New cardiologist not care about my cholesterol

[Koolau]

This was not a big shock exactly as it has been high (220-240) for a good 30 years and none of the several PCP or other cardiologist has cared either. . . . PCP says always runs higher in her thyroid patients . . . it just struck me as so odd the way he said it. Basically that they had been in there poking around taking photos (I had an angiogram in the hospital a bit back due to hypertensive crisis) and he was like more or less we can see you don't have any build up nothing to treat.

I'm good with this as I didn't want meds and was there for blood pressure . . . but I thought some of you would probably be amazed since I know many here have very very conservative goals for it. Of course if I develop more problems or get older they may change their tune. I just thought I'd throw it out there since I was thinking over the visit.

No real point to this post I guess. . . not trying to convince anyone to ignore what their doctor advises based on their circumstances of course.

He was at least open to trying to reduce my bp meds so that was a plus. Some of them think if 120 is good then 100 is better. . . . um not if it requires multiple meds . . . at least not as far as I am concerned.

I should have asked him about the local research study trying to get people to get their LP(a) checked but I didn't. I don't really want to know mine as there is nothing I can do about it. Figured mine would suck and I'd just worry. Not worth at $45 gift card.

Having relatively recently switched cardiologists (the first one retired) I notice that they are very different in what they emphasize, what they treat, how they treat it, etc. Kinda makes me wonder if a good PCP (which I believe I have) could treat my CAD just as well??

 

[badatmath]

Having relatively recently switched cardiologists (the first one retired) I notice that they are very different in what they emphasize, what they treat, how they treat it, etc. Kinda makes me wonder if a good PCP (which I believe I have) could treat my CAD just as well??

I don't think I really need a cardiologist. I met the first one in the hospital for a hypertensive crisis and just stuck with him to sort out the blood pressure which was a months long painful process but seems sorted for now. We'll see.

 

[Teacher Terry]

At age 50 despite being in excellent shape I ended up in the hospital with my BP 200/100 and tachycardia. A cardiologist got me on medication and I have been fine for 20 years. He was a real jerk and after a year I just had my GP monitor my condition.

About every 5 years the beta blocker stops working and we try a different one. Luckily I get a headache when the medication stops working. I also take my BP regularly. My GP said if I start to have problems in the future I will need to see a cardiologist but for now I don’t.

 

[aja8888]

At age 50 despite being in excellent shape I ended up in the hospital with my BP 200/100 and tachycardia. A cardiologist got me on medication and I have been fine for 20 years. He was a real jerk and after a year I just had my GP monitor my condition.

About every 5 years the beta blocker stops working and we try a different one. Luckily I get a headache when the medication stops working. I also take my BP regularly. My GP said if I start to have problems in the future I will need to see a cardiologist but for now I don’t.

I contracted SVT a few years ago and it was fixed with an ablation. No meds needed going forward. BP now normal and average resting pulse right at 51.







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[Teacher Terry]

I contracted SVT a few years ago and it was fixed with an ablation. No meds needed going forward. BP now normal and average resting pulse right at 51.


AJA, I have 2 separate problems. The HBP is genetic as everyone on my mom’s side of the family gets it fairly young. The too fast irregular heartbeat isn’t afib and my tachycardia is of unknown origin. However, it’s never happened again in 20 years because of the medication. Luckily one medication solves both problems. I occasionally have an ekg to make sure it hasn’t returned. The doctor said it was lucky that I didn’t have a stroke because of my blood pressure being so high so I am on the medication for life.

 

[aja8888]

I contracted SVT a few years ago and it was fixed with an ablation. No meds needed going forward. BP now normal and average resting pulse right at 51.


AJA, I have 2 separate problems. The HBP is genetic as everyone on my mom’s side of the family gets it fairly young. The too fast irregular heartbeat isn’t afib and my tachycardia is of unknown origin. However, it’s never happened again in 20 years because of the medication. Luckily one medication solves both problems. I occasionally have an ekg to make sure it hasn’t returned. The doctor said it was lucky that I didn’t have a stroke because of my blood pressure being so high so I am on the medication for life.

My SVT was from an electrical pulse, unknown source from my brain. Doc said when my heartbeat went to 200+ beats per minute, my heart was running a marathon while my legs and lungs weren't. Maybe it had something to do with the marathons I ran in my younger days? Who, knows, but the RF energy blast to the lightning bolt in my heart that kicked it off, fixed it. No meds, no more SVT!

 

[Teacher Terry]

That’s great AJA!!

 

[Koolau]

I contracted SVT a few years ago and it was fixed with an ablation. No meds needed going forward. BP now normal and average resting pulse right at 51.


