Re: Help understanding my lipid profile and statin choices?
Posted: Mon Mar 18, 2019 10:43 pm
I am grateful to all who spent some of their precious time sharing information and sympathy with me. I’ve been indecisive avoiding the lipids issue for several years and your comments have moved me to action.
My cardiologist’s advice is premised on my last blood test in June 2018. It occurred to me that a prescription for something that is so important to heart and brain health should not be based on data 9 months old - and only on the simplest type of panel. Before I act I want fresh data. I paid for my own blood test taken Saturday that includes particle size and insulin resistance. I ordered a used Cholestec from Ebay cheap (thanks to info gleaned from the board and private messaging help). And I will suggest to the physician that because of the cognitive risk I should have a full lipid profile and be tested more than once a year. The rosuvastatin is at lowest dose (5 mg) every other day and I might do it if I can monitor changes with objective data rather than waiting blindly to see whether I lose my memory again. My TG/HDL ratio is 10, when > 3 is a sign of much greater heart risk; that can’t be ignored.
Julie G, I admire you for your service to the APOE4 community and for your wide knowledge of AD. Thanks for the detailed ideas. My earlier loss of memory was caused by the lowest dose of pravastatin every other day. I was surprised myself. I might have erroneously attributed causation, but my memory cleared up in the weeks following cessation. As for lifestyle remedies, I’ve been unable to do more than 3 bouts of mild exercise a week because of post-exertional malaise since 2011 (it seems that over the last two months I’ve beat that back with an unorthodox treatment). But my lipids were the same as now back in 2008-2010 when I was lifting weights three times a week and running twice.
I’ve been following the perfect-health-diet for about five years, no grains, no legumes, etc.; more closely in the last two years. Your words prompted me to restudy keto and PHD diets. On PHD I can cut down carbs some and increase fat some, and also add plentiful nitric oxide greens (the greens you named I actually like but have not bothered to eat, not understanding their relevance). I don’t do well on full keto. However, I can get more aggressive about intermittent fasting, which is what Jaminet recommends. I’m now in the third day of a DIY fasting-mimicking diet, will repeat monthly for a few months; and will also work over the next two months to consistently extend my overnight fast from 12 to 16 hours. That would have good blood and brain consequences. Good to be pushed on Hb1aC!
I am long and strong on anti-inflammatories - fish oil, magnesium, CoQ10 (lately ubiquinol) for 20 years; metformin for 15; curcumin for 10; pomeguard, pterostilbene, EMIQ Quercetin, NAG, MSM, pine bark and grape seed extracts, ALA, NAC or glutathione, and others off and on.
Judy H, the knowledge shared on this board will allow us to guide our physicians to make better diagnoses and prescriptions.
NewRon, I saw a study showing increased risk of T2D from statins. But what the heck, I’ve already got T2D.
Fiver, there is no lipid clinic in my health system. My current cardiologist, who was assigned to me because recently hired, is beloved in patient ratings, so I will push her on questions first, gently asking whether there is a lipid specialist. We can correspond by system email.
Cflegal, I came across "The Role of Statins in Both Cognitive Impairment and Protection Against Dementia: a Tale of Two Mechanisms" as well. And also came across studies with evidence both ways. The truth is probably conditional - that statins help cognition in certain types of people, and hurts other types of people, but we don’t yet know the conditions.
Mike, I too recall seeing that study about a benefit only to a subgroup. I think statin advocates would respond that, regardless, statins are shown to extend longevity (probably because of their anti-inflammatory effect?). In reading study claims, I learned, it’s important to distinguish relative reduction of risk from absolute reduction of risk. If statins reduce risk from 2% to 1% adversity or death that’s a 50% relative reduction of risk but a 1% absolute reduction of risk.
SoCalGuy, I was teaching myself the various lipid components and studying the cholesterol medications and came to understand that my TC and my LDL are pretty good, but HDL and TG are not. As you pointed out, fibrates are good at raising HDL and lowering TG, and I will bring that up with the doc. And thanks or the reference, I will start speedwatching Dayspring tonight,
I will report back a few times in the next 6 months, and let you know what worked for me and what not.
