Page 1 of 4 123 ... LastLast
Results 1 to 10 of 35

Thread: Cholesterol test results - don't want statins again!! page

  1. #1
    Misabi's Avatar
    Misabi is offline Senior Member
    Join Date
    Oct 2010
    Location
    New Zealand
    Posts
    2,783

    Cholesterol test results - don't want statins again!!

    Primal Blueprint Expert Certification
    Hi all,

    I've read a fair bit about the cholesterol/lipid myth and cholesterol tests etc., and personally I'm not worried about getting mine tested, but my dad has been on statins for a number of years so has been brow beaten by his old Dr. into being quite concerned about his levels. If Griff or anyone else who's got a good knowledge of this stuff can scan through this to make sure I'm on the right track I'd be grateful

    My dad has been eating primally since January this year, after I'd convinced him that it would help with his IBS (it did for me) and help him get off of the statins that he'd been taking for several years and had been experiencing the side affects of for just as long.

    He's 62, works in a manual labour job and exercises (swims, runs, body weight exercises) several times a week. 5' 7", 155 to 160 lbs. Has lung issues due to fibreglass exposure a few decades ago and has suffered from IBS forever.

    Well, after only a couple of months of eating this way and a change of doctor (coincidental) he stopped taking the statins and surprise surprise the issues he was having with sore muscles etc. have disappeared. His cholesterol was also tested at when the new doc agreed to stop the meds as the total cholesterol was around 5.5 mmol/l down from over 7 mmol/l the year before, but they said they would review in a few months just to make sure he was staying on the right track.

    The review test was done this week and he called me today to discuss the results as the doc wants to speak to him about it next week to discuss his "options". His results are as follows:

    Score (UK) Ideal range Score (US)

    Triglycerides: 1.4 mmol/l 0.5 - 1.86 124 mg/dl
    Total Cholesterol: 7.2 mmol/l 3.5 - 5.2 278 mg/dl
    Total LDL (Calculated): 5.2 mmol/l 1.4 - 4 201 mg/dl
    Total HDL: 1.35 mmol/l 0.8 - 1.7 52 mg/dl

    (The results were given in mmol/l and the ideal range, I worked out the US measurements using the conversion table here)

    Looks like they used the Friedweld formula to workout the LDL as I got the same answer here .

    I've read that the ratios are more important that the individual measurements, so have worked those out as per Griff's cholesterol primer:

    Total Chol/ HDL: 5.3 (ideal = 5 or below)
    Trig / HDL: 1.0 (ideal = 2 or below)
    LDL / HDL: 3.8 (ideal = 4.3 or below)

    The only ratio that isn't great is the total cholesterol:HDL. I don't see this as an issue really, but I'm guessing it's the total and the LDL levels that the doc is going to be concerned about. But if the LDL count is high due to intermittent lipoproteins being incorrectly counted as LDL because the LDL is workout out using a calculation rather than actually being measured this isn't an issue, nor is it a problem (from what I've read here and elsewhere) if the LDL count turns out to be accurate but is made up of pattern A LDL (big fluffy particles) instead of patter B LDL (small dense particles) - from what I understand if trigs are low and HDL high, then it's unlikely that the LDL will be pattern B, correct?

    If LDL turns out to be high and made up of pattern B, my feeling is that a better recommendation would be to try to increase his HDL through increasing good fats and change the ratio that way, rather than worry about decreasing LDL. If he continues to eat correctly, with low trigs and high HDL then we should see a change of the type of LDL, right?

    I'm going to suggest that if the doc is really concerned that they run a VAP test to see what the high LDL counts is being made up of, and a c-reative protein test to get a better idea of any CHD risk.

    There's also a history of osteoporosis in the family (3 of his sisters have it) so I'm thinking of suggesting vit D, magnesium and calcium to be checked too.