AJA, I have 2 separate problems. The HBP is genetic as everyone on my mom’s side of the family gets it fairly young. The too fast irregular heartbeat isn’t afib and my tachycardia is of unknown origin. However, it’s never happened again in 20 years because of the medication. Luckily one medication solves both problems. I occasionally have an ekg to make sure it hasn’t returned. The doctor said it was lucky that I didn’t have a stroke because of my blood pressure being so high so I am on the medication for life.

I wasn't going to buy one, but my Big Sis bought me the Kardia Mobile device to watch for A-fib or SVT. It really w*rks. I also take BP reading pretty much every day. Good results past several months on meds only.

 

[teetee]

Last May the blood test showed my cholesterol at 236 mg/dL. I started taking Lipitor this March and yesterday's blood test showed my cholesterol level is 146 mg/dL. All lipid panel test results were normal.

I still enjoy fry chicken, all you can eat buffet from time to time but most meals are now low carb, low fat, and high fiber. I think the most change I made is putting lots of hours into the gym.

 

[braumeister]

most meals are now low carb, low fat, and high fiber.

Just so you know, it's not really possible to eat both low carb and low fat. There are only three macronutrients (carb, fat, protein) and that would mean you're eating mostly protein. Almost no one can tolerate more than about 25% protein in their diet, so you may be eating more of one than you realize.

 

[Koolau]

Just so you know, it's not really possible to eat both low carb and low fat. There are only three macronutrients (carb, fat, protein) and that would mean you're eating mostly protein. Almost no one can tolerate more than about 25% protein in their diet, so you may be eating more of one than you realize.

Do you have a citation for the 25% figure? I'm currently avoiding carbs and emphasizing protein. I'm sure that means I do get a fair amount of fat as well. But 25% as a tolerance level doesn't seem right but I am NOT an expert. I just know that I can lose weight on a very low carb diet. How much protein I get, I'm not sure. I just don't eat much carbs and don't pay attention to anything else. A citation might be valuable if you know a source (thanks.)

 

[Golden Mean]

Do you have a citation for the 25% figure? I'm currently avoiding carbs and emphasizing protein. I'm sure that means I do get a fair amount of fat as well. But 25% as a tolerance level doesn't seem right but I am NOT an expert. I just know that I can lose weight on a very low carb diet. How much protein I get, I'm not sure. I just don't eat much carbs and don't pay attention to anything else. A citation might be valuable if you know a source (thanks.)

Yeah, is the 25% weight or cals or ? If you eat very a high lean protein diet (like only chicken or rabbit) you can get in trouble but I don't think there's any issue with "tolerating" protein. I mean, we use protein the build our skin and muscles, and animal fat to build cells and hormones and burn for energy. Guess what macro we don't use (or need) to build and maintain our bodies...

 

[braumeister]

Most experts say from 10 to 35% of your calories should come from protein. Too much is as bad as too little, and most people seem to naturally settle on around 20-25%.

 

[Aerides]

25% for protein does sound about right, just from a practical way to eat. The average person trying to gain muscle mass shoots for 1.2 ish gm of protein per pound of body weight. (1gm per pound is probably fine for most people trying to gain mass).

So, 150 lbs, gonna have to eat about ~175 gm of protein a day. Even when trying, that is a LOT of protein. 4 cals per gm = 700 cals. A person trying to gain muscle mass working out significantly with a diet total of 2800 calories is also about right.

For a "normal" person not trying to gain 10-20 lbs of muscle, who is just maintaining a normal healthy diet of ~2000 calories, having 500 from protein means still over 100 gms of protein a day. It's not easy unless you are planning your macros. It's also pretty hard to do unless you are eating lots of meat every meal, or adding protein shakes and powders. I can get a nice overnight-oats with protein powder and high protein yogurt, but that's me going out of my way to add protein to my diet.

For example, a 6oz chicken breast has 46 gms of protein, so...if you are eating something like that for lunch and dinner, and then packing on eggs for breakfast, it's still hard to get consistently well over 100 gms of protein without really trying. And if I had a big protein lunch I won't naturally want one for dinner too.

There are also some studies suggesting you can only benefit from 30-40 gms of protein in a sitting. So even if you eat that 18oz ribeye, chances are your body didn't process all 67 gms of that serving.

 

[Golden Mean]

There are also some studies suggesting you can only benefit from 30-40 gms of protein in a sitting. So even if you eat that 18oz ribeye, chances are your body didn't process all 67 gms of that serving.

