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  • #31
    Originally posted by howardroark View Post
    I looked at DirectLabs and didn't see a test with both ApoB and ApoA1 measured. Do you know which tests your doctor normally orders? I would be paying out of pocket, so that's why I am looking at DirectLabs.
    I'm not in USA

    Sent from mobile
    Four years Primal with influences from Jaminet & Shanahan and a focus on being anti-inflammatory. Using Primal to treat CVD and prevent stents from blocking free of drugs.

    Eat creatures nose-to-tail (animal, fowl, fish, crustacea, molluscs), a large variety of vegetables (raw, cooked and fermented, including safe starches), dairy (cheese & yoghurt), occasional fruit, cocoa, turmeric & red wine

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    • #32
      An update:

      My 23andme results are back.

      Relevant results to this thread:
      APoE: 3/3
      Familial Hypercholestemia Type B: Negative
      Coronary Heart Disease Risk: Average
      Hypothyroidism Risk: Higher than Average

      CVS is about to throw out my Lipitor if I don't pick it up soon. I think I am going to go pick it up, try to see if I can boost my thyroid a bit (eating a bit more carbs and supplementing Iodine) and get both an NMR and thyroid panel in about a month. If my LDL levels are still as high as they are, I will think about maybe making some changes.

      Any other thoughts?

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      • #33
        So all of those are normal except maybe something with thyroid. Why do you think you need a statin? Your HDL and TG are excellent (posted before), and you don't have enough info about the LDL breakdown to infer anything without particle tests. But with the other numbers you have, it's a pretty safe assumption that your LDL is not primarily the harmful type B. If you aren't eating lots of refined carbs or PUFA oils, there is absolutely no reason a statin would benefit you, but it can certainly hurt you.

        If your doctor insists on using a simple LDL number as a reason to take statins, you need a new doctor.

        Originally posted by howardroark View Post
        An update:

        My 23andme results are back.

        Relevant results to this thread:
        APoE: 3/3
        Familial Hypercholestemia Type B: Negative
        Coronary Heart Disease Risk: Average
        Hypothyroidism Risk: Higher than Average

        CVS is about to throw out my Lipitor if I don't pick it up soon. I think I am going to go pick it up, try to see if I can boost my thyroid a bit (eating a bit more carbs and supplementing Iodine) and get both an NMR and thyroid panel in about a month. If my LDL levels are still as high as they are, I will think about maybe making some changes.

        Any other thoughts?
        Last edited by NewOldGuy; 10-26-2013, 11:14 AM.

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        • #34
          Originally posted by NewOldGuy View Post
          So all of those are normal except maybe something with thyroid. Why do you think you need a statin? Your HDL and TG are excellent (posted before), and you don't have enough info about the LDL breakdown to infer anything without particle tests. But with the other numbers you have, it's a pretty safe assumption that your LDL is not primarily the harmful type B. If you aren't eating lots of refined carbs or PUFA oils, there is absolutely no reason a statin would benefit you, but it can certainly hurt you.

          If your doctor insists on using a simple LDL number as a reason to take statins, you need a new doctor.
          I am definitely not going to start taking the statins until I know more about my LDL-P (will know more when I get an NMR). Even if it looks dire, I am not sure that I want to take them at all.

          I included the hypothyroidism thing because it is interesting; I may be genetically predisposed to hypothyroidism, and a low carb diet exacerbated the effects, thus raising my LDL-C. I will be really interested to see what my T3 is in conjunction with my NMR profile. I'll keep you posted, but I may not have an update for another month or so. I want my weight to remain steady (although increases may be okay) for a month before getting my lipids checked again.

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          • #35
            Originally posted by howardroark View Post
            I am definitely not going to start taking the statins until I know more about my LDL-P (will know more when I get an NMR).
            Be sure to get a test that includes "Small LDL-P" and not just total P. The liposcience NMR will have both.

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            • #36
              Originally posted by NewOldGuy View Post
              The ratio is usually referred to as the triglyceride to HDL ratio (not the other way around), and it's now considered one of the best predictors of MI risk. People with TG lower than HDL don't have heart attacks. You can find lots of stuff on Google, even from conservative sources like the American Heart Association.
              Did the knuckleheads at the AHA finally admit that? Because that directly says eat animal fat and don't eat sugar/gains and you won't have a heart attack (which goes against the last 50yrs of crap government recommendations). I'm going to Google around but if you have a specific link that would be cool….

