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My test results and deciding on statin therapy
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An_243333 posted:
I am considering statin therapy. My doctor, prior to this test has prescribed them.

Background: I am male, 55yrs, aerobically active (cycling, hiking/walking, XC skiing), 184lbs on a low carb diet since august, family history of heart disease (paternal grandfather-died of heart failure, father-2 bypass surgeries, 50yr old brother-stint... though none of them had my active lifestyle or diet)

Test results:
HDL 50 Ideal (>40)
HDL-2 11 (>10)
LDL 144 (<130)
Lp(a) 5 (<10)
IDL 10 (<20)
Density Pattern A
VLDL-3 11 (<10)
triglycerides 85 (<150)
VLDL 19 (<30)
Non HDL chol. 163 (<160)
LDL-R 128 (<100)
apoB 103 (<109)

My conclusion: I may be a candidate for statin therapy. Statins would not have much effect on inherited risk factors (Lp(a) and IDL) that are low anyway. Statins do have a known effect on LDL-R which for me is elevated. I am not at all excited about this conclusion, but will consider, and discuss it with my doctor.

Can you provide any guidance?
Thank you!
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JoeRamey responded:
In my background, I should have included I am 6ft, 184lbs.
 
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bobby75703 responded:
The choice is yours. I would certainly weigh the risks against the rewards.
 
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billh99 responded:
I see that you had a VAP test.

Do you have high BP or other risk factors?

Your LDL is high the fact that it is large buoyant (pattern A, and low apoB) does reduce your risk somewhat.

You might want to get a Cardio Scan (CT calcium scan). These are not covered by insurance. They can cost $300-500. But they are often available for $50.

They indicate the amount of calcium in the plaque in the coronary arteries. It can be used help determining your risk.

And other test is an ultrasound of the carotid arteries. That can show plaque buildup in the neck arteries.

If either of those are low then you might not need any treatment.

I don't know about your diet, but if you watch the amount of saturated fats, and make sure that you get lots of healthy fats (olive oil, fish, avocados, nuts, soy) that might help lowering the LDL.

One non-statin option is a plant sterol/stanol. This is what is added to some benecol margarine and other brands and some orange juice and yogurt.

But the oj and yogurts are not available in my area and I don't use that much margarine.

So another option is to use pills. Two brands are Cholestoff and CardioTabs. The Cholestoff is available at Costco and may drug stores.

The CardioTabs might be harder to find, but can be ordered.

http://www.cardiotabs.com/heart-healthy-resource-center/natural-cholesterol-lowering-strategies.html

http://www.naturemade.com/Products/Health-Solutions/Cholestoff-with-Reducol
 
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JoeRamey replied to billh99's response:
Thank you Bill,

Yes I have had the VAP test and my BP is quite normal, typically 110/70.

After some minor sedentary (never during exercise) chest pain last spring I had a Cardio Scan that showed no blockage with a 90% certainty.

As for diet, after reading Gary Taubes and Mark Sisson books I am quite convinced that dietary fat has little to do with my (and probably your) blood cholesterol. In fact my previous low fat-high carb diet produced high total cholesterol, lower HDL and very high triglycerides. Changing to a low carb-high fat diet has increased my HDL and dramatically lowered my triglycerides, and taken 10 lbs off. My question is why has my LDL not changed at all through radical diet change? And what are the risks with high LDL especially the LDL-R factor?
 
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billh99 replied to JoeRamey's response:
I had a Cardio Scan that showed no blockage with a 90% certainty.

A cardio scan does not indicate blockages as such. However, there is a CT scan where a contrast agent is injected, a CT angiograph, that does.

The cardio scan shows total amounts of calcium that are reported in Agatston units. And with that you can compare it to others to get your risk.

Now maybe you score was so low that what the doctor based the "no blockage" comment.

http://www.nhlbi.nih.gov/health/health-topics/topics/cscan/

http://www.nhlbi.nih.gov/health/health-topics/topics/cscan/show.html

And the second one has a link to risk calculator.

Yes, a low fat high carb diet does increase cholesterol (and body fat).

But note I was not talking about a low fat diet. Only low saturated fats, but lots of monostaturated fats.

And it now appears that at least some saturated fats might be healthy or at least neutral. For example those in grass feed beef and wild game.

I don't know my your LDL did not drop more. But I know that most people are generators - that is they mostly produce their own cholesterol. And some are absorbers - get lot of it from food.

And some people do excellent on the ultra low fat diets, such as Ornish, and even have plaque reduction.
 
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bobby75703 replied to JoeRamey's response:
"Changing to a low carb-high fat diet has increased my HDL and dramatically lowered my triglycerides,"

Me too! I ditched wheat and other refined grains and ate steak and eggs. For the first time in my life increased my HDL. In fact my HDL doubled.


"after reading Gary Taubes and Mark Sisson books I am quite convinced that dietary fat has little to do with my (and probably your) blood cholesterol."
100% agreed. The dated articles citing eating dietary fat and cholesterol causes high cholesterol levels, need to be filed away in the "Oops!" file. I am living proof.









 
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bobby75703 replied to bobby75703's response:
Its ironic. The drug companies have invested millions upon millions of dollars in research and development trying to make a drug that raises HDL. Yet I was able to double my HDL, by accident and without drugs.