The APOE4 board is helping a lot of people to enjoy better health.
My cardiologist’s advice is premised on my last blood test in June 2018. It occurred to me that a prescription for something that is so important to heart and brain health should not be based on data 9 months old - and only on the simplest type of panel. Before I act I want fresh data. I paid for my own blood test taken Saturday that includes particle size and insulin resistance. I ordered a used Cholestec from Ebay cheap (thanks to info gleaned from the board and private messaging help). And I will suggest to the physician that because of the cognitive risk I should have a full lipid profile and be tested more than once a year. The rosuvastatin is at lowest dose (5 mg) every other day and I might do it if I can monitor changes with objective data rather than waiting blindly to see whether I lose my memory again. My TG/HDL ratio is 10, when > 3 is a sign of much greater heart risk; that can’t be ignored.
Julie G, I admire you for your service to the APOE4 community and for your wide knowledge of AD. Thanks for the detailed ideas. My earlier loss of memory was caused by the lowest dose of pravastatin every other day. I was surprised myself. I might have erroneously attributed causation, but my memory cleared up in the weeks following cessation. As for lifestyle remedies, I’ve been unable to do more than 3 bouts of mild exercise a week because of post-exertional malaise since 2011 (it seems that over the last two months I’ve beat that back with an unorthodox treatment). But my lipids were the same as now back in 2008-2010 when I was lifting weights three times a week and running twice.
I’ve been following the perfect-health-diet for about five years, no grains, no legumes, etc.; more closely in the last two years. Your words prompted me to restudy keto and PHD diets. On PHD I can cut down carbs some and increase fat some, and also add plentiful nitric oxide greens (the greens you named I actually like but have not bothered to eat, not understanding their relevance). I don’t do well on full keto. However, I can get more aggressive about intermittent fasting, which is what Jaminet recommends. I’m now in the third day of a DIY fasting-mimicking diet, will repeat monthly for a few months; and will also work over the next two months to consistently extend my overnight fast from 12 to 16 hours. That would have good blood and brain consequences. Good to be pushed on Hb1aC!
I am long and strong on anti-inflammatories - fish oil, magnesium, CoQ10 (lately ubiquinol) for 20 years; metformin for 15; curcumin for 10; pomeguard, pterostilbene, EMIQ Quercetin, NAG, MSM, pine bark and grape seed extracts, ALA, NAC or glutathione, and others off and on.
Judy H, the knowledge shared on this board will allow us to guide our physicians to make better diagnoses and prescriptions.
NewRon, I saw a study showing increased risk of T2D from statins. But what the heck, I’ve already got T2D.
Fiver, there is no lipid clinic in my health system. My current cardiologist, who was assigned to me because recently hired, is beloved in patient ratings, so I will push her on questions first, gently asking whether there is a lipid specialist. We can correspond by system email.
Cflegal, I came across "The Role of Statins in Both Cognitive Impairment and Protection Against Dementia: a Tale of Two Mechanisms" as well. And also came across studies with evidence both ways. The truth is probably conditional - that statins help cognition in certain types of people, and hurts other types of people, but we don’t yet know the conditions.
Mike, I too recall seeing that study about a benefit only to a subgroup. I think statin advocates would respond that, regardless, statins are shown to extend longevity (probably because of their anti-inflammatory effect?). In reading study claims, I learned, it’s important to distinguish relative reduction of risk from absolute reduction of risk. If statins reduce risk from 2% to 1% adversity or death that’s a 50% relative reduction of risk but a 1% absolute reduction of risk.
SoCalGuy, I was teaching myself the various lipid components and studying the cholesterol medications and came to understand that my TC and my LDL are pretty good, but HDL and TG are not. As you pointed out, fibrates are good at raising HDL and lowering TG, and I will bring that up with the doc. And thanks or the reference, I will start speedwatching Dayspring tonight,
I will report back a few times in the next 6 months, and let you know what worked for me and what not.
The APOE4 board is helping a lot of people to enjoy better health.