I believe this is based on one very old study and is almost certainly bunk. It makes no sense from an evolutionary perspective. It's like the "you only use 10% of your brain" myth. Here's a recent study on the subject. From the summary, "we show that the ingestion of 100 g protein results in a greater and more prolonged (>12 h) anabolic response when compared to the ingestion of 25 g protein."

There is a group of people that eat one meal (of properly fatty beef) a day and do well.

 

[Koolau]

The very low-carb, high protein diets (most rigorous is probably Adkins) supposedly "w*rk" because they stabilize blood sugar and one rarely feels "hungry." I notice that I can see someone eating a big chunk of chocolate cake or a huge slice of berry pie with ice cream and - yeah, sure, I'd like to join them - But I don't have a real "craving" for the "forbidden fruit." My temptation is fleeting.

I've lost 50 pounds in a year and feel fine. All my blood w*rk is "normal" (for me) and A1C is now normal where it had been elevated (as was fasting blood sugar which is now normal.) My carbs are "incidental" (like the added sugars in beef jerky or the table spoon of peanut butter I have as a treat.) I'm sure I get a fair amount of fat, but tend toward very low fat items such as the already mentioned jerky, tuna in water, 98% lean ham, pork loin, chicken breast, etc. I can have "as much as I like" but I'm rarely actually hungry so limit my portions even though I'm not required to.

If there truly is a "25% limit" for protein (either weight or calories) I'd like to know as I'm reasonably sure I'm over that every day - though I've never actually calculated it.

My doc was "concerned" about my weight loss even though I told him exactly what I was doing. He suggested that weight loss was a serious symptom of several diseases - especially cancer and he might have to "investigate" if I lose more weight (which I plan to do.) BUT he made no comments about my intake of protein. YMMV

 

[braumeister]

If there truly is a "25% limit" for protein (either weight or calories) I'd like to know as I'm reasonably sure I'm over that every day - though I've never actually calculated it.

Nobody ever said anything about a limit. The comment was simply that most people don't want to eat more than that on a regular basis.
And it's trivial to calculate it for yourself.

 

[Golden Mean]

The very low-carb, high protein diets (most rigorous is probably Adkins) supposedly "w*rk" because they stabilize blood sugar and one rarely feels "hungry." I notice that I can see someone eating a big chunk of chocolate cake or a huge slice of berry pie with ice cream and - yeah, sure, I'd like to join them - But I don't have a real "craving" for the "forbidden fruit." My temptation is fleeting.

I've lost 50 pounds in a year and feel fine. All my blood w*rk is "normal" (for me) and A1C is now normal where it had been elevated (as was fasting blood sugar which is now normal.) My carbs are "incidental" (like the added sugars in beef jerky or the table spoon of peanut butter I have as a treat.) I'm sure I get a fair amount of fat, but tend toward very low fat items such as the already mentioned jerky, tuna in water, 98% lean ham, pork loin, chicken breast, etc. I can have "as much as I like" but I'm rarely actually hungry so limit my portions even though I'm not required to.

If there truly is a "25% limit" for protein (either weight or calories) I'd like to know as I'm reasonably sure I'm over that every day - though I've never actually calculated it.

My doc was "concerned" about my weight loss even though I told him exactly what I was doing. He suggested that weight loss was a serious symptom of several diseases - especially cancer and he might have to "investigate" if I lose more weight (which I plan to do.) BUT he made no comments about my intake of protein. YMMV

If you are cutting out the carbs, there's no good reason not to take in the quality animal fat(s). It's what your body is designed to run on. If you keep carbs and fat low your are forcing your body to use protein for energy which is inefficient and could be harmful in extreme cases (and lean meat kinda sucks). Also, your body needs quality animal fats to make hormones, build cells etc. A choice ribeye steak probably has the right ratio of fat to protein.

Note: I'm not a doctor, so this isn't health advice. That said, I'm 5' 10" and 158lbs. My last doctor was 5' 8" and 220+ lbs...

 

[Koolau]

Nobody ever said anything about a limit. The comment was simply that most people don't want to eat more than that on a regular basis.
And it's trivial to calculate it for yourself.

Thanks for the clarification.

Yeah, it's trivial to calculate - I just never thought there was any need to do it as I'd never heard of not wanting to eat more than 25% protein. For a couple of months I ate virtually all protein (and fat - no carbs.) I had no problems with it other than realizing I had virtually no appetite. Who knew?? I lost weight so fast my doctor jumped me about it. I added back enough carbs that my weight loss slowed and (more or less) satisfied my doctor. HIS thing wasn't my diet - just the weight loss (suggesting disease.)