Cholesterol Gurus Needed! (Long post-sorry!)
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Update: I phoned the "Healthcare advisor" today. A very nice RN. I had my whole spiel ready to go. Mentioned my weight loss, improvements in HDL/TG, thoughts about the particle makeup of my LDL's, and was ready to get into the research and finer points with her, but she didn't seem that interested. She agreed the 9 week online weight management course (my other option in order to receive the HSA deposit) was probably overkill given a BMI of around 18.9% and asked if I wanted to speak to a "wellness coach" about my diet or any stress I might have (I assume excluding the stress this whole biometric/HSA mess was causing me). I said I wasn't interested and she said fine and she would put it into the system that we talked and to have the full HSA incentive added to our account. So, a pretty easy win! And, as a bonus, my stress level has dropped!
Much thanks to all of you who had responded and your advice. My yearly physical is coming up and I am in a much stronger place knowledge-wise to discuss further testing, etc. This community is amazing!13 -
Keep us posted! 1 -
Update: I phoned the "Healthcare advisor" today. A very nice RN. I had my whole spiel ready to go. Mentioned my weight loss, improvements in HDL/TG, thoughts about the particle makeup of my LDL's, and was ready to get into the research and finer points with her, but she didn't seem that interested. She agreed the 9 week online weight management course (my other option in order to receive the HSA deposit) was probably overkill given a BMI of around 18.9% and asked if I wanted to speak to a "wellness coach" about my diet or any stress I might have (I assume excluding the stress this whole biometric/HSA mess was causing me). I said I wasn't interested and she said fine and she would put it into the system that we talked and to have the full HSA incentive added to our account. So, a pretty easy win! And, as a bonus, my stress level has dropped!
Much thanks to all of you who had responded and your advice. My yearly physical is coming up and I am in a much stronger place knowledge-wise to discuss further testing, etc. This community is amazing!
Great result with that phone call. After all the RN gets paid the same if you get your incentive or not. Glad you found someone who just did the right thing.3 -
That's great! Thanks for the update! This stuff is really helpful for everyone.2
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Your welcome. I thought it was interesting that after my first LCHF attempt my cholesterol was 343 and my triglycerides were 506. This sounds crazy but it was much higher before. The ratio was 1.484. This article says if you are less than 2 it's good. I'm hoping to be 30 pounds lighter than I was in the previous test when I get bloodwork done in a month.
Good luck!2 -
Your welcome. I thought it was interesting that after my first LCHF attempt my cholesterol was 343 and my triglycerides were 506. This sounds crazy but it was much higher before. The ratio was 1.484. This article says if you are less than 2 it's good. I'm hoping to be 30 pounds lighter than I was in the previous test when I get bloodwork done in a month.
Good luck!
The ratio is triglycerides to HDL, not total cholesterol. I am guessing your HDL was well under 100. Generally you won't see high HDL with triglycerides that high. LCHF will almost always raise HDL and lower triglycerides but HDL over 80 is very unusual.4 -
Chol/HDL Ratio (None) 6.6 Ratio No Flag
Cholesterol (140-200) 343 mg/dL H
Direct HDL (30-75) 52 mg/dL No Flag
LDL-Direct (0-130) 177 H
Triglycerides (35-160) 506 mg/dL H
I guess you're right. I'm not freaked out by it. I know when I lose another 50 pounds the doctor will be looking at the numbers thinking something is broken with his tester. ha ha This looks horrible but it's much better than it was and I'm still obese.
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@cstehansen I'm still a newbie when it comes to all of this-why would an HDL level over 80 be very unusual?2
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@cstehansen I'm still a newbie when it comes to all of this-why would an HDL level over 80 be very unusual?
Over 40 is generally considered good or at least acceptable. I even saw one place that showed above 35 was considered acceptable.
I don't really know what the upper limit is. I just know from what I have seen, heard and read that getting above 80 is not common. It does and can happen, but don't expect it. In the keto community you will generally see higher than average.
For instance my last test showed 68 with triglycerides at 52 for a ratio below 1. For those doing keto, you will see this semi regularly. In the non-keto world, having a ratio below 1 is pretty rare from all I have seen.
If you eat the SAD, you are likely going to have a hard time getting the ratio below 2 once you hit middle age unless you just born with awesome genes.0 -
@cstehansen I'm still a newbie when it comes to all of this-why would an HDL level over 80 be very unusual?
I, too, am curious.
Mine was 104 last time.1 -
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Coronary Artery Calcium (CAC) scan results in reclassifying 50% of patients initially in the "need-statins" category to "no statins."(!) https://www.ncbi.nlm.nih.gov/pubmed/26449135
"CONCLUSIONS:
Significant ASCVD risk heterogeneity exists among those eligible for statins according to the new guidelines. The absence of CAC reclassifies approximately one-half of candidates as not eligible for statin therapy."
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Coronary Artery Calcium (CAC) scan results in reclassifying 50% of patients initially in the "need-statins" category to "no statins."(!) https://www.ncbi.nlm.nih.gov/pubmed/26449135
"CONCLUSIONS:
Significant ASCVD risk heterogeneity exists among those eligible for statins according to the new guidelines. The absence of CAC reclassifies approximately one-half of candidates as not eligible for statin therapy."
