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    Statin or no Statin?
    jujulang posted:
    I'm 54 yr old female that just received a phone call from my Dr. freaking out over my cholesterol level. I have a total of 253. The LDL is 167 and the HDL is 71. Not sure what the tryglicerides were. I'm assuming low. She wants me on a statin. I'm not so sure I need one.
    I am a little overweight at 160 for a 5 ' 6' frame but I've been working on that and recently lost 10 lbs. I was 170 lbs. So, I'm thinking that the LDL will come down with diet.
    I am also low on B12 so maybe that may have something to do with the higher level as well.
    I guess I'm just looking to see what the general concensus is about when you really need to take a statin.
    bobby75703 responded:
    Ultimately, that decision is up to you. But I am curious, do you have any known heart disease?
    BillH99 responded:
    I don't think that losing another 10-20 lbs will reduce your LDL that much.

    Exercise can help.

    And diet can help.

    See the Portfolio Diet at the top of the Cholesterol forum. But that is not an easy diet. But one of the items, plant sterols/stanols is easy. They talk about fortified foods, but I don't like that as I don't eat that much margarine.

    But you can get the same benefit from sterol/stanol supplements such as CholestOff or CardioTabs.

    But a Mediterranean diet is also beneficial and easy to follow.

    The other things to look at is your risk factors. Those include hypertension and family history of heart disease.

    A detailed look at the cholesterol particles to see how atherosclerosic that they are. There are different ways of looking at them LDL particle count, particle size, or A/B pattern. Small dense LDL particles are more dangerous than large fluffy particles.

    The VAP and NMR test are 2 that give more details on the cholesterol. They are available through Quest and LabCorp. There is also the Berkley Heart Lab, but I think that the blood samples need to be sent directly to them. Many PCP are not familiar with them.

    PLAC (Lp-PLA2) test. That is an indicator of plaque being formed in the arteries.

    A CardioScan (coronary calcium CT scan). This indicate that if calcified plaque has formed. This can cost $200-300 and is not covered by insurance. But many hospitals offer it for $50-100.

    All of these together can give you a better indication of your risk and then just the basic lipid panel.
    jujulang replied to bobby75703's response:
    I do not have any known history. I have had ekg's and echocardiograms for arrythimia issues and heart murmur, inconclusive mitral valve prolapse, but no stress tests and ejection fraction was good.
    bobby75703 replied to jujulang's response:

    "I am also low on B12 so maybe that may have something to do with the higher level as well."

    This shows you are thinking. A deficiency in a B vitamin such as B12 can cause fatigue. If a person has a metabolic deficiency, their body's internal furnace may not be burning with a bright blue flame.

    Calories that fail to burn off, cause lipids in the blood stream to become elevated. This is a strong characteristic of a person with thyroid hormone deficiency, however their can be other reasons.

    In a nutshell, B vitamins help convert food into energy. That is an over simplistic statement, but it does sum it up in short words.

    So if I were in your shoes, I would be tempted to correct a known deficiency first. Then retest everything else. Its sometimes amazing how when one problem is corrected, everything else falls into place.

    Statins are very effective at lowering cholesterol. But they have not been shown to prevent heart disease in otherwise healthy people.

    If you want to lower your cholesterol, one effective way for most people to lower cholesterol is to cut calories no matter where those calories come from. But thats a message most people don't want to hear. Sometimes the physiological truth is very unpopular. People would rather take a pill.

    If I were in your shoes I would:

    1. Correct B12 deficiency.
    2. Test thyroid function.
    3. Eat till 80% full and stop.
    4. Increase physical activity.

    jujulang replied to bobby75703's response:
    Let me give you some of my history. I have been diagnosed with slow gastric emptying, gallbladder at 24% ejection fraction, (normal is over 50%) gastritis and of course the catch all diagnosis of IBS-C. I've been on Prevacid for 8 years and if I don't take it the acid kicks up.
    I have had the thyroid tested repeatedly and am always told it's normal.
    As for diet, I've been eating much better since June. Not that I ate bad before. I like to cook.............
    I have 20 lbs to lose to make myself more comfortable, but I wouldn't say I'm obese. The weight is coming off slowly, it's been 10 lbs since July 4th.
    How much B12 should I take? There are so many different amounts.
    Thanks for your time.
    BillH99 replied to jujulang's response:

    The bile is involved in the bodies absorption of fats and production of cholesterol. In fact most gallstones are formed from cholesterol.

