Another negative lipid profile trend

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JimBG
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Re: Another negative lipid profile trend

Postby JimBG » Mon Jun 18, 2018 8:33 am

by NF52 » Sun Jun 17, 2018 9:47 pm
Hi Jim,
Like you, I had sky high LDL-P, and Lp(a), although with a clear CAC. I am on a low dose of atorvastatin, which has halved the LDL-P score (haven’t checked the Lp(a), but expect it to not change much. I too asked my Dr. about Dayspring’s recommendations to aggressively treat high LDL-P with Zetia and/or niacin. His response was that changes in LDL-P scores from Zetia, which were impressive, weren’t found to result in any further reduction in “cardiac events”, and that no cardiologist he knew was recommending niacin because of risk of side effects. He predicted that we’ll know much more about Lp(a) in 5 years, but that LDL-P may not always track well with actual cardiac risk.
But of course we’re all N=1 subjects in our own decisions on what to do with these results!


Thanks NF52. Appreciate your thoughts. Curious as to how low your particle count has gotten and how long it took to reduce it with the atorvastatin. I have read both in Bredesen's book as well with Dr. Brian Edwards posts and book that 700 should be the goal (Dayspring noted 800), and below that can cause plaque regression. I did take Lipitor a number of years ago but stopped as I felt tired and experienced muscle spasms. If I do go on a statin I am leaning towards perhaps a low dose of Crestor or Zocor. I don't know my Lp(a). Had asked my cardiologist to order it with this last blood work but it didn't go through for some reason. I have checked by genetic code for Lp(a) (rs10455872; rs3798220) and both appear normal. So hopefully its not an issue, but I'll see for sure on the next bloodwork.

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Re: Another negative lipid profile trend

Postby JimBG » Mon Dec 03, 2018 9:42 am

Thought a good time for an update. After 3 ProLon cycles and maintaining a relatively strict diet (eliminating saturated fat; lots of vegetables; lots of fish, avocados & EVOO) as well as adding daily steel cut oats and a beta glucan supplement, also TRF (10 hour window), I have made some good progress on my Lipid numbers:

------------------------4/5/18 (Lab)------------6/5/18 (Lab)------------10/15/18 (Lab)----------12/3/18 (Home)
TC------------------------261-----------------------225--------------------------195------------------------189
HDL-----------------------55------------------------48---------------------------61-------------------------56
Tri------------------------126-----------------------109--------------------------60--------------------------77
LDL-----------------------182------------------------155-------------------------122-------------------------117
TC/HDL-------------------4.7------------------------4.7--------------------------3.2------------------------3.4
LDL P#-------------------1974-----------------------2101------------------------1482------------------------NA
Lipo (a)---------------------------------------------------------------------------45

Also noteworthy is my Omega 6/3 ratio has improved: (5/14/18----5.6:1) -- (11/15/18----3.9:1)

A1C: 5.2 and HsCRP: 0.4 have been stable.--- BP: 110/70---BMI: 23.8

However since my CAC was 175, putting me in the 69th percentile per the MESA data, my cardiologist has recommended I start on a statin. This is also in line with the new AHA/ACC cholesterol guidelines which indicate that even if 10 year ASCVD risk is intermediate (mine is 7.6%, just over the 7.5% threshold) if CAC is over 100 statin therapy should be initiated. So I will start on a low dose of Rosuvastatin (5mg/day) and see how much lower I can drive the LDL particle number. From what I understand Rosuvastatin has less side effects compared to Atorvastatin/Lipitor possibly because it is water soluble vs fat soluble. I wanted first to see how much better I could get my numbers based on lifestyle changes and now believe its prudent to add a low dose statin with the objective of getting the particle number under 1000.

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Re: Another negative lipid profile trend

Postby Brainz » Mon Dec 03, 2018 6:28 pm

You may want to watch some of the videos on YouTube by Ivor Cummins. He's a big proponent of CAC scans for measuring CV risk. BUT, he also acknowledges that its the trend in CAC that matters. If you're otherwise doing the right things for your health (low carb, intermittent fasting, excercise) then you may not have any further issues and may see improved CAC over time. Stick with your good diet and get retested in a year.

Full disclosure: Count me as a BIG skeptic of statins. You need to research their effectiveness on overall mortality and determine whether such a minimal improvement is really worth the side effects/risks (which include, ironically, depression and dementia). There are numerous videos on YouTube about these risk with links to medical studies that show their questionable benefit.

Do statins lower LDL? Yes, very effectively. But, as Ivor Cummins will show you, that's probably not what needs fixing for CV health - - its the hyperinsulinemia and inflammation. And even if LDL does matter, statins dont improve motality outcomes.

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JimBG
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Re: Another negative lipid profile trend

Postby JimBG » Mon Dec 03, 2018 8:21 pm

Thanks Brainz for your thoughts. I am quite familiar with Ivor Cummings, have read his book, understand his views and follow him on Twitter. And I certainly agree that hyperinsulinemia and inflammation are very important. But also believe that LDL particle concentration is also very important. I have also been quite hesitant to initiate statins for the reasons you mention. However after researching it further have changed my view. There are numerous threads on this forum discussing statin use with folks strongly for and against. Just do a search on statins if you haven't done so already. You can also check out a recent post of mine where I comment on the Peter Attia podcasts with Dave Feldman and Thomas Dayspring and explain my current opinion on this topic. Those podcasts are quite in-depth and I highly recommend them. They may change your view.

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Re: Another negative lipid profile trend

Postby Brainz » Mon Dec 03, 2018 9:39 pm

Good to hear and understood. I will continue to learn more. Lots of evolving and often contradictory perspectives.

