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  • Today's Doctor Visit And His Concern About My Lifestyle

    Hey, everyone.

    I came back from an appointment with the doctor at my job's health center today. After reviewing my blood work, he voiced concern and even told me that he felt I may have to go on statins if my cholesterol remained the way it was. He even kept trying to find abnormalities (to no avail) in the rest of my blood profile to get me to stop intermittent fasting and eating red meat and veggies as regularly as I do. He was also concerned about vitamin D figure, asking if I ate a lot of dairy. I told him that I eat almost no dairy, as I’m allergic but do supplement with Carlson’s lanolin vitamin D pills.

    Mind you this physician admits that I am in better shape than any other patients he's seen at my job and himself, but told me he's concerned that my "lifestyle" will catch up with me despite the fact that everyone else here is overweight and doesn't have the energy I have. I told him that I would try to find a primal/paleo-knowledgable physician who would d a VAP test to see what my cholesterol profile really is. He urged me to see the dietician on staff and to change my diet and to eat more often (I told him that I really try o only eat when hungry. He stated that "one can train their body to get hungry more often as daily fasts are unhealthy"). I really don't agree with anything he said, and told him that, but said I was grateful for his concern.

    Your thoughts?

    Here’s my blood work (this was all taken after a recent stint of not-so primal eating outside of my norm):

    Total cholesterol: 296
    HDL: 77
    Triglycerides: 44
    LDL: 210
    Chol/HDLC ration 3.8
    Fasting glucose: 93
    Urea Nitrogen: 15
    Creatinine: 1.03
    eGFR Non-Afr. American >60
    eGFR African-American >60
    Sodium: 143
    Potassium: 4.9
    Chloride: 104
    Carbon Dioxide: 21
    Calcium: 9.9
    Protein 8.0
    Albumin 4.6
    Globulin 3.4
    Albumin/Globulin Ration 1.4
    Bilirubin 0.5
    Alkaline Phosphate 85
    AST 24
    ALT 14
    Vitamin D 110

    I also had trace levels of ketones.

    He also told me that fasting is "unhealthy." I asked him if he thought Americansd in general were overfed. While I like him, he himslef is obviously overweight with a good amount of obvious visceral fat. He asked me if I ever felt heart palpitations while fasting during the day. I told him I did not. he tehn checked the paperwork again to look for signs of dehydration, but found none.

    He then told me that I strike him as somone who could ignore hunger if I put my mind to it and that I should eat more. I said to him that I often just wait until I am hungry to air and don't force myself to eat. I asked him if he didn't belive the body gives cues for when to eat and drink? He agreed hesitantly, but told me I should try to eat "a pievce of fish and fruit in the morning or aftrenoon, because there's nothing worng with it." i replied that I agree there's nothing wrong with that if I am hungry, but countered that I don't feel I should eat if not hungry.

    He then voiced concern about my longevity as he stated "You're young and may feel invincible now."

    By no means am I malnourished. At 32 years old, approximately 6 feet tall, I weigh about 185 pounds.

    As I left his office today, he told me yet again that from our other meetings he thought me to be in excellent health, but is now "very concerened ased on my cholesterol numbers and philosophy about diet." he also urged me to stop taking vitamin D. I asked if he fel that wise based on the fact that I'm black and live in high latitude. He said that vitamin D deficiency is usually only a concern for women and that my levels are abundant and that he'd be afraid I'd overdose. I told him that my levels are probably good as a black New Yorker who works inside most of the day, because I supplement.

    I'm prone to steer away from most traditional doctors as they cater to Big Pharmaceuticals and when looking at the way AMericans are currently thriving on their advice, I shudder to imagine what lies in store.

    And when I stated that as a 6 foot, 185 lb. man that I'm clearly not starving, he was speecheless save for looking concerned. I look at him and his waste line (subtlely, of course) and asked him did he not think most Americans are actually overfed. He hesitantly agreed.

    I'm not averse to admitting things when wrong, but I've actually physically felt better and looked better than I have my entire life, including mentally, allergy-wise (as anyone knows that growing up that my allergies and asthma highjacked my entire life) and physically (body composition).

