LDL Measurements and Statin Use Poll

[Chuckanut]

One thing I object to is the idea the LDL is 'bad' and HDL is 'good'. From what I understand, minimal that it is, we need both to survive. What may be a problem is if they are out of balance. But, the idea that one is bad for us and one is good for us is not accurate.

 

[razztazz]

Effort to increase HDLs have not been successful in reducing CHD or mortality rates.

 

[braumeister]

razztazz, I'm not sure exactly what point you were making, but there is a very well established correlation showing that subjects with lower HDL are more likely to develop heart disease than those with higher HDL. And increasing your HDL is very easy with a low carb, high fat diet.

 

[Katsmeow]

razztazz, I'm not sure exactly what point you were making, but there is a very well established correlation showing that subjects with lower HDL are more likely to develop heart disease than those with higher HDL.

I believe that is true. That does not, however, prove that raising HDL will lower risk. That is, it could be that something other than the HDL is causing the correlation to which you refer such that simply raising HDL wouldn't do anything.

And there is actually some research addressing this.

http://www.nytimes.com/2012/05/17/h...esterol-found-not-to-cut-heart-risk.html?_r=0

All of that said, I don't think the book is closed on this issue and more research needs to be done.

 

[braumeister]

Agreed.
HDL certainly has anti-inflammatory properties, and this is most likely a big contributor, but the actual mechanisms are still unknown, I think.

 

[razztazz]

And then, predictably, there is this:

Study: “Good” Cholesterol Can Be Bad for Your Heart | Yahoo Health

HDL—the so-called “good” cholesterol—sometimes goes rogue and clogs arteries instead of keeping them healthy, according to a groundbreaking new study published in Nature Medicine.

Cleveland Clinic researchers have solved a longstanding scientific mystery: despite numerous studies showing that HDL has heart-protective properties, all studies conducted to date on therapies designed to boost good cholesterol have failed to show any significant improvement in cardiovascular health.

As long as they keep hiding behind "latest studies show" and moving the goal posts with no actual stable data to show anything, we kinda know what the medical industry is up to. And all existing "very well established correlation" regarding cholesterol and heart disease is unfounded regardless of what they say and has been countered all along the way by other data that is just as good. (but perhaps not as lucrative).

As we used to day in the aviation biz: Good data is good. No data is bad. Bad data will get you killed

 

[braumeister]

And all existing "very well established correlation" regarding cholesterol and heart disease is unfounded regardless of what they say and has been countered all along the way by other data that is just as good.

The HDL correlation I mentioned above is very well founded, from numerous large studies. I would be interested in seeing what you consider countervailing data.

 

[Chuckanut]

The risks of heart disease varies by what drug Big Pharma can get approval for.

 

[razztazz]

The HDL correlation I mentioned above is very well founded, from numerous large studies. I would be interested in seeing what you consider countervailing data.

The HDL correlation I mentioned above is very well founded, from numerous large studies.

Which is proof of large studies. Correlation? they'll need to do better than that. Heart disease correlates 100% with people who go to the bathroom every day. The studies you cite are in fact not conclusive as results vary by study. Cite all the other studies then reconcile them then you can have a reason to believe.

I however see no reason to engage in the internet laundry list game. I already know what "Studies show" hence no cross of cholesterol to crucify anyone on. I am making no extraordinary claims nor saying anything unusual.

 

[razztazz]

The risks of heart disease varies by what drug Big Pharma can get approval for.

True story: Late 1990s. My doctors was hype-selling statins and my need to avoid an imminent heart attack at age 41 with cholesterol of 215. At the time I figured hey, play it safe. So.... as a vegetarian on statins my LDLs came down but my triglycerides were 400-600 and HDLs had dropped to high teens/low 20s. Doctor says don't pay any attention to them they don't matter. ONLY LDLs matter. I joked and said, yes until they come out with a pill that raises HLDs or lowers triglicerides

A little white later they start advertising this pill on TV, I forget the name and I'm not sure it's even still being sold. The commercial started with

"WHEN LOWERING YOUR CHOLESTEROL IS NOT ENOUGH! This drug increases "good cholesterol" and lowers triglycerides an important indicator of heart disease!