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              • #37
                Originally posted by KimchiNinja View Post
                Did the knuckleheads at the AHA finally admit that? Because that directly says eat animal fat and don't eat sugar/gains and you won't have a heart attack (which goes against the last 50yrs of crap government recommendations). I'm going to Google around but if you have a specific link that would be cool….
                The AHA is still a strong proponent of total cholesterol. They do have this Harvard study hiding on their web site though.

                Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial Infarction
                Some of you may die, but that is a risk I'm willing to take.

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                • #38
                  Originally posted by KimchiNinja View Post
                  Did the knuckleheads at the AHA finally admit that? Because that directly says eat animal fat and don't eat sugar/gains and you won't have a heart attack (which goes against the last 50yrs of crap government recommendations). I'm going to Google around but if you have a specific link that would be cool….
                  No, but the Interheart trial effectively did by promoting the ApoB/ApoA1 ratio as the best marker of CVD. AHA has quietly ignored it

                  Sent from mobile
                  Four years Primal with influences from Jaminet & Shanahan and a focus on being anti-inflammatory. Using Primal to treat CVD and prevent stents from blocking free of drugs.

                  Eat creatures nose-to-tail (animal, fowl, fish, crustacea, molluscs), a large variety of vegetables (raw, cooked and fermented, including safe starches), dairy (cheese & yoghurt), occasional fruit, cocoa, turmeric & red wine

                  Comment


                  • #39
                    Originally posted by peril View Post
                    No, but the Interheart trial effectively did by promoting the ApoB/ApoA1 ratio as the best marker of CVD. AHA has quietly ignored it

                    Sent from mobile
                    Another interesting thing I noticed: the INTERHEART study mentions consumption of fruit and vegetables as being protective, but nothing about "heart health whole grains." No wonder the AHA ignored it.

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                    • #40
                      Originally posted by peril View Post
                      Where is your evidence of fault with Interheart?
                      Originally posted by peril View Post
                      ...the Interheart trial effectively did by promoting the ApoB/ApoA1 ratio as the best marker of CVD. AHA has quietly ignored it
                      Interheart found ApoB/ApoA1 ratio as one of nine observable risk factors and they confirmed a strong correlation of a lower number there to lower incidence of MI. But the takeaway that has been widely published is that lower LDL particle count (for which ApoB is a proxy) means lower risk. Which is wrong enough to matter. Only the typeB particle count matters to CVD/MI risk. They make no distinction and don't even mention the particle types anywhere that I've found. And people that eat the right diet (and other lifestyle choices) don't have typeB particles or oxidized particles, so their count can be through the roof without increased risk. TypeA (i.e. large) LDL particles do not become embedded in arterial walls.

                      As for the denominator, everyone agrees that higher HDL (for which ApoA1 is a proxy) is good, so that isn't anything new.

                      Furthermore, the Interheart conclusion on lipids is interpreted in many secondary medical articles, and I believe by the average physician, as meaning that lower LDL means lower risk, which is simply the old totally discredited cholesterol hypothesis again. And the misinterpretations are made even worse since Interheart refers to this risk factor simply as "abnormal lipids" in their conclusions, which is pounced on by the establishment (and the drug companies) to mean high LDL/low HDL and that they were right all along, and high LDL is still the culprit. Their thinking is that ApoB = LDL and >LDL = bad. A totally wrong chain of reasoning, but I see it explained that way all over the place.

                      So even though Interheart correctly identified a useful correlation, the actual cause of that correlation, and how it might be useful, is widely misinterpreted to the point of just being harmful. It has perpetuated the use of statins and perpetuated LDL as the cause of CVD.

                      As for the other top MI risk factors identified by Interheart, who didn't already know that cigarettes, obesity, and stress are bad and veggies and exercise are good? Come on.

                      So that's why I think the lipid part of Interheart hasn't really helped change the thinking on cholesterol.

                      Edit: It's also interesting to note that the Interheart questionnaire did also ask people about their consumption of grains and cereals, and about their consumption of vegetable oils. I think these didn't make the top risk factor list because most people eat both, and so there probably weren't enough people not eating any of those to show the known correlation to lower CVD from avoiding those things. Or at least it didn't rise above the other nine call-outs statistically.
                      Last edited by NewOldGuy; 10-28-2013, 01:35 PM. Reason: sp.

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