    Don't have any ideas if your problems make serum (blood) cholesterol worse or better.
    bobby75703 replied to jujulang's response:

    You are doing the right thing paying attention to diet. The fact that weight is slowly coming off tells me you are doing something right.

    If a friend came to me and said they had digestive problems (as you described), the first thing i would suggest to that friend is to ditch gluten, and see what happens.

    If a friend came to me and said they had bad acid reflux, I would suggest to my friend to eliminate all batter fried foods, baked goods, and sugary foods. Then I would suggest drinking a club soda to snuff out the acid reflux when it happens.

    Club soda has sodium bicarbonate ( baking soda) which has a higher PH, meaning its less acid and more alkaline. Its soothes the acid as it washes down, then settles the stomach. No drugs.

    How much B12 depends on how deficient you are. Did your physician not do anything about the B12 deficiency? There are shots which come by prescription from your doctor, or you can use B12 tablets under you tounge. The dosage would depend upon the deficiency.

    You may want to follow up on your thyroid labs. I got told mine were normal when in fact they were not. Others have reported the same experience as me. If you want, I can help you understand what the numbers mean.

    jujulang replied to bobby75703's response:
    I don't know what I can have for tests that haven't been done already. As soon as I get the lab results I'll post all the numbers.
    I will be interested to see what you think. I can tell you that the numbers were always leaning on the lower side of "normal".
    I'm going to call tomorrow on the B12 because we didn't discuss how much to take. I'm not a vegan so I'm more concerned as to why it's low to begin with.
    Thanks again.
    bobby75703 replied to jujulang's response:
    Ok, sounds good. On second thought, If you are able to lose weight you are probably doing good on thyroid hormone. But We can look at the numbers anyway.

    If you are consuming foods with B12, but low on b12, that mkes me ask the same question as you. WHY?
    bobby75703 replied to bobby75703's response:
    The Low B12 might be responsible for abnormal heart rhythm.

    Low B12 status, coupled with IBS symptoms points towards possible problems with the ingestion of wheat.

    For certain individuals, the protein in wheat called Gluten can damage the intestine's ability to absorb nutrients. If this were happening, it would offer a plausible explanation why a person may have low B12 status despite consuming foods with B12, and could also produce the symptoms of IBS.
    jujulang replied to bobby75703's response:
    Hi Bobby,
    Got my numbers today.
    TSH is 1.70 with a normal range of 0.35-4.94,
    B12 is 191.0 with a normal of 230.0-1050.0
    Vitamin D is 52 with a normal of 30-100.
    Triglycerides 74
    HDL 71
    LDL 167
    Cholesterol /HDL Ratio is 3.6
    LDL/HDL Ratio is 2.4
    Potassium and Sodium are within normal guidelines so I don't know what's causing my leg cramps.
    bobby75703 replied to jujulang's response:

    Wow! Your Lab work looks fantastic with the exception of B12 being low.

    If I were in your shoes, I would correct the B12 deficiency and see what happens. You might see an improvement in your leg cramps. No promises, but its worth a try and costs next to nothing.

    I would also encourage you to also experiment with eliminating gluten from your diet for a period, and see what happens. It costs nothing in terms of money, but it does take discipline since wheat is in so many processed foods. This could possibly help with the IBS.

    Concerning your cholesterol numbers: Your lipid profile reminds me of a certain population with numbers just like yours. If its of any encouragement to you, they had the lowest amount of heart disease of any population in the world. The Greenland Inuit.

    The Greenland Inuit mean cholesterol values:
    * Total cholesterol in the 240's
    * Low triglycerides
    * HDL 62
    * LDL170

    Concerning taking statin drugs, that is your decision. I would encourage anyone to weigh the risks and rewards before taking drugs. Following is a link to an award winning article in Business week magazine about cholesterol lowering drugs.

    Tygrebright replied to bobby75703's response:
    Great reply Bobby. I would like to say that high cholesterol is a symptom and not a disease. Lowering you cholestserol with drugs is not going to cure what is causing the problem. But drugs certainly have side effects and should be avoided if possible. Diet, exercise and life style changes are the way to go in your case jujulang. I believe you are on the right track...keep it up!
    crj210 responded:
    Remember that the LDL is the bad one and HDL is the good one.

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