High cholesterol

[nilla]

Hi Dinoiii,
I have high cholesterol and it runs in the Fam,my father has already had a stent put in due to his.
I have so many questions i dont know where to start??

My #'s Have been in the upward of 300-350!
I tried statins and my #'s went down to around 150-200.
At the moment i have took myself of statins due to all the bad things i read about the damage they can cause,coq-10,muscle,and the aging factor,,,"so ive read"

Ive have read lots on the fact that cholesterol is not the real prob but "inflamation" is the real culperate.
I have spoke to my doc and asked him for a few test to check other things out like c-reactive protien,and some test to check the size of cells "not sure"??and a few others as directed by a member of the American Heart Accociation boards.

As of now ive been of statins for almost a year and have improved diet and added evo,plant sterols,fish oil,grape seed extract,and a ton of oats.
I will be getting these test i spoke of done here soon.

Lots goes through my head with this whole cholesterol prob i have..
I read statins are bad,then i read cholesterol is not that bad and is not the source of the problem.
I ponder who to believe BIG PHARMA or the DOC or people on line??