Thank you for this. Here is a link to the free full text version:
http://www.onlinejacc.org/content/accj/66/15/1657.full.pdf
I was had a bit of an argument with my dad this weekend who was prescribed and is taking a statin because his total cholesterol hit 200. He is about to turn 71. His trigs are low and HDL is high and given all the research, especially for those in his age group, he seems to be in more danger of his cholesterol being too low rather than too high.
He is skeptical of those who are skeptical because he has a sister who is a bit of a conspiracy nut (the kind that buys into all the crap in What the Health) and thinks every drug and vaccine should be banned. Trying to convince him that just because some drugs are good doesn't mean they all are.0 -
I really don't understand statins well enough.
My mother's doctor is pushing her to try statins again. Another variety. Last time she tried it she had the classic muscle pain and it was affecting her memory. She's 74, obese, never had CAD, has normal cholesterol, triglycerides and BG so she's at high risk of CAD. A 25% chance of a heart attack in the next 5 or 10 years. A checked the math - statins may take her risk down from 1in 4 to 1 in 5. Is that worth it?
I babbled... The reasons the doctor gave for pushing statins is that it stabalizes the plaques so they won't break off. But I have read that statins increase calcification in the arteries and that may be why the plaques are more stable - they're growing.
Any thoughts or comments? Statins just confuse me.
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cstehansen wrote: »Coronary Artery Calcium (CAC) scan results in reclassifying 50% of patients initially in the "need-statins" category to "no statins."(!) https://www.ncbi.nlm.nih.gov/pubmed/26449135
"CONCLUSIONS:
Significant ASCVD risk heterogeneity exists among those eligible for statins according to the new guidelines. The absence of CAC reclassifies approximately one-half of candidates as not eligible for statin therapy."
Thank you for this. Here is a link to the free full text version:
http://www.onlinejacc.org/content/accj/66/15/1657.full.pdf
I was had a bit of an argument with my dad this weekend who was prescribed and is taking a statin because his total cholesterol hit 200. He is about to turn 71. His trigs are low and HDL is high and given all the research, especially for those in his age group, he seems to be in more danger of his cholesterol being too low rather than too high.
He is skeptical of those who are skeptical because he has a sister who is a bit of a conspiracy nut (the kind that buys into all the crap in What the Health) and thinks every drug and vaccine should be banned. Trying to convince him that just because some drugs are good doesn't mean they all are.
Yep, I think a black/white, all-or-nothing approach to taking meds and many other life choices is something we should all make a conscious effort to resist.
(Even the same drug may be beneficial at one point in someone's life and detrimental at another...)
The best of the lipid experts are careful to distinguish between discrete risk groups and include advanced lipoprotein and CAC scores in their discussion. Meanwhile, the crude lipid panels and Framingham risk factors continue to drive many treatment recommendations....
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cstehansen wrote: »The calcium score @RalfLott mentioned is the biggest thing IMO. Everything else is just a marker for potential disease. The calcium score shows actual. If actual = 0, then why give a rip about a marker showing potential?
Other than that, an NMR which does measure particle size along with hsCRP which are much more accurate markers would be second best option.
FYI...
Micheal Eades suggests looking at the volume:density ratio, an increase in volume over time being a bad omen; an increase in (protective) density, a good one.
Calcium Density of Coronary Artery Plaque and Risk of Incident Cardiovascular Events
https://www.ncbi.nlm.nih.gov/pubmed/24247483
https://youtu.be/itUoG2IfJp8
@nvmomketo, maybe this will be helpful!
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I really don't understand statins well enough.
My mother's doctor is pushing her to try statins again. Another variety. Last time she tried it she had the classic muscle pain and it was affecting her memory. She's 74, obese, never had CAD, has normal cholesterol, triglycerides and BG so she's at high risk of CAD. A 25% chance of a heart attack in the next 5 or 10 years. A checked the math - statins may take her risk down from 1in 4 to 1 in 5. Is that worth it?
I babbled... The reasons the doctor gave for pushing statins is that it stabalizes the plaques so they won't break off. But I have read that statins increase calcification in the arteries and that may be why the plaques are more stable - they're growing.
Any thoughts or comments? Statins just confuse me.
from Google Scholar:
cwhn.ca/en/node/39417
pbs.org/newshour/rundown/surge-statin-use-among-elderly-without-heart-trouble-raises-doubts/
tandfonline.com/doi/abs/10.1080/14017430801993180?scroll=top&needAccess=true&journalCode=icdv20
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From Google Scholar:I really don't understand statins well enough.
My mother's doctor is pushing her to try statins again. Another variety. Last time she tried it she had the classic muscle pain and it was affecting her memory. She's 74, obese, never had CAD, has normal cholesterol, triglycerides and BG so she's at high risk of CAD. A 25% chance of a heart attack in the next 5 or 10 years. A checked the math - statins may take her risk down from 1in 4 to 1 in 5. Is that worth it?
I babbled... The reasons the doctor gave for pushing statins is that it stabalizes the plaques so they won't break off. But I have read that statins increase calcification in the arteries and that may be why the plaques are more stable - they're growing.
Any thoughts or comments? Statins just confuse me.
cwhn.ca/en/node/39417
Here's the study it came from: ti.ubc.ca/2014/05/28/statins-proven-and-associated-harms/
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