    Thanks folks
    Last edited by Misabi; 07-01-2011 at 10:47 PM. Reason: make corrections and to apologise for the long post ;-)

  2. #2
    ShannonPA-S's Avatar
    ShannonPA-S is offline Senior Member
    Join Date
    Jul 2010
    Location
    Metro Detroit
    Posts
    616
    I'm interested to see what others say with regard to this post. I am a physician assistant student and we are taught statins are so awesome they should be in the water supply -- I obviously don't believe that. But with his numbers (specifically, the LDL), I would be in a great deal of trouble if I didn't prescribe a statin.

    That said, I had a rotation with an ob/gyn who did the VAP test. And if those numbers turned out to be the fluffy type of LDL, he would NOT have prescribed a statin. So it is catching on.
    Last edited by ShannonPA-S; 07-01-2011 at 11:00 PM.

  3. #3
    Misabi's Avatar
    Misabi is offline Senior Member
    Join Date
    Oct 2010
    Location
    New Zealand
    Posts
    2,783
    Thanks for the feedback Shannon

    The side affects of the statins he was taking before just aren't worth the benefit of taking them, especially as there doesn't seem to be a great deal of proof that there is a benefit to reducing total cholesterol or even LDL levels necessarily. As far as I'm concerned they should be an absolute last resort after all attempts to resolve an issue with cholesterol levels through diet and lifestyle changes have failed, and the patient has multiple other CHD/CVD risk factors. If high cholesterol is their only issue, then I don't see that as an a risk in and of itself.... but then, what do I know I'm not a Dr.

  4. #4
    peril's Avatar
    peril is offline Senior Member
    Join Date
    Jun 2010
    Location
    Sydney, NSW
    Posts
    2,680
    Griff's ratios are for mg/dL. They don't convert directly for any ratio involving trigs. Using the numbers converted to mg/dL, the Trig/HDL ratio is greater than 2 so in the bad range. Thus two of the ratios are out.

    Your Dad's trigs are high for someone on a primal diet and his HDL is low. This means there is a good chance his LDL is pattern B. How compliant has he been? Sticking to a strict primal diet should see his HDL and trigs improve.

    If he has not had a vascular event (heart attack or stroke) then there is no evidence that statins will help him
    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

  5. #5
    Misabi's Avatar
    Misabi is offline Senior Member
    Join Date
    Oct 2010
    Location
    New Zealand
    Posts
    2,783
    Quote Originally Posted by peril View Post
    Griff's ratios are for mg/dL. They don't convert directly for any ratio involving trigs. Using the numbers converted to mg/dL, the Trig/HDL ratio is greater than 2 so in the bad range. Thus two of the ratios are out.
    Thanks Peril, you were one of the knowledgeable members I was hoping would see this (I remembered reading some of your posts about taking niacin and could picture your avatar clear as day, just couldn't remember your handle ).

    From what he and my mum say, apart from a few beers a week he's being pretty compliant. Maybe a little to heavy on the nuts, he has a 1/2 to 1 cup of 'no-grain'ola roasted nuts with some greek yoghurt every day (it was the best compromise we could come up with to get him off of cereal & toast). No grains or legumes, some greek/natural yoghurt, a little cheese now and then and some milk in his coffee. I guess cutting all dairy could be the next step.

    He doesn't eat eggs (can't stand them), and is still a little nervous about eating fat etc. after so many years stuck on the CW track.
    I've asked him to keep an accurate food diary for me for a few days, as he is concerned that he's not getting enough protein, so I'll have a better idea of what he's actually eating after I see that. As long as he's being truthful obviously...

    Quote Originally Posted by peril View Post
    Your Dad's trigs are high for someone on a primal diet and his HDL is low. This means there is a good chance his LDL is pattern B. How compliant has he been? Sticking to a strict primal diet should see his HDL and trigs improve.
    Trigs/HDL are high/low for someone on a primal diet, but within the recommended range according to his test results slip, so they shouldn't be a concern for the doc should they? It's just the high LDL score that's pushing up his total cholesterol score, which I understand they are concerned about.

