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  • Time for Statins (Lipitor)?

    So, some background first before any questions.

    In 2009 I started eating a low-carb paleo diet, I lost a lot of weight (which I have kept off) and my bloodwork was fine. In 2014 my doctor found that my cholesterol was high and it has been high ever since - LDL in the 5 range and HDL in the 1~2 range with a total cholesterol of 6~7 (metric system). This has been consistent between 2014 right up to today.

    As an experiment in 2014, I switched back to a higher than normal carb diet - around 100mg - but it had no effect on cholesterol. I more recently switched to a ketosis style diet over the last 8 months and similarly it has had no impact on cholesterol. I had an LDL fraction test done (only one available in Sydney) and that showed the LDL breakdown was mostly benign and the specialist's opinion was that there was no increased risk of heart disease based on this test but still recommended to my GP to follow standard treatment procedure.

    I have also tried more natural methods like a prebiotic and eating a bunch of almonds which is suppose to potentially naturally lower cholesterol but to no avail. I finally gave in to my doctor since I can't think of anything else to try and my GP has been more than open to trying anything and everything before prescribing statins so I don't doubt his integrity in this. All my other metrics are fine its just cholesterol and my doctor believes its hereditary and not necessarily an indication that there is something wrong with my heart or I have heart disease but wants to see the LDL numbers reduced.

    Considering I have been testing for 3 years now with no impact and consistent results I feel I am at a dead-end here. So my question from others in the same or similar situation:

    1) Do I need to worry about high cholesterol, even if its LDL that is high? To me, I am seeing a consistent pattern here which potentially indicates a problem.

    2) Is there anything else I may have missed?

    3) I tend to be suspect when a doctor says its "hereditary" since this seems to be a catch-all for things that they can't explain. How common is high cholesterol/LDL without an underlying issue really?

    4) My real worry is - do I have heart disease of some type if it isn't "hereditary"? I don't feel in any way sick but I do feel that the high LDL count is potentially an indication of a bigger underlying problem (or maybe not if it is hereditary/genetic).

    One last thing, I do heavy weights 2~3 times a week, do a 100 pushups 5 days a week and sprint twice a week. So I also have a pretty good exercise routine. My Dad is the only other person in my family who has had high cholesterol and had a bypass in his 70s and has been on statins ever since.

    Finally, I am 45 years old and a caucasian of mederteranin descent. Doctor wants me to have 1/2 a Lipitor tablet once a day and retest in a month.

    Thank you.


  • #2
    Have you read, The Cholesterol Myths? It is only $1.25 for an e-copy on Amazon. Give that a read. It's a very insightful book into how the pharmaceutical companies have manipulated cholesterol ranges and pushed for more GPs to have patients on statins.

    https://www.amazon.ca/Cholesterol-My...olesterol+myth
    Moved on over to www.primalforums.com

    Comment


    • #3
      You might well be an outlier that lives perfectly well with higher LDL levels. What about your LDL/HDL/Trig ratios? It's my understanding that those are more important than specific numbers, but I'm no doctor or researcher.

      I do like the fact that your doctor has been patient, working with you and wants to start you on a low dose. OTOH, according to Dr. Eades, the research shows that statins are effective in a narrow age range - something like 55-70 - , men only, and AFTER a cardiac event. Here are his blogs about statins:
      https://proteinpower.com/drmike/?s=s...&submit=Search

      Good luck.

      Comment


      • #4
        I read somewhere that cholesterol levels are 80:20 genetics vs. diet, but I have no idea where that number comes from or its validity. However, I think it's safe to assume that there is a large component of both reflected in an individual's lipid levels.

        This question pops up here every week or two. You might want to pick through the sneaker spam and look for the recent discussions. With the number of people who ask the question on an otherwise indolent forum, it might make you think about whether the LCHF diet is a good choice. It's not consumed as a traditional diet outside of a few, very limited populations, it's unlikely to reflect the real paleolithic diet, and it's unvalidated as a safe or long term healthy choice for people living in the industrialized world. Some people may tolerate it, but there are a lot of people who exhibit deteriorating metabolic results while eating this way.

        I won the cholesterol genetics lottery. My sedentary, sweet-eating father has superb lipid numbers and so do I. It doesn't depend on my diet, it's effortless, and it's genetic. OTOH, when I married my husband, his numbers were not so great, not terrible, but not good either. He cut out beer and soda, lost 30 lbs, and then started exercising. That fixed his triglycerides and HDL, but until the addition of daily oatmeal a year ago, his LDL didn't improve. He still prefers sugar to vegetables, though.

        There's a big middle ground between healthy carbs and white sugar/white flour bakery treats. Fats are pretty much fats, proteins are pretty much proteins albeit with varying fatty acid and amino acid profiles which in a mixed diet and in reasonable amounts are probably meaningless. "Carbs", OTOH, run the gamut between rapidly absorbed glucose and completely (human) indigestible cellulose. You don't have to skip low glycemic load, whole food carbs to control your weight and blood sugar or to eat a healthy diet. In fact, a sugar found in beans actually reduces your blood sugar.

        There is a lot of data that says that eating large amounts of saturated fats (with or without elevated lipids) and having elevated lipids increases your risk of heart disease. You could certainly try cutting way down (not eliminating!!) fats for a few months and see if things get better for you. Try eliminating added fats (Grok ate coconut -- maybe --, not tablespoons of coconut oil), cutting down on meat portions, eating leaner meats, eating more whole food carbs. Give it three months or so and then recheck your lipids. Give it a fair trial and then you can re-evaluate.

        You could even eat a daily bowl of oatmeal!

        Comment


        • #5
          You might have to do the 'unthinkable' and drastically change your diet because that's likely the root of your problem. And it's such a common issue in this forum that I'm just going to re-post the response I gave to the last person.

          My lipids were almost identical to yours at LDL 203 mg/dl (~5.2mmol/l) and Total Cholesterol of 287 mg/dl (~7.4 mmol/l) when I was eating a higher fat paleo/primal diet. My doc had also warned me that if I didn't lower it I was looking at statins. I was at normal weight at the time and no other labs were abnormal.

          I reduced my consumption of saturated fat from all meats, eggs, oils, cheese, butter etc and increased my consumption of whole food carbs like beans, lentils, rice, oats, potatoes, grains, fruits and starchy veggies. The key is to reduce saturated fat which is high in paleo/primal. My LDL dropped to 109 mg/dl (2.8mmol/l) and Total Cholesterol dropped to 179 mg/dl (4.6mmol/l) and it has stayed constant (within +/-10mg/dl) in the last 2 years (I test every 6 mths).

          My fasting blood glucose has ranged from 70-81mg/dl (normal is 65-99) and last A1c was 5.2% (normal is 4.8-5.6) which are both perfect despite a diet high in carbs (75% or about 300g), and I've lost 35+ lbs and maintained it for 2 years now. We've been misled to believe that eating high carb increases the risk of diabetes and gaining weight. It doesn't.

          Bottom line is, a healthy diet should not result in abnormal blood tests. And in many cases, a primal/paleo diet high in saturated fat has caused many folks' LDL to go abnormally high. Just search for 'High LDL' on the forum and you will find numerous threads just like yours. Many have also taken the advanced test and found even that test to show their numbers in high risk ranges.
          Last edited by KimLean125byMar15; 04-05-2017, 08:58 AM.
          *Starting Wt - 151 lbs (January 2015) * Current Wt - 113 lbs (November 2016)
          *95% Plant-Based (from June 2015) ~ *75%Carbs *10-15%Protein *10-15%Fat
          *Exercise ~7-10 hrs/week

          Comment


          • #6
            Originally posted by solomani View Post
            ..... All my other metrics are fine its just cholesterol and my doctor believes its hereditary and not necessarily an indication that there is something wrong with my heart or I have heart disease but wants to see the LDL numbers reduced......

            ......Do I need to worry about high cholesterol, even if its LDL that is high? To me, I am seeing a consistent pattern here which potentially indicates a problem..........
            Bob Harper (US Biggest Loser trainer) had a massive heart attack (he's 51) nearly 2 months ago. He's fit as a fiddle, obviously health conscious, but he's been on a paleo diet for years. He even said he drank 'bulletproof coffee' (with coconut oil and butter) 'for energy' every morning before working out. That's pure saturated fat. Yes, he does have a family history, his mum died of a heart attack at 70 (usually risk is considered high when 1st degree female relatives get heart attacks at 65 or less or when 1st degree male relatives get them at 55 or less). So this suggests that his diet played a major role.

            This week, he gave an interview saying his cholesterol was in the high range and he has to monitor it. His doctors have advised a mediterranean diet (usually low in saturated fats and low in red meat but emphasizes fish, whole grains, potatoes, beans/lentils (legumes), veggies, fruits etc)

            Incidentally, he said he's been getting his annual physical without fail. I'm guessing he might have dismissed an elevated cholesterol since that's what many paleos even on this forum say to those who post about rising LDL.
            *Starting Wt - 151 lbs (January 2015) * Current Wt - 113 lbs (November 2016)
            *95% Plant-Based (from June 2015) ~ *75%Carbs *10-15%Protein *10-15%Fat
            *Exercise ~7-10 hrs/week

            Comment


            • #7
              Here's the Eades piece to read: https://proteinpower.com/drmike/2008...k-for-statins/

              Comment


              • #8
                You are not necessarily at high risk of heart disease. Cholesterol levels can be interpreted different ways.
                You can do things, other than take statins, that will affect your cholesterol levels.
                You can do things, other than take statins, that will lower your chance of heart disease. Notice this is different from the previous line.
                Statins will not necessarily benefit you. Their side effects can be substantial.

