose consumption. Carb consumption (baked potato, oatmeal, rice) and Glucose consumption remained normal. Being wheat free had no effect. In my case, I kept my fructose consumption below 25g daily for 3 months. Triglycerides dropped from 92 to below 43. The best part is my SDLDL was confirmed to be Pattern A (large buoyant) (Sorry, no before test). SDLDL is the bad player in heart disease. ...

Interesting. Thanks for posting! Maybe the 'crazy' Dr. Lustig isn't so crazy.

[ohyes]

DH went to the doctor last month for a tetanus shot. BP was elevated. A LOT, but DH cannot remember the #'s. Doctor put him on Lisinopril (20 mg) and ordered blood work. EKG and chest x-rays.

A week later, partial report arrives in the mail, saying his cholesterol was 310. That number was circled. DH goes back next month for more tests.

So, I have been reading this thread with great interest, fearing the dr. may want to try statins. Have already told DH he is going to a different dr. if this one insists on statins. Probably getting ahead of myself and not certain DH is convinced I know more than the dr.

However you slice it, it is serious business. When it happens to you or somebody you love, you start paying more attention.

[tfudtuckerpucker]

Quote:

Originally Posted by ohyes DH went to the doctor last month for a tetanus shot. BP was elevated. A LOT, but DH cannot remember the #'s. Doctor put him on Lisinopril (20 mg) and ordered blood work. EKG and chest x-rays. A week later, partial report arrives in the mail, saying his cholesterol was 310. That number was circled. DH goes back next month for more tests.

Diet and exercise should normally be the first focus. Even the Lipitor ads (reluctantly) say this. Your doctor may want to immediately jump to statins, but please do your homework. I suspect some doctors don't push patients for diet and exercise, because so many patients just want a pill to "make it go away".

[Letj]

Avoiding statins is all well and good if your cholesterol is caused by lifestyle choices. However, for a small number of people whose high cholesterol is caused by a genetic defect, statins is the only thing that would prevent early death from heart disease. It's fairly easy to reverse high cholesterol by switching to a plant based diet if it's not genetically based.

[Chuckanut]

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Originally Posted by Letj Avoiding statins is all well and good if your cholesterol is caused by lifestyle choices. However, for a small number of people whose high cholesterol is caused by a genetic defect, statins is the only thing that would prevent early death from heart disease. It's fairly easy to reverse high cholesterol by switching to a plant based diet if it's not genetically based.

Good point. I am suspicious of drugs that have to be sold to me on TV, and the use of statistics that give the impression the benefits are a lot larger than they really are. But, modern medicine has done some real wonders with treating various diseases. My mother lived into her 90's thanks, in part, to blood pressure medicine that kept her BP at safe levels.

[Letj]

Quote:

Originally Posted by Chuckanut Good point. I am suspicious of drugs that have to be sold to me on TV, and the use of statistics that give the impression the benefits are a lot larger than they really are. But, modern medicine has done some real wonders with treating various diseases. My mother lived into her 90's thanks, in part, to blood pressure medicine that kept her BP at safe levels.

As you should be. BTW, it's prohibited by law in most of the developed world to advertise drug. I believe drug ads and all ads aimed at children should be illegal. Ads have an insidious way of corrupting and manipulating the mind and in my opinion is partly responsible for our drug culture and easy fix mindset as well as the obesity epidemic.

[Chuckanut]

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Originally Posted by Letj As you should be. BTW, it's prohibited by law in most of the developed world to advertise drug. I believe drug ads and all ads aimed at children should be illegal. Ads have an insidious way of corrupting and manipulating the mind and in my opinion is partly responsible for our drug culture and easy fix mindset as well as the obesity epidemic.

All of these drug and surgery ads on TV depress me. I think I will talk to my doctor about Calmdumba.

[sengsational]

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Originally Posted by Letj Avoiding statins is all well and good if your cholesterol is caused by lifestyle choices. However, for a small number of people whose high cholesterol is caused by a genetic defect, statins is the only thing that would prevent early death from heart disease. It's fairly easy to reverse high cholesterol by switching to a plant based diet if it's not genetically based.

It sounds as if you are under the impression that "cholesterol" is correlated with "early death". Not even what kind of cholesterol? Cholesterol is essential for health!! It serves an essential role in the body. There happens to be one type of particle that carries cholesterol that is suspected of promoting CVD, but that particle is usually not even measured. Google "framingham offspring study" and see for yourself that higher LDL-C is not a good predictor of CV 'events'!

[Letj]

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Originally Posted by sengsational It sounds as if you are under the impression that "cholesterol" is correlated with "early death". Not even what kind of cholesterol? Cholesterol is essential for health!! It serves an essential role in the body. There happens to be one type of particle that carries cholesterol that is suspected of promoting CVD, but that particle is usually not even measured. Google "framingham offspring study" and see for yourself that higher LDL-C is not a good predictor of CV 'events'!

I know a family where many of the males experience early death from heart attacks and they all had or have one thing in common - high cholesterol in the 300 to 400 range.

[harley]

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Originally Posted by Letj I know a family where many of the males experience early death from heart attacks and they all had or have one thing in common - high cholesterol in the 300 to 400 range.

And nothing else? Overweight, genetic predisposition, high blood pressure, smoking, alcohol use, coronary artery disease, etc?

