Another negative lipid profile trend

[Stavia]

And do a search on the site for statins. We have discussed them extensively over the last few years.

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[JimBG]

Thanks Stavia. Very much appreciate your balanced perspective.

Am going through the threads on statins, calcium scoring and plaque reduction. Also reading Ivor Cummings book "Eat Rich Live Long" and watched "The Widowmaker". Lots to read and consider. After I feel comfortable that I'm up to date on the subject I'll have a consult with a cardiologist and take it from there. Perhaps stricter lifestyle and supplements for a period of time and/or low dose/intermittent statins. We'll see.

[KatieS]

Jim, after trying three statins and two different doses, I finally settled on the same statin (SV) and the same dose (lowest 10mg) as my 3/4 mother has tolerated for decades. Should you have any close relatives who are on statins, ask them their experiences. Higher doses or potency statins halved my HDL-P count, so I also recommend serial advanced lipids.

[JimBG]

Thanks Katie for your input. Agree in the need for serial advanced lipids. And as I understand it certain lipid ratios are more predictive of risk than absolute numbers, and overtime can help determine if one is making progress.

[JimBG]

As an update I saw a cardiologist today. I frankly felt more informed than him. Long story short as Stavia indicted the recommendation was a statin and aspirin. He felt that APOE status, lack of symptoms and some good biomarkers showing low inflammation and insulin receptivity does not change his recommendation in view of the 175 calcium score. It's all irrelevant. He said if I see 5 cardiologist they will all tell me the same thing. I'm pretty sure he is right. He agreed to order a baseline CIMT and a new NMR including LP(a) and redo it in 3 months to see if there is any changes. He felt that unless it was significantly better he would still want me on at least a low dose statin like Crestor.

[ru442]

JimBG,

Been there an done that (my score was 1263... but my stress tests were clear). I was on 20mg Crestor but stopped taking last fall when prescription ran out. I've since being seeing a Bredesen trained doc, and I've started a load of supplements in addition to detox for inflammation (possible mold issue) and pre/pro biotics for gut. She wants me to wait 3 months when retest is scheduled and we'll see where my numbers are... if good then no statin. Otherwise I'll get back on a low dose... it is what it is.

RU

[JimBG]

Thanks RU for your thoughts. I went through your story over the past 2 years and it looks like you have made some amazing progress. Congratulations! Hope all continues well when you get your updated numbers. Like you I am looking at my score as history with the objective of keeping it where it is or have only minimal growth. I am not aware of any Bredesen trained docs here on Long Island and so will try to "use" my cardiologist to get the tests I want to check my progress. So far he seems amenable to that. In the meantime I am trying to implement most of Bredesen's protocol and will get even more strict now to see if I can move my lipid profile.

[JimBG]

Got my labs done again and although some improvement, still a mixed bag:

---------------------4/5/18-------------- 6/5/18
Glucose---------------- 98------------------76
T Chol----------------- 261-----------------225
LDL--------------------182-----------------155
HDL-------------------- 55-----------------48
Trig --------------------120----------------109
T Chol/HDL------------ 4.7-----------------4.7
LDL/HDL-------------- 3.3----------------- 3.2
Trig/HDL-------------- 2.2----------------- 2.3
LDL Particles-----------1974----------------2101
Hem A1C---------------- 5.1----------------- 5.3
HS CRP ---------------- 0.49 ---------------0.30

Although all the lipids declined the ratios are still the basically same. Fasting glucose was a nice surprise and CRP improved. However my LDL particle count is high and increased.

I am struggling to get more clarity on whether to use statins to reduce the LDL and particle count, or to keep on a very strict diet (mild ketosis; 60% fat mostly EVOO, avos and nuts; no sugar, refined carbs, wheat or dairy; mostly fish and limited other animal protein) and a good exercise program, and see how much better I can do. In researching I found that Drs. Thomas Dayspring and Brian Edwards, both lipidologists, recommend using statins as well as Zetia to drive the particle number very low, which they feel should be the objective/goal of any CVD treatment. Edwards also uses Edur-acin, a sustained release niacin although I'm not sure what Dayspring view is since the FDA pulled niacin from their CVD treatment protocol. Most other cardiologists focus on driving LDL down to 70.

Any thoughts on the labs or treatment options are welcome from this knowledgeable group.

[NF52]

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!

[HeatherLst]

You doubled your testosterone, from borderline low(ish) to solidly in the "normal limits"?????? wow. I'll need to re-read your thread. But, any idea how/why this increased so much?

I understand having Italian relatives who can make extra challenges for this kind of diet. Makes to doubt the "Med diet" since it does not seem very "Italian" to avoid carbs or try too darn hard to maintain a healthy diet. I do admire their seemingly low stress levels, however! and wine....

Just to be clear, pasta and pizza are the Italian diet, not the Mediterranean diet. If you look at the blue zones and the longevity Mediterranean diets, their diets are very different from that. We also have to be savvy to differentiate the AHA-Americanized version of the Mediterranean diet, which often takes their agenda to shape what they want the diet to be.


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