Please give impression - doctor visit next week

[adventure]

I've been fighting taking a statin and have been trying to lower my cholesterol with diet and exercise. My efforts however are being stymied by not being able to stop losing weight. In the beginning losing weight was a nice side-effect but now it has become a problem. I can't seem to stop losing weight without eating things that raise my cholesterol.

Anyway...I paid for some blood work thru LifeExtension that uses LabCorp. I don't know what to make of my results. Some seem awful and others encouraging. Is it possible that high LDL might not be that bad if other things look okay...or am I just totally deluding myself with wishful thinking?

I would appreciate anybody's impression of these results.

Cholesterol, Total 262

LDL-C 155 (borderline 130-159)
LDL-P 1677 (high 1600-2000)
small LDL-P <90 (<=527)
LDL Size 22.1 (Pattern A 20.6-23.0)
(The Cleveland Clinic website is saying that LDL particle size does not relate to risk, that it is the LDL-P that is important for risk. I also read elsewhere that people with familial hypercholesterolemia have Pattern A but still high risk)

HDL-C 90
HDL-P (Total) 35.9 (high >34.9)

LP-IR Score <25 (low <27)

Lp-PLA2 activity 57 (<75)

Apo A-1 201 (116-209)
Apo B 102 (54-133)
Apo B/A-1 Ratio 0.5 (0.0-0.6 average risk)

My genetic testing through 23andme looked at 2 genes related to statin induced myopathy. One showed a 5 times average risk and the other gene double risk. And my mom when she took a statin became as dumb as a brick (she recovered once she stopped). My doctor seems stuck on my LDL and doesn't seem interested in anything else.

[Nancy]

Sounds like a conundrum.
Are you eating the foods suggested in Stavia's Primer or recommended by Bredesen or Gundry?
I don't do well with statins either, so I also avoid them, though my cholesterol levels are very high. I am trying to stick to the above protocols as much as I can. Not perfectly yet. My doctor recommended I take four fish oil pills per day plus one niacin since I do not want to take statins. And low animal fat/refined carbs. I am losing weight but not that quickly. Nuts, olive oil, avocados, and fatty fish plus veggies and fruits should keep you from getting too thin, I would think. I have not been retested since starting these protocols. What are the foods you're eating to keep from losing too much weight?

[KatieS]

Adventure, as another 63 y/o 3/4, I reviewed your first posts when your TC was 334, so you have made incredible progress in less than a year. As Nancy said, focus on achieving the weight loss, maybe with the CRON-O-Meter to also lower that saturated fat % to ~7% of calories. Unlike me, your LDL-C and LDL-P are concordant. Did not see a lp(a), another independent risk factor. Your lack of family history of CV disease despite high cholestrols and your mom's cognitive impairment with statins (which one?), seems to indicate you should be cautious. Do you have evidence of atherosclerosis on Calcium scan or carotid artery ultrasound? If these test are abnormal, you might consider a more hydrophilic statin like pravastatin or rosuvastatin, the latter I'm on a low-dose. Are there other factors such as hypertension as to why your doctor is promoting a statin?

[ru442]

Adventure... at first glance your numbers look good to me.... as you probably have seen in other threads the LDL numbers are controversial for 4's. As KatieS has indicated, if your CV is not your risk factor I would not focus on that but on your cognitive issues.

I also had weight loss issues... the only way I could stop it was to introduce more protein, in my case I added animal fats of very high quality (pork and chicken mostly, some bison/beef/lamb but maybe once every 2 weeks, all 100% pastured). I rotate these in every other meal or every 3rd or 4th meal depending on availability. You can also add in more fatty fish.... salmon or my new favorite Arctic Char (tastes like beef... lots of fish fat on these). For me I continue on a statin only because it is cardio protective for me at this point in my journey however; my goal is to stop statins if my numbers support it.

I'd be interested in Stavia's opinion also...

[Julie G]

I think (could be wrong!) that adventure is having trouble keeping weight on. I find nuts helpful in this regard. Dr. Gundry specifically recommended macadamia nuts in Bounder for other members dealing with this.

Congrats on all of the improvements. Like Katie, unless you have evidence of CAD (via an EBT scan) I see little to be concerned about. Your numbers look great. With such a low LPIR and small LDL-P, I assume your glycemic markers are great. Out of curiosity, what are your TGs?

[Stavia]

Adventure we have no idea if your numbers are clinically significant in YOU without a coronary calcium scan.
In your introduction you said there was no family history of heart disease.
You are insulin sensitive.
Your coronary arteries may not have significant atherosclerosis.
I as a doctor would not knee-jerk react to just the lipid numbers and give you a statin without looking carefully at your individual risk.
Lipids are a very blunt marker of cardiovascular risk.

[ru442]

I think (could be wrong!) that adventure is having trouble keeping weight on. I find nuts helpful in this regard. Dr. Gundry specifically recommended macadamia nuts in Bounder for other members dealing with this.

That was my take away also... and I also eat a lot of macadamia (I try to buy in bulk to keep the cost down... small can of Mauna Loa are like $5).

[GenePoole0304]

LDL is a major risk factor as it gets oxidized and then forms plaque that blocks the arteries. That is the reason why the calcium score is important. Now heart disease is multifactorial so you can see that why most doctors want LDL reduced as it has some basis when it is higher than normal.

http://www.lifeextension.com/magazine/2 ... rs/page-01

http://www.nhlbi.nih.gov/health-pro/gui ... rence-html

[adventure]

I appreciate everyone's feedback. My doctor has told me to reduce fats and then to reduce carbs. I don't see how to do both and stay at a reasonable weight. I actually should gain some weight now and I don't know whether to do it with fats or carbs. I am already eating lots of nuts, avocado, and chicken and fish in addition to a lot of vegetables, some sweet potato and fruit like blueberries. I don't eat grains but I do have 2 cups of milk a day. From what I have read, it seems like LDL-P responds best to low carbs so I guess I will try to add more fat to my diet and see what happens.

I can't find my Lpa results but I remember they weren't high. My triglycerides were 87. My C-reactive protein was 0.6

My mom's cholesterol runs around 300 and she doesn't have the APOE4 gene so I think I have two genetic things trying to push my cholesterol up. I have not had the calcium scan because I don't want any more radiation to my chest. I have had so many CT scans that my doctors are alarmed. But maybe it would make good sense to check the arteries in my neck for plaque. I think I will pursue that.

I rescheduled my cardiology appt in Jan. because I don't feel like being lectured or pressured right now. Thinking about finding a lipid specialist. Think I also might order more blood work - check for oxidized ldl.

[Nancy]

Have you been losing weight for a while? Do you know the cause? Is your weight dangerously low?
I think adding carbs helps with weight gain more than adding fats. Also, for me, and many others I've seen, adding certain fats can really raise cholesterol a lot. I'm not saying adding carbs is great, but if I had to choose between the two because I kept losing too much weight, I'd probably add something like lentils, oatmeal, brown rice, beans, and continue with the sweet potatoes. Not a lot, but some. Maybe a small helping with your dinner. That's just my opinion. Others on here may totally disagree.