Correlation does not imply causation. Cholesterol probably does have something to do with heart disease, but I've done a lot of reading on the topic (brother died of a heart attack at 42, cholesterol level was well below 200) and I don't think they've got good handle on the cause yet. And it's easy to throw pills at a condition, but it's hard to prove that using the pills has ever extended anyone's life.

It's similar to when I was diagnosed with diabetes. My doctor tried to put me on pills, and barely mentioned lifestyle changes. Just like patients, doctors sometimes take the easy way out.

[razztazz]

People with familial hypercholesterolemia (cholesterol over 400) have, in some studies not all, been shown to a heart attack rate a whole whopping (meaningless) 6% higher than the gen pop. (Malcolm Kendricks MD et al) And that was not correcting for any other factors. Cholesterol is pretty worthless for indicating anything except the patient is about to have his pocket picked.

[Letj]

Not necessarily disagreeing but I do want to point out that I happen to know well at least one of the individual practically all his life. He's never smoked, drank nor had a bad diet. In fact, he was an athlete for much if his youth. He started his cholesterol regimen in his 30s and is now 51. When he started, his doctor told him that with such high cholesterol levels, he must already have some build up in his arteries. Sure enough, after a recent heart scan, he was told that he has moderate arterial blockage. Not exactly sure what this means for him.

[imoldernu]

When it comes to personal health, I think that we tend to obsess over the concept of "normal", and the idea that if we do everything ""right", then we should live a long happy life... and... if we can do it without resorting to unnatural chemical substances, we should be even healthier.
That's a little hard to take for those who have physical anomolies that are out of the normal range and are advised that they can be cured with exercise or diet.
The frustration of not being able to control cholesterol, triglycerides or weight with lifestyle changes sometimes leads to a feeling of failure and a loss of self esteem, especially with younger people.

As to drugs, studies, and "what they're not telling you... a simple internet search will bring up a "proof" for whatever the current health fad might be. All of the theories are backed with scientific truths to suit the predilection of the source.
Alternate medicine... Homeopathy, Ayurveda, Chiropractic and Acupuncture, and natural alternatives to drug remedies all have strong adherents, many of whom are absolutely certain that they have discovered the holy grail of eternal life.

Coming from an era when "drugs" and were limited to aspirin, milk of magnesia, Cuticura, Dristan and Tums, ... I see the growth of the pharmaceutical industry as being the single, most amazing evolutionary event since the invention of printing.

Practical thought?... Do whatever works. Try whatever sounds good and logical, watch for side effects, and keep an open mind. This curmudgeon lived through the "discovery" of cholesterol and the first tests of cholesterol level... went through 6 different 'statin drugs with limited results... original cholesterol at 380, and when triglycerides became de rigueur... off the scale at 1000+. Lipitor worked but resulted in severe muscle ache and muscle loss. Finally, a few years ago, settled on fenofibrate, which brought the readings down to borderline high. Total Cholesterol 200, Triglycerides 240.

With all of that, I am not sure that any of this is good, bad, or indifferent. Overall health is pretty good... no serious health problems (except for normal age related arthritis, some neuropathy, and slow onset of some kind of dementia.) DW thinks my early days as an athlete helped. And so we continue... doing whatever seems right or logical, and trying to figure out who to believe. So far, so good.

[Chuckanut]

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Originally Posted by Letj He's never smoked, drank nor had a bad diet. In fact, he was an athlete for much if his youth.

Interesting. Like my mother and her blood pressure medicine your friend seems to be somebody at significant risk who will benefit from the statin. I hope it helps him.

I am guessing that he did not need an advertisement to get get him to ask his doctor about the statin. In fact, I will bet that his doctor, after reviewing his and his family's medical history, recommended it. What a radical thought!

I like that kind of medicine, a sharp shooter approach. What many people are skeptical of, IMHO, is the shotgun approach. "Let's give a large number of people this medicine, though they have no diagnosed disease, in the hope that it will prevent one or two percent of them from getting sick. We'll worry about the side effects later."

[okapi]

Red Yeast Rice worked for me.Used in Asian countries for years.Drug companies trying to get it banned in U.S. Dollar is the bottom line.Drug companies hate healthy folks cause they don"t make money off them.My changing to a more plant based eating lifestyle along with exercise helped also.

[ohyes]

DH had 1 month re-visit to dr. after cholesterol reading of 310. They took more blood, and dr. said this was "to get good, bad and ugly, but this is going to be ugly."

He gave us three months to get cholesterol down with diet/exercise. His advice: chicken or turkey, no oil, lots of veggies. Recommended red yeast rice, CQ-10, Niacin, fish oil (2 g/day- i have not figured out which one to purchase...any advice?). He said Niacin can cause flushing and take baby aspirin to counteract that. We had already purchased all of those, but cvs.com said do NOT take niacin with lisinopril, so we had held off. DH's dr. said there is no problem with mixing any of these with the BP med.

So, here we go....hope DH has marvelous results three months from now.

Funny thing is, DH gave up butter over a decade ago. Has avoided chicken skin, fried food, etc. This just kinda snuck (?) up...

[sengsational]

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Originally Posted by ohyes He gave us three months to get cholesterol down with diet/exercise. His advice: chicken or turkey, no oil, lots of veggies.

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?