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A potential visit to a cardiologist....(to humor my PCP)

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  • A potential visit to a cardiologist....(to humor my PCP)

    I did post this under Griff's cholesterol primer (I have read the entire thing already), but didn't receive any responses, so I'll try again here. Bottom line is how to I best arm myself to talk to a cardiologist?

    Here are my stats:
    I am 5'0", female, 38years old. My cholesterol has always been stupidly
    high and I have consistently refused medication. Both my mother (63) and grandmother (84) have
    high cholesterol but so far no heart attacks.

    2009 - 123 lbs, not primal
    Total 293
    HDL 44
    Triglicerides 65
    LDL 236 (Freidewald)
    LDL 202 (Iranian)

    Total/HDL 6.66
    Trig/HDL 1.47
    LDL/HDL 5.4 (Freidewald)
    LDL/HDL 4.6 (Iranian)


    2011 - 114 lbs, realistically 85/15 primal since Nov 2010
    Total 320
    HDL 59
    Triglicerides 66
    LDL 248 (Freidewald)
    LDL 212 (Iranian)

    Total/HDL 5.4 (ideal is <4.4, therefore not great)
    Trig/HDL 1.12 (ideal is <2, therefore good)
    LDL/HDL 4.2 (Freidewald) (ideal is <4.3, so ok)
    LDL/HDL 3.6 (Iranian) (ideal is <4.3, so better measured this way)

    However, according to my lab results they state that all my ratios are too
    high because they only look at Total/HDL and LDL/HDL (which they claim must
    be less than 3.2, not 4.3)

    So they want me to have a cardiac evaluation, ok fine I suppose I can humor them since
    I still have plenty of money in my HCRA!
    My question is what questions should I arm myself with for the cardiologist?
    And what tests should I specifically ask for?

    Thanks!
    Sasha

  • #2
    Your numbers seem to me to be improving. (I am far from an expert in that stuff.) What I would ask for (no, insist on) would be more time.
    Ancestral Health Info

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    • #3
      More time would be good, as things have really improved. Your triglycerides were already low, but your HDLs are now in a good place. Have you considered asking for a VAP test? At least then you could actually know something meaningful about your LDLs (particle size.)

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      • #4
        I will ask for a VAP test before I think about making an appointment with a cardiologist, thanks.

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        • #5
          Get a VAP and CRP before anything else. Those are going to be the only ture measure of risk. Find out whether your LDL is Pattern A or Pattern B and CRP will tell you about inflammation. How any doctor can gauge heart disease risk off of a basic cholesterol test is beyond me.
          Check out my primal blog: http://primalroar.posterous.com/

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          • #6
            Turns out I can't get a VAP or CRP without the cardiologist approving them, so I've made an appointment (hopefully with someone who understands heart disease a lot better than my PCP!!). I am quietly hopeful that the doc I've chosen isn't going to be completely useless.....we shall see!

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            • #7
              Berkley HeartLab test results:

              Total Chol 311
              LDL 240
              HDL 58
              Triglicerides 63
              ApoB 147
              LpA 45
              CRP 1.1
              LDL III a+b 7.50%
              LDL iV b 0.90%
              HDL2b 32
              Homocysteine 7.9
              Lp-PLA2 194
              Fibrinogen 344
              Insulin 3
              NT-proBNP 36
              Vitamin D 39
              ALT 19
              AST 17
              Q-IIIa+IIIb 12.9
              Q-LDL IVB 1.9

              Cardiologist turned out to not be very sensible and still recommended a statin, which i politely declined.
              LDL is pattern A, which is good. I was a little surprised that my CRP was 1.1. They recommended a value less than 1.0, so it's only a little high, but I guess I thought it would be lower since eliminating inflammation causing grains.
              Should i be shooting for a higher level of Vit D?
              Is there anything else that jumps out at you from these results?

              Thanks for your insight!
              Sasha

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              • #8
                This is why I avoid my own doctor. This is also why I love reading Dr. Eades' blog. You are not your lab numbers and doctors who treat lab numbers instead of diseases are idiots. If you do not have heart disease, having high cholesterol numbers doesn't indicate anything. The only people on the planet that have ever benefited from statins are men under age 65 who have already had a heart attack. There is some evidence that high cholesterol in women actually is protective and leads to a longer life.

                I've spent a lot of time reading the archives of Dr. Eades' blog and one of these days I am going to take notes and track down the studies he mentions so that I can have the information at the ready and not come off as some kind of crackpot patient who read stuff on some blog on the Internet. I'm just really bummed that Dr. Eades' blog seems to have died because he lives in my home town and I've tried to contact him through his blog to get a referral to a better doctor. No response. I'm really bummed.
                Female, 5'3", 50, Max squat: 202.5lbs. Max deadlift: 225 x 3.

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                • #9
                  I'll check out his blog, thanks.

                  One of the things that totally sucks is that our health insurance provides a discount for 'healthy people' which I do not qualify for because my cholesterol is high. Ironically if I took a statin then I would qualify (regardless of all the crap that statins do to many people!)

                  That may be the subject for another post, but being punished by insurance companies for improving my own health and well being through my own educated choices really bothers me!

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