    I realize that I'm not the ultimate authority on any of this, but if I know the prior way (and I did already have a "healthy" diet) wasn't working the way this is, then why would I go back to gfeeling less than optimal?

    I'm really wary of most advice today as they doctors seem and pharmaceutical companies cater to an increasingly obese population and I told you he kept trying to find maladies in the rest of my results. he found none, save for his concern about my LDL number. He couldn't explain the fact that my total ratio was excellent or that my HDL was way beyond the healthy standard.

    As for his concern over my not eating regularly, I take anyone who is overweight with a grain of salt when they criticise my eating habits. And that's not a dis, but to me they obviously overeat as most people are full of shit who claim to be overweight due to heredity. Only a minute portion of the world has any kind of genetic problem that affects their metabolic processes. The rest actually screw up their metabolism with constant overfeeding.

    Also, the doctor today told me to eat oatmeal. Why would I eat oatmeal of meat and veggies? Oatmeal has almost no nutritional value whatsoever. All it offers is a large supply of starch aka sugar. And if it's not in sweetened flake form or in a smoothie or cookie, I can't stand it as it tastes like cardboard for the most part to me.

    A friend f mine just sent me the contact info of a physician here in NYC that advocates a paleo lifestyle. I plan to call his office to set up an appointment for a second opinion tomorrow.

    Sorry for all the rambling, but was curious about some of your opinions and knowledge.

  • #2
    Tell your doctor VAP test or GTFO. Particle side matters a lot more than simple LDL level. When the standard tests measure LDL they measure total volume so people eating a lot of good fats and few carbs have "high LDL" because their particles are huge pattern A lipoproteins rather than the dangerous little ones. Huge is difficult to oxidize, small is easy to oxidize and that's where the danger is. Your HDL looks good and your trygs look good and those are far more of a predictor of heart disease risk than HDL to LDL.

    Probably see Griff's cholesterol thread in primal research. He puts it quite eloquently.
    Stabbing conventional wisdom in its face.

    Anyone who wants to talk nutrition should PM me!

    Comment


    • #3
      Thanks, Stabby. My friend's doctor said that I should get a VAP. I will request that when I make an appointment with him. Also, the doctor I saw today feels that my vitamin D is too high and that I should cease all supplementation immediately. I told him it's probably high, because I supplement and would not be if I didn't as almost all blacks in the U.S. are vitamin D deficient as our skin color in this latitude blocks out what little UV rays we get unless we're outside for hours at a time during mid-day. He really seemed stumped at that.
      Last edited by rahchis; 04-28-2010, 08:46 PM.

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      • #4
        Huh? My doctor said that the normal range upper limit was 200 or so. Those tests suck though. There is also a much better vitamin d test than those silly standard doctor tests.
        Stabbing conventional wisdom in its face.

        Anyone who wants to talk nutrition should PM me!

        Comment


        • #5
          Thanks, Stabby. As I thought. I'm still kind of reeling from his advice that I should retrain my body to eat when not hungry. I told him that I used to be a grazer, and all that resulted in was overeating and feeling stuffed and lethargic all day.

          Comment


          • #6
            I'm sure your doctor has the best intentions, but that doesn't mean he's right. I agree with Stabby, your HDL is good, your triglycerides are nice and low, and your fasting blood glucose is great. As for vitamin D, the toxic dose is over 50,000 IU per day for several months. As long as you're keeping your supplementation reasonable (10,000 IU or less), you'll be fine. Next time you get your blood tested, have them check your vitamin D levels again and if the number has gone way up, then maybe you're getting too much.

            Eating only when you're hungry is unhealthy? How has the human race survived this long?

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            • #7
              Just made an appointment with the paleo-friendly doctor that my friend referred me to. Will have another blood test done this afternoon.

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              • #8
                Any chance you could give out that doc's contact info? I'll be in NY for school next year and if I need to see somebody, would like to see somebody who doesn't go goggle-eyed when I say I don't eat bread.

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                • #9
                  Originally posted by rahchis View Post
                  Just made an appointment with the paleo-friendly doctor that my friend referred me to. Will have another blood test done this afternoon.
                  YAY! Good luck. Let us know how it goes. (And let us know what he says when you tell him what the previous doctor told you!)