    Triglycerides: 1.4 mmol/l 0.5 - 1.86
    Total Cholesterol: 7.2 mmol/l 3.5 - 5.2
    Total LDL (Calculated): 5.2 mmol/l 1.4 - 4
    Total HDL: 1.35 mmol/l 0.8 - 1.7
    Total Chol/ HDL: 5.3
    (with my incorrect calculations removed, these are the results as given to my dad)

    Quote Originally Posted by peril View Post
    If he has not had a vascular event (heart attack or stroke) then there is no evidence that statins will help him
    Nope, no history or evidence of vascular events or disease. I'll pass on this point. Now you say it, I vaguely recall reading about the fact that statins have only been shown to be effective in patients who have previously had vascular issue... Don't suppose you have any references saved that back this up? Just in case his Dr. disputes?

    I'm trying to get him to increase his intake of monounsaturated and saturated fats (he barely eats any sat fat, doesn't like fatty meats or eggs), which if he does should help increase his HDL right?


    Thanks again

  6. #6
    js290's Avatar
    js290 is offline Senior Member
    Join Date
    Feb 2011
    Posts
    2,026
    Quote Originally Posted by ShannonPA-S View Post
    I'm interested to see what others say with regard to this post. I am a physician assistant student and we are taught statins are so awesome they should be in the water supply -- I obviously don't believe that. But with his numbers (specifically, the LDL), I would be in a great deal of trouble if I didn't prescribe a statin.
    Conclusions
    Despite a widespread and increasing utilisation of statins, no correlation to the incidence or mortality of AMI could be detected. Other factors than increased statin treatment should be analysed especially when discussing the allocation of public resources.

  7. #7
    peril's Avatar
    peril is offline Senior Member
    Join Date
    Jun 2010
    Location
    Sydney, NSW
    Posts
    2,680
    Misabi,

    Here is a good article on the benefits, or not, of statins.

    Re lipids, the ratios are as important as the individual ranges. Being OK on the ranges but not the rations is not OK

    You seem to have two main questions here:

    * How will his doctor react?
    * What should he be doing?

    His doctor will be alarmist, saying the LDL is high and needs to be reduced as soon as possible. To some extent the doctor will be right, as the pattern of LDL may not be good. The fact is the doctor is at risk if s/he doesn't prescribe statins here, despite the actual scientific evidence. However, statins aren't the answer. If your father is willing to buck medical advice this isn't a problem. Your problem will be getting him to adopt a good primal diet.

    An anti-artherogenic diet has the following:

    * low carb, as per primal. However, it doesn't need to be VLC. Around 100g carbs per day should be right. Low carb and low alcohol is the best way to keep the trigs down
    * low sugars, especially low in fructose
    * low vegetable oil
    * very few nuts and only whole
    * lots of whole foods - meat and vegetables. Eating the whole animal is the best but you can only lead him as far as he wants to go. Definitely plenty of saturated fat to raise the HDL. If he won't eat offal, at least get him to eat meat on the bone and bone stocks
    * I think it is better to eat whole fish than to take fish oil. Only expensive fish oils are any good
    * Some foods will help keep the blood thin to avoid a vascular event - cocoa, turmeric and red wine are the ones I choose

    Good luck
    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

  8. #8
    Misabi's Avatar
    Misabi is offline Senior Member
    Join Date
    Oct 2010
    Location
    New Zealand
    Posts
    2,783
    Thanks again Peril, excellent advice.

    He's pretty adamant that he doesn't want to go back on statins, so he's just got to commit to PB more than he perhaps has up to now.
    I'll post an update once all the dust has settled

  9. #9
    Misabi's Avatar
    Misabi is offline Senior Member
    Join Date
    Oct 2010
    Location
    New Zealand
    Posts
    2,783
    Quote Originally Posted by peril View Post
    Misabi,

    Here is a good article on the benefits, or not, of statins.
    I can't see a hyperlink anywhere

  10. #10
    Misabi's Avatar
    Misabi is offline Senior Member
    Join Date
    Oct 2010
    Location
    New Zealand
    Posts
    2,783
    Quote Originally Posted by peril View Post
    * low sugars, especially low in fructose
    How low are we talking? Cut out fruit juices, only a couple of pieces of fruit a day, no fruit?..

Page 1 of 4 123 ... LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •