Cholesterol Gurus Needed! (Long post-sorry!)
Replies
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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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canadjineh wrote: »
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/
Thanks...
I'm wondering if my mother's doctor is just making up *kitten* saying that statins stabilize the plaques. The link says:
How do statins work?
"Statins inhibit the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase at an early stage of the mevalonate pathway. Cholesterol is generated by this pathway, but so are a number of other products with a pivotal role in bodily functions, such as coenzyme Q10, heme A, isoprenylated proteins, sex steroids, corticosteroids, bile acids, and vitamin D.1 Statins reduce plasma cholesterol by inhibiting HMGCoA reductase in the liver, but also inhibit this enzyme in tissues throughout the body."
That is not what my doctor told my mother. Probably because her cholesterol is fine.
And I've heard that "stabilizing plaques" line elsewhere too. Where are doctors getting that?0 -
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/24247483https://youtu.be/itUoG2IfJp8
@nvmomketo, maybe this will be helpful!
Thank you. I'll watch this soon!0 -
canadjineh wrote: »
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/
Thanks...
I'm wondering if my mother's doctor is just making up *kitten* saying that statins stabilize the plaques. The link says:
How do statins work?
"Statins inhibit the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase at an early stage of the mevalonate pathway. Cholesterol is generated by this pathway, but so are a number of other products with a pivotal role in bodily functions, such as coenzyme Q10, heme A, isoprenylated proteins, sex steroids, corticosteroids, bile acids, and vitamin D.1 Statins reduce plasma cholesterol by inhibiting HMGCoA reductase in the liver, but also inhibit this enzyme in tissues throughout the body."
That is not what my doctor told my mother. Probably because her cholesterol is fine.
And I've heard that "stabilizing plaques" line elsewhere too. Where are doctors getting that?
Here's a mouthful (careful what you ask for!).
Plaque regression and plaque stabilisation in cardiovascular diseases.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3872716/ (2013}0 -
@nvmomketo I just went a month ago to the doctor with my parents and mentioned that my mom was on statins and asked why? He re-looked at her list of meds and profusely apologized (several times in fact) since they have mainly been watching regular blood glucose and blood pressures etc to keep those meds adjusted each month at the regular check up. He did know that statins don't work for women - another doc had put her on them several years ago and that info just got missed in the shuffle. Statins probably damaged her muscles beyond repair and caused the diabetes (or at least accelerated the process). At least she's no longer on it. Good thing I reviewed her meds before the appointment. Crap happens, but it's really sad when a doc doesn't admit it, like in your mom's case.1
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Just had my biometric screening done this week in order to have money added to our new HSA. First, a bit of my background. Have been Keto (10g carbs or less/day) for 2 years now. I (50 y/o small framed 5'4" F) was 230+ pounds when I started. By last March I had lost 110 pounds and reached my first goal. I have been working over this past year to-very slowly!-loose 15 more pounds. As of this morning, I am 0.8 pounds away from my 105 pound goal weight. I don't have any known medical conditions. As far as exercise, I walk or slow run at least 12,000 steps or 5 miles/day. I last had blood work done 5 years ago which I never followed up on as I was so embarrassed with my weight.
2012 results. 2017 results
Total cholesterol. 228. 293
HDL. 41. 73
LDL. 161. 207
Triglycerides. 139. 66
Chol/HDL ratio. 5.6. 4.0
Trig/HDL ratio 3.4. 0.9
FBS. 86. 87
HbA1C. 5.3%
I am really pleased with my HDL, Trigs, and ratio improvements. But, due to my LDL, I "failed" this part of the screening and in order to earn back the HSA deposit I either need to have a discussion with a counselor about my diet or participate in a 9 weekly online "weight loss program" (haven't had time to investigate these 2 options fully yet).
Based on my readings, I would expect a LDL particle test to show more of the fluffier particles. I am looking into having this test done through healthcheckusa.com along with the hsCRP in order to hopefully bolster my argument if I go the counselor option. Any other advice/recommendations?