                You can probably reduce your chance of heart disease significantly by doing things that would promote good thyroid hormone levels, eg eat more sodium, magnesium, zinc, and carbohydrates, and eat less polyunsaturated fat. I would absolutely not take a statin, but you have to find an answer that satisfies you.
                My opinions and some justification

                Comment


                • #9
                  Thank you everyone, this is great information, will go through each one of the links. I don't eat a lot of meat as I cut that back as well. I do eat a lot of fat - mostly via avocados for example. One thing I have noticed about my diet now I think about it is that I don't eat fruits except incidentally. Seems to have naturally happened not anything I have forced/changed.

                  Originally posted by JBean View Post
                  You could even eat a daily bowl of oatmeal!
                  Any idea why oatmeal or is it just an increase in carb intake - what do you think? I am curious. My wife is of asian descent so likes to eat rice so thats easy to add to my diet if I choose to.

                  Comment


                  • #10
                    Oats are good sources of lipid-lowering soluble fiber. The fiber in oatmeal, called beta glucan is also found in barley, but not in rice. Other aoluble fibers have similar effects on lipids. Soluble fiber has kind of a gluey texture and is found in fruit in the form of pectin, in eggplants and okra, and in psyllium fiber husks (Metamucil is one brand). A dose of Metamucil with every meal will usually lower LDL by 10-15%, but tasty, it isn't.

                    Avocado should be fairly neutral with repect to your cholesterol. Are you eating a lot of coconut or palm oil?

                    The reason for adding carbs to your diet is mostly to displace some of the fat. Whole food carbs also offer some additional benefits beyond just soluble fiber in satiety and nutrients. Grains aren't particularly nutrient dense, but the panic about lectins is silly. If specific grains bother you, then don't eat them. Carbs aren't magic either, so just adding them to your diet isn't necessarily going to fix things, but they also aren't to be feared. Some people do really well on a "plant based" diet with low added fat, some don't. However, if you have a cholesterol problem, it might be worth trying for a few months to determine whether it suits you and gives you the result that you are looking for. If you find it makes you feel deprived and miserable, then stop.

                    Do you have weight to lose? Weight loss by any diet normally improves cholesterol too.

                    If your weight is normal, your diet is pretty healthy, and a low fat plant-based diet doesn't work, then you may have to consider the statin. The incidence of negative side effects is actually pretty low and, again, if it doesn't work for you, you can always stop it. Of course, if you smoke or have blood sugar problems, getting those issues under control is super important for preventing heart disease.

                    Comment


                    • #11
                      JBean, you forgot coffee. Loads of soluble fiber, about 1.5 grams per standard 8 floz cup.

                      Comment


                      • #12
                        Originally posted by OnTheBayou View Post
                        JBean, you forgot coffee. Loads of soluble fiber, about 1.5 grams per standard 8 floz cup.
                        Coffee as a drink has no fiber. If you eat coffee beans, you would get some fiber.
                        I moved to primalforums.com to escape the spam.

                        Comment


                        • #13
                          Originally posted by sharperhawk View Post

                          Coffee as a drink has no fiber. If you eat coffee beans, you would get some fiber.
                          Sorry, you are wrong. https://www.bing.com/search?q=coffee...ZI&form=MOZSBR

                          Perhaps you are confusing undigestible literally fibrous material with the poorly named soluble fiber.

                          Comment


                          • #14
                            Soluble fiber in my coffee -- I knew that I was drinking it for all the right reasons, I just didn't know what those reasons were! Apparently, coffee also provides a high percentage of the average adult's antioxidant intake too.

                            Comment


                            • #15
                              The upshot is: Doctors say we don't know what is normal for you, but the current standard of care recommends the lowest possible LDL levels; so a statin it is. It doesn't matter that lower levels of LDL often predict worse outcomes for their owners (proven, BTW). Me, I just think surviving day to day w/o added muscle pain and need for extra CoQ10 from statin use is good enough for me. I am fast approaching 75 years of age, and have been dodging statins for 21 years due to severe reaction and suspicions, even with a major stroke and heart troubles.

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