Cholesterol madness

[braumeister]

And some people just like their chocolate, salt, beer, bacon, in excess and don't want to cut back.

Hold on there!
Using the word "excess" in the same sentence with chocolate, beer, and bacon seems very wrong IMHO.

 

[audreyh1]

Doctors do not learn nutrition in US medical school, so most farm out nutritional counseling if prescribed to dieticians. Dieticians are still in general taught very much old school food pyramid bunk. So the doctors would probably have been taught that too anyway.

Doctors definitely do diet intervention when someone is diagnosed as diabetic, but the patient is usually sent to a dietician who gives the American Diabetes Association diet, which is a high carb diet.

 

[RAE]

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

Yeah, there are similar websites showing locations of functional/integrative physicians across the country also. I've done some searching on those, but I live in a rural area, and there are none within a few hundred miles of me, as far as I can tell. So for now I'll probably just continue to go to my current doc, mainly for my annual blood test, which I basically interpret myself anyway. Fortunately, my health is good, so at this point I don't really need a better doctor. It would be nice, though, to actually go to a doctor who I could converse with about some non-traditional approaches to health and healing - someone that I might actually learn something from. As it is now, I basically just go for my blood test results, and that's about it.

 

[ER Eddie]

Doctors definitely do diet intervention when someone is diagnosed as diabetic, but the patient is usually sent to a dietician who gives the American Diabetes Association diet, which is a high carb diet.

Same diet as caused diabetes. Genius!

...As it is now, I basically just go for my blood test results, and that's about it.

Same here. My last doctor just looked at the computer screen and read lab results. She just went from lab results to prescription pad, that was her whole focus. I lost 40 pounds and she didn't even comment. My HDL went up and triglycerides went down, and she didn't comment. But she raised concerns about a small increase in LDL (oh noes). I tried to talk with her about how unreliable cholesterol research is, but she wasn't listening. She's gone now, which is good. I'll be getting a new doc soon, but it's kind of a roll of the dice when you're going through employee health. Fortunately I don't have any major health issues.

 

[athena53]

<snip>I would suggest that you switch doctors, but it probably wouldn't do any good, as the vast majority of doctors will continue to push statins and other drugs to control things that are not causing any harm in the first place.

I will be having my annual exam/blood test at the doc's office this fall, and I will probably get the same advice that you just got (although he knows how I feel about statins). So I mainly go for the blood test (covered by insurance), the results of which I will interpret myself, as I always do.

My last employer had a Wellness program that made sense in general (I ended up buying a new laptop with all the Amazon gift cards I got from regular workouts), but offered me a massive number of brownie points if I'd get my total cholesterol down. I'd already tried statins and discarded them because of tendonitis and, as I noted in an earlier post, most of the individual components and ratios are good. Clearly the best way to get those points was to take statins again. No way.

Thanks to Braumeister, I used Requestatest.com for my last bloodwork. I paid out of pocket but a Basic Heart Health Panel is only $79 at nearby Quest and LabCorp labs. I've made some tweaks to my diet and will be retesting in July (6 months after the last test)- no doc needed.

 

[sengsational]

I'd never heard of requestatest. I wonder how prices and selection compares to lifeextension.org. I need to put that research on the to do list.

 

[RAE]

Thanks to Braumeister, I used Requestatest.com for my last bloodwork. I paid out of pocket but a Basic Heart Health Panel is only $79 at nearby Quest and LabCorp labs. I've made some tweaks to my diet and will be retesting in July (6 months after the last test)- no doc needed.

I have been thinking about doing something like this also, as it's a major battle to get my doctor to order a couple of the blood tests that I'd like to have done (fasting insulin, for one). I have not heard of requestatest.com either, but I know Life Extension and a few other places offer the same kind of thing, and the prices don't seem too bad. So I'm assuming your experience with requestatest.com was pretty good?

 

[audreyh1]

The pharmacy at my HEB offers a cholesterol screening that I think is even cheaper than $79. It’s probably a limited number of items. Requires fasting.

Yep here it is: $29.99! https://www.heb.com/static-page/article-template/Second-Saturday-Screenings

I used some other online test ordering service several years ago.

 

[braumeister]

I'm assuming your experience with requestatest.com was pretty good?

I've been using them for at least six years. Very satisfied.

 

[audreyh1]

I have been thinking about doing something like this also, as it's a major battle to get my doctor to order a couple of the blood tests that I'd like to have done (fasting insulin, for one). I have not heard of requestatest.com either, but I know Life Extension and a few other places offer the same kind of thing, and the prices don't seem too bad. So I'm assuming your experience with requestatest.com was pretty good?

My “crazy” doc, who is very aggressive with blood tests, now does fasting insulin and A1C on everyone regardless of blood glucose. I had normal blood glucose - usually in the 80s.

My fasting insulin was 8.6. I think the lab normal range was up to 19. But Doc says should be below 8. So mine was a little high indicating slight insulin resistance.

 

[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]

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]

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]

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]

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]

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]

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]

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]

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]

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.