I'm still baffled by it.
 
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vic69 replied to bobby75703's response:
You do not include a CRP( C-Reactive Protein), a high level would be another indication of a statin tocounter inflamation. I generally agree with BillH99, he is very informed, and I suspect has a medical background. I must confess back in the mid 80's I was not in favour of stains. Now I think they should be put in the water, as it seems you almost have to find a reason not to take them. You, however, do not fit the typical profile, sedentary, poor diet, hypertensive, etc. There is a good chance you could well be mangaged without statins, Stanosterol, Sitosterol, are good alternatives, if your hypercholesteroemia is diet related, but they must be taken in adequate doses. Unless you are naturalist, or have a CI to statins, or SE, I don't understand your reluctance.
 
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Adynna replied to vic69's response:
I took statins until leg pain, which is apparently CoEnzyme10 deficiency from the statin that no doctor warned me about. Stopped the statins and embarked on low carb eating. Immediate change in sugar issues and triglycerides. Last blood test shows total cholesterol still high, but HDL went up 33%, LDL dropped about 12%. Taking flaxseed, fenugreek, plant sterol yoghurt, cinnamon, anything you ever heard might help. I'm sure the doctor will still want me to go statins but the side effects may not be worth it. Only risk factor I know of is now-controlled diabetes.

It's gambling since statins are a zillion dollar industry and may not be the only way to keep healthy.
 
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bobby75703 replied to vic69's response:
"You do not include a CRP( C-Reactive Protein)", Vic, my CRP has always been low and in the healthy range.

" it seems you almost have to find a reason not to take them."
I can think of many reasons not to take statins.

"I don't understand your reluctance."I myself have received permanent lifelong injuries from a cholesterol lowering drug. ( niaspan) I have witnessed the damage statins can do to others. The risks are real and the benefits are controversial. The end point absolute risk reductions of statins are around 1%, making them the poorest performing drugs on the market.




 
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bobby75703 replied to Adynna's response:
"It's gambling since statins are a zillion dollar industry and may not be the only way to keep healthy."


Bingo! Zillion dollar industry. If there were no money to be made, there would no push to take them.
 
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larsstarscanary replied to vic69's response:
"statins. Now I think they should be put in the water"


Hi, Vic 69.


Are you saying that people should be forced to take statins?
 
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JoeRamey responded:
Thank you all for your personal insights. I think the responses here pretty much incapsulate the debate over statins. I have decided statins are not a healthy alternative for me. I believe it comes down to which medical paradigm you choose to believe is good for you:
1) traditional medicine - low fat, high carb diet
2) alternative - low carb, high fat diet.
I have personal proof to discount the former and believe in the latter.

Here is a recent study that illustrates my personal experiences:

http://well.blogs.nytimes.com/2012/03/14/do-statins-make-it-tough-to-exercise

I had been told 4% of statin patients report side effects. Up to 75% percent reported here is startling if true. "Statins save lives," Dr. Thompson says. "Most people cannot control their cholesterol with diet and exercise alone." Because most people continue to eat a high-carb low-fat diet (with low exercise) that the mainstream medical field continues to advocate. I am quite convinced it is a high carb/low exercise lifestyle that lead to heart disease, all else being healthy. Recomendations to lower triglycerides and raise HDL? Exercise and low carb diet. Recommendations to lower LDL? exercise and low fat diet. http://www.atherotech.com/images/vapliterature/pdfs/CholesterolTest.pdf These two recommendations are incongruous. They are two differing paradigms. Since I have gone high-fat low-carb, my triglycerides and HDL have markedly improved. My LDL has not changed in spite of eating 3 eggs/day plus additional meat including bacon and sausage. Greatly increased dietary fat has not raised my LDL bad cholosterol one point! I am quite convinced that the low-fat high-carb diet paradigm is wrong for me and probably most folks. I am becoming further convinced that LDL is not as important as the medical establishment currently thinks, but that high HDL and low (<100) triglycerides are important. You can still see the confusion over the paradox though"026Statins are good"026 they *must* be good"026 but be careful if you are an athlete who is taking statins (wait"026 an athlete taking statins?"026 i thought exercise would reduce my risk of heart disease"026 why are athletes taking statins?) You can just see people struggling with the reality of these conflicting ideas. If you take statins, you'll be less likely to exercise (because of your muscle soreness), and if you do exercise, you will do more damage"026 that your body can't repair (because you took its cholesterol away) but isn't exercise good for heart disease? AAAUUUUGGHH!
[blockquote>The effect was magnified in the runners, whose cells showed 226 percent more oxidative stress than exercising animals that had not been given statins.[/blockquote> So wait"026 Statins cause damage"026 *oxidative stress* to muscles"026 particularly to muscles that are *exercised*. (Hmmm"026 what muscle can you name that gets "exercised" about 60-90 times per minute?) Hmm"026 what might happen if you systematically deprived the body of the material that it needs to (re) build cell walls? My guess is just about anything"026.
I have to admit to becoming even more skeptical about a) the importance of cholesterol at all, and b) the use of statins. The memory issues that people report (especially women) can be really profound. To the point of actual really serious amnesia.
 
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bobby75703 replied to JoeRamey's response:
Standing ovation for JoeRamey

http://www.youtube.com/watch?v=TylvUGJIi_w


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