Thanks!Just had my biometric screening done this week in order to have money added to our new HSA. First, a bit of my background. Have been Keto (10g carbs or less/day) for 2 years now. I (50 y/o small framed 5'4" F) was 230+ pounds when I started. By last March I had lost 110 pounds and reached my first goal. I have been working over this past year to-very slowly!-loose 15 more pounds. As of this morning, I am 0.8 pounds away from my 105 pound goal weight. I don't have any known medical conditions. As far as exercise, I walk or slow run at least 12,000 steps or 5 miles/day. I last had blood work done 5 years ago which I never followed up on as I was so embarrassed with my weight.
2012 results. 2017 results
Total cholesterol. 228. 293
HDL. 41. 73
LDL. 161. 207
Triglycerides. 139. 66
Chol/HDL ratio. 5.6. 4.0
Trig/HDL ratio 3.4. 0.9
FBS. 86. 87
HbA1C. 5.3%
I am really pleased with my HDL, Trigs, and ratio improvements. But, due to my LDL, I "failed" this part of the screening and in order to earn back the HSA deposit I either need to have a discussion with a counselor about my diet or participate in a 9 weekly online "weight loss program" (haven't had time to investigate these 2 options fully yet).
Based on my readings, I would expect a LDL particle test to show more of the fluffier particles. I am looking into having this test done through healthcheckusa.com along with the hsCRP in order to hopefully bolster my argument if I go the counselor option. Any other advice/recommendations?
Thanks!
@eneild When I tested LDL cholesterol size the fluffy ratio was high indicating high LDL being a non health issue.1 -
canadjineh wrote: »
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/
Thanks...
I'm wondering if my mother's doctor is just making up *kitten* saying that statins stabilize the plaques. The link says:
How do statins work?
"Statins inhibit the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase at an early stage of the mevalonate pathway. Cholesterol is generated by this pathway, but so are a number of other products with a pivotal role in bodily functions, such as coenzyme Q10, heme A, isoprenylated proteins, sex steroids, corticosteroids, bile acids, and vitamin D.1 Statins reduce plasma cholesterol by inhibiting HMGCoA reductase in the liver, but also inhibit this enzyme in tissues throughout the body."
That is not what my doctor told my mother. Probably because her cholesterol is fine.
And I've heard that "stabilizing plaques" line elsewhere too. Where are doctors getting that?
Here's a mouthful (careful what you ask for!).
Plaque regression and plaque stabilisation in cardiovascular diseases.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3872716/ (2013}
I am working through that one slowly. Thank you.
The video link you gave was interesting. So increased density of the calcium (plaques) may be more stable than a lower density, higher volume plaque. I am not sure how a LCHF diet would play into that. On LCHF, LDL usually becomes larger and less dense so supposedly less goes into the plaques... That would explain a loss in size but how does it get less dense?
And statins lower all cholesterol, so less would be available again.... Do plaques constrict in upon themselves if they are not getting a steady new load of LDL?
I don't expect you to answer this for me. You have been a huge help already.
I'll get to it once summer business passes. 1 -
canadjineh wrote: »@nvmomketo I just went a month ago to the doctor with my parents and mentioned that my mom was on statins and asked why? He re-looked at her list of meds and profusely apologized (several times in fact) since they have mainly been watching regular blood glucose and blood pressures etc to keep those meds adjusted each month at the regular check up. He did know that statins don't work for women - another doc had put her on them several years ago and that info just got missed in the shuffle. Statins probably damaged her muscles beyond repair and caused the diabetes (or at least accelerated the process). At least she's no longer on it. Good thing I reviewed her meds before the appointment. Crap happens, but it's really sad when a doc doesn't admit it, like in your mom's case. oh wow. That is just not right.
In my mom's case, I worry because the doctor seems to believe she needs statins so much that muscle pain and cognitive impairment are a fair price to pay. Who is deluded here? Her or my mom and me? Saying no would be easier if she did not believe mom needed it so much. It is hard to question the doctor's advice when I am not medically trained. Is my mom's life at stake or her quality of life? kWIM?
I'll keep researching. Slowly.
. Thanks for the support. . You guys are great. 0 -
The study I referenced was of 10990 women so it's not like they checked out 10 women and found no positive results. Your mom has the right to say NO to whatever, even if it is proven to be 'necessary'. Legally it is her body and she has the right to choose whatever path she wants. Fire that doc after sending links to the studies. You also need to look at whether the numbers are a 'relative' risk. The % that they state doesn't necessarily corelate to a worthwhile benefit. ie. If there are 3 ppl dying out of 10,000 and the meds prevent 1 death they can state that the meds lower risk of death by 50%. That doesn't tell the whole truth though.1
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Sorry..... Rant over
Okay, I'm having a good night lol. "Lowers risk of death by 33%" no math skills tonight. 1 -
@nvmomketo, if your mum has never had diabetes or CAD, hasn't had a Coronary Artery Calcium CT scan (and scoring), and doesn't have an advanced lipoprotein test showing alarming LDL subparticle numbers.... then why does the doc think she's got plaque that so desperately needs stabilizing?
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@nvmomketo, if your mum has never had diabetes or CAD, hasn't had a Coronary Artery Calcium CT scan (and scoring), and doesn't have an advanced lipoprotein test showing alarming LDL subparticle numbers.... then why does the doc think she's got plaque that so desperately needs stabilizing?
No idea Mom is an obese, 74 year old lady with slightly high BP. It appears her heart is very slightly enlarged... I don't think statins help with that though.
I get to go with her to see the cardiologist on Friday. She has had a stress test and a rest test. We'll see what she has to say then.
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I'm a huge newbie to understanding the sciences, and I'm hesitant to trust too much of the internet given all the inaccurate things.
Do you guys know how LCHF lifestyles affect plaque in the arteries?0 -
I'm a huge newbie to understanding the sciences, and I'm hesitant to trust too much of the internet given all the inaccurate things.
Do you guys know how LCHF lifestyles affect plaque in the arteries?
Good question!
Are you asking about plaque that's known to be present or preventing it from accumulating in the first place?0 -
Good question!
Are you asking about plaque that's known to be present or preventing it from accumulating in the first place?
Kind of both! It's a subject I'm not knowledgeable on. Of course we wouldn't want to make it worse -- but if it's possible to avoid the issue or reverse existing plaque that'd be useful info~0 -
@tayusuki we are all searching for the same info. Reversing existing plaque seems possible. Using high levels of Vitamin D3 and Vitamin K2 may be a good point to start googling.
I paid $100 last May to learn my coronary artery calcium score. It came in at a very low (good) score of 9.3 but I have been LCHF with <50 grams of carbs since Oct 2014 when I was 63 years old. I plan to retest next May. All things being equal the score should increase by about 10% for most people. If it is only 10% worse then that will be good. If it decreases then I know reversing existing plaque did occur.
Human medical research is hard to find. Vit K2 did reduce plaque build up in a rat study. If someone with a CAC score of 1000 could over time say lower it to 800 that would be good info to have. There is one MD states he is lowing CAC scores but he does not say HOW but just invites people to come to his clinic. Each year as we report our results here should be helpful.1 -
Good question!
Are you asking about plaque that's known to be present or preventing it from accumulating in the first place?
Kind of both! It's a subject I'm not knowledgeable on. Of course we wouldn't want to make it worse -- but if it's possible to avoid the issue or reverse existing plaque that'd be useful info~
I don't feel competent to utter sweeping pronouncements, though I am all in with a ketogenic diet to reduce inflammation, improve my lipoprotein particle profile, and keep my mild plaque at bay, (The plaque was revealed through a Coronary Artery Calcium CT scan)1 -
Good question!
Are you asking about plaque that's known to be present or preventing it from accumulating in the first place?
Kind of both! It's a subject I'm not knowledgeable on. Of course we wouldn't want to make it worse -- but if it's possible to avoid the issue or reverse existing plaque that'd be useful info~
I don't feel competent to utter sweeping pronouncements, though I am all in with a ketogenic diet to reduce inflammation, improve my lipoprotein particle profile, and keep my mild plaque at bay, (The plaque was revealed through a Coronary Artery Calcium CT scan)
What about the diet keeps it from getting worse?1 -
You can't dissolve fat in water. Since plaque is fat deposits in the arteries, it makes sense that they can only be dissolved by having sufficient quantities of fat circulating in you bloodstream.0
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@tayusuki - I'm no expert, but the top two things in my mind are reducing inflammation & getting your lipids in better shape (this would show up on a NMR Advanced Lipoprotein test). The % of fluffy, larger LDLs tends to increase, as does HDL, and triglycerides tend to come down. But it's not that simple, and there are bound to be vast individual differences.
Your reaction may also depend on which of the 1001+ LCHF diets you're following..0
This discussion has been closed.