Best wishes in your journey. Please continue to keep us posted. Interesting stuff.

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Re: Another negative lipid profile trend

Postby JimBG » Wed Apr 17, 2019 4:43 pm

As an update I recently obtained lab results and have made considerable progress in my lipid profile:

--------------------------4/5/18 (Lab)------------3/19/19 (Lab)
TC------------------------261-----------------------163
HDL-----------------------55------------------------ 63
Tri------------------------126------------------------82
LDL-----------------------182------------------------87
TC/HDL-------------------4.7----------------------- 2.6
LDL P#-------------------1974-----------------------1177
A1C------------------------5.1------------------------5.3
CRP-----------------------0.49----------------------0.30

The improvement is due to a combination of lifestyle and low dose statin. I have tried to avoid as much as possible refined carbs and animal fats, do time restricted eating within a 10 hour window, eat steel cut oats and an apple every day and do a Prolon fast quarterly. I also started on 5mg of rosuvastatin every other day since January. I have not experienced any statin side affects such as fatigue, fogginess or muscle weakness, as in the past (10 years ago) with atorvastatin. I also have continued to work out 2 to 3 times a week following a pretty intense resistance regimen and walk at least 5 miles a day. I am pretty satisfied with my results thus far and will continue to monitor them.

My recent focus has been on improving the quality of my sleep. I obtained an Oura ring, read Matt Walker's book on "Why We Sleep" and just finished listening to Attia's 3 week podcast with him. (Rhonda Patrick also recently released a great interview with him). I have become convinced that sleep is critical, perhaps the most important and frankly most overlooked pillar of health, and have started to implement many of his recommendations.

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Re: Another negative lipid profile trend

Postby CarrieS » Wed Apr 17, 2019 5:27 pm

JimBG wrote:As an update I recently obtained lab results and have made considerable progress in my lipid profile:

--------------------------4/5/18 (Lab)------------3/19/19 (Lab)
TC------------------------261-----------------------163
HDL-----------------------55------------------------ 63
Tri------------------------126------------------------82
LDL-----------------------182------------------------87
TC/HDL-------------------4.7----------------------- 2.6
LDL P#-------------------1974-----------------------1177
A1C------------------------5.1------------------------5.3
CRP-----------------------0.49----------------------0.30

The improvement is due to a combination of lifestyle and low dose statin. I have tried to avoid as much as possible refined carbs and animal fats, do time restricted eating within a 10 hour window, eat steel cut oats and an apple every day and do a Prolon fast quarterly. I also started on 5mg of rosuvastatin every other day since January. I have not experienced any statin side affects such as fatigue, fogginess or muscle weakness, as in the past (10 years ago) with atorvastatin. I also have continued to work out 2 to 3 times a week following a pretty intense resistance regimen and walk at least 5 miles a day. I am pretty satisfied with my results thus far and will continue to monitor them.

My recent focus has been on improving the quality of my sleep. I obtained an Oura ring, read Matt Walker's book on "Why We Sleep" and just finished listening to Attia's 3 week podcast with him. (Rhonda Patrick also recently released a great interview with him). I have become convinced that sleep is critical, perhaps the most important and frankly most overlooked pillar of health, and have started to implement many of his recommendations.

Thank you for giving us an update on your progress Jim. You've worked hard and found the groove that works for you which is indeed satisfying! High Five! What do you like best about the Oura ring?
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JimBG
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Re: Another negative lipid profile trend

Postby JimBG » Wed Apr 17, 2019 5:58 pm

Thanks Carrie. The Oura ring provides motivation to take steps to improve my sleep quality. Although it may not be as accurate as a sleep lab in monitoring the stages of sleep, its pretty accurate in recording the timing and duration of sleep as well when I wake up at night and for how long. It also seems to be relatively accurate when I'm in a REM stage. Each morning I check my sleep score and review my average and minimum heart rate and other metrics. When I have exercised very heavily or am under stress it shows up very clearly in the metrics.

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CarrieS
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Re: Another negative lipid profile trend

Postby CarrieS » Wed Apr 17, 2019 9:19 pm

JimBG wrote:Thanks Carrie. The Oura ring provides motivation to take steps to improve my sleep quality. Although it may not be as accurate as a sleep lab in monitoring the stages of sleep, its pretty accurate in recording the timing and duration of sleep as well when I wake up at night and for how long. It also seems to be relatively accurate when I'm in a REM stage. Each morning I check my sleep score and review my average and minimum heart rate and other metrics. When I have exercised very heavily or am under stress it shows up very clearly in the metrics.

Sounds like a great device to have! I’ve heard really good things so I’m happy to hear that you are finding it useful too.
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Re: Another negative lipid profile trend

Postby MelodieGraber » Sat Apr 20, 2019 1:54 pm

Orangeblossom wrote:I eat a mediterranean style diet and also include grains and legumes, plenty of fruit and veg. using this Blood Sugar Diet as a resource https://thebloodsugardiet.com/the-low-carb-plan/

Hi Orangeblossom,

This diet looks interesting. I've been trying to follow the Keto diet for the last five months with not the greatest results. I am a long distance runner and my energy has taken a big hit although it has improved a bit once I started running before I ate anything. The other issue for me is that I've had two illnesses - one where a simple cold virus developed into pneumonia - just felt like my body had nothing to fight with. This is so highly unusual for me. I rarely get sick and when I do, it is a 1-3 day quick passing affair. I am concerned about the stress the Keto diet is placing on my body and looking for another option that could be more healthy for me. I'm thinking that I need to add some whole grains back into my diet. I have Hashimoto's hypothyroidism and not sure how much this is playing into the way I am responding to the low carb way of eating.


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