Next visit shyster doctor says we need to get you on this new drug. Your triglycerides are too high and your good cholesterol is too low.

Every doctor I've had since then says the same thing. I have been off statins since 2002 unilaterally due to a host of medical problems all caused by statins. Doctor insisted they couldn't be caused by statins. No consderation or the patient's health or well-being. None of these doctors even hears me or wants to. Not interested in treating anything but cholesterol because apparently there's nothing else wrong with me. At least nothing they can pimp to me.

I ask them, so just what does this or that study actually say? And they can never tell me. I ask, OK so when you say risk what do you mean? Give m a number. what's the risk difference between this number and that number? No can do. Robot-clone-tourettes-afflicted parrots. Can only repeat what the Man on TV or their Boss tells them to think. Data? Knowledge? Interest in the patient? They have none. This is 100% personal ongoing experience not misstated, misinterpreted paper "studies".

I still haven't had that heart attack and since I stopped statins I feel much better.

 

[braumeister]

Doctor says don't pay any attention to them they don't matter. ONLY LDLs matter.

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.

 

[mpeirce]

Studies that show correlation are interesting and very helpful to point researches in a certain direction for further studies, BUT are much less compelling for behavior changes than harder science that show cause and effect.

A good example of this was peptic ulcers. For YEARS doctors didn't really know what was causing most ulcers. Eat better! Reduce your stress! None of it really worked long term.

Then folks figured out the actual cause: Helicobacter pylori infection.

When they cured that infection, the vast majority of cases were cured.


We need more of this type of research in medicine and less correlation studies. The later simply show how little we understand about how the body really works at this point.

 

[sengsational]

I still haven't had that heart attack and since I stopped statins I feel much better.

Statins can be really bad. They put my FIL in a wheel chair (for a bit). After he started on statins, but before it got bad, I was pulling weeds in the garden with him and he started complaining that after squatting around, his legs really hurt. I told him right then "you need to get off those statins", but he said "what about my numbers" . He finally went to the guy who prescribed the drug and only got off the statins when the doc told him to. That same doc mailed me a prescription for Zocor when my LDL was 115 and my TC to HDL ratio was 2.9! (my research at the time indicated that <4.5 is desirable, 3.3 optimal). That was the last time I went to that guy.

Check your local hospitals in February (heart health month, or something like that). Mine is going to have a 'sale' on getting a calcium score ($99). It's a CT of your carotid, so involves radiation, but you'll see real disease progression (or not!). Or if you don't like radiation, you can get a CIMT, which shows build-up before it calcifies, so actually earlier detection.

 

[Chuckanut]

A good example of this was peptic ulcers. For YEARS doctors didn't really know what was causing most ulcers. Eat better! Reduce your stress! None of it really worked long term.

Then folks figured out the actual cause: Helicobacter pylori infection.

When they cured that infection, the vast majority of cases were cured.

IIRC, the people who held the view that ulcers were caused by an infection were pretty well criticized, before they were proven correct.

 

[Chuckanut]

as a vegetarian on statins my LDLs came down but my triglycerides were 400-600 and HDLs had dropped to high teens/low 20s.

Interesting, since the latest thinking is that the ratio of Trigs/HDL is a better predictor of CVD than cholesterol. It should be under about 2.

Better Know Your Triglyceride/HDL Ratio if You Want to Prevent a Heart Attack

High Ratio of Triglycerides to HDL-Cholesterol Predicts Extensive Coronary Disease

 

[Helen]

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.

 

[lynxville]

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.

 

[braumeister]

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.

 

[Animorph]

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."

 

[Chuckanut]

Uh Oh!

Cholesterol Drugs Linked To Eye Damage, JAMA Study Confirms Anew | Health Impact News

 

[Lisa99]

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

 

[lynxville]

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.

 

[Lisa99]

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.

 

[Chuckanut]

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.

 

[InParadise]

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.

IP