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                  • #10
                    Weird about the Vit d. My doc is always worried that I eat too many eggs and too much sat fat, but she's always urging me to suplement with fish oil.
                    The more I see the less I know for sure.
                    -John Lennon

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                    • #11
                      First, get a VAP test because your high HDL and low triglycerides almost guarantee that your LDL is Pattern A--the good kind. My endo did a VAP test on me, and my LDL is 100% Pattern A. He said that in patients with high HDL and low trigs, he almost always finds Pattern A LDL.

                      By the way, I brought the results to my primary doctor who talks statins to me, and he was puzzled. Like the guy you talked to, a lot of doctors are just uninformed. Certainly this guy knew nothing about nutrition--ignore everything he said.

                      My concern is the Vit. D level you posted--110? What was the lab range? I ask because my labs list the ranges as 30-100, and I've heard that optimum is about 50-60. You don't want to supplement if you're too high. There's VitD toxicity.

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                      • #12
                        Thanks, everyone for your insights.

                        Repicheep, the new doc I was referred to is named Grant Macaulay. And he’s very cool! I saw him today, and he took blood to run the VAP.

                        Diane, as I said Dr. Macaulay was cool, yet respectful. He affirmed that he understood my other doc’s concern, but that many physicians unfortunately are ignorant about the different types of cholesterol and their necessity.

                        Earthmomma and emmie, Dr. Macaulay was not concerned at all about my vitamin D level. (Although, the lab range of normal is 20-100). In fact, he was happy to see a dark-complexioned (black) person here in the U.S. with such a high level. As my skin color is adapted for equatorial latitude and all it’s solar rays. As someone who works indoor for the most part, he was certain that my supplementation with Carlson’s 10,000 IU (made from lanolin) capsules are what made it that way. Almost every dark-skinned person he sees is deficient. He asserts that you cannot overdose on non-synthetic vitamin D as your body used as you need. Moreover, I don’t take it everyday. One day, I may take 5 capsules for a total of 50,000 IUs and then I may not take a gain for several days. Macaulay is of the mind that the minimum levels may need to be elevated, as most Americans of all skin tones are deficient.

                        I was happy that Macaulay was objective in that he still wanted to wait to see the breakdown of my LDL. He didn’t want to venture a guess about its particle size beforehand. Especially, since my dad died of type 2 diabetes complications at age 54 (when I was 21).

                        I told him that the blood work results I brought on were not gotten through a clean diet as I’d been eating non-paleo quite a bit in the last few weeks off and on. He said we should definitely run another one in a couple of months as I recommitted to strictly paleo eating this week.

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                        • #13
                          Great story. I am in NYC too, would you mind sending me his contact info via private message? I would appreciate it.
                          .`.><((((> .`.><((((>.`.><((((>.`.><(( ((>
                          ><((((> .`.><((((>.`.><((((>.`.><(( ((>

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                          • #14
                            Repicheep and rphlslv,

                            Here is the info:

                            Grant R Macaulay MD
                            210 East 86th Street (between 2nd and 3rd Avenues)
                            New York, NY, 10028
                            Phone Number: (212) 737-0555

                            Comment


                            • #15
                              Originally posted by rahchis View Post
                              He also told me that fasting is "unhealthy." I asked him if he thought Americansd in general were overfed. While I like him, he himslef is obviously overweight with a good amount of obvious visceral fat. He asked me if I ever felt heart palpitations while fasting during the day. I told him I did not. he tehn checked the paperwork again to look for signs of dehydration, but found none.


                              That is a stange question as IF is rather linked to correcting cardiac arrhythmias (see http://www.ncbi.nlm.nih.gov/pubmed/16529878).

                              I have suffered significant heart palpitations for over 15 years and three times needed conversion to sinus-rythm (once with a drug called Corvert and two times with elecroconversion) when my frequent heart palpitations turend into non-stopping atrial fibrillation.

                              Since I began regular IF (ca. 2-3 times a week) and gradually changing my lifestyle to more paelo/primal, I have never been better. Only occasional heart palpitations and gradually loosing weight (fat, not muscles), ca. 10kg (20 pounds) since January and only 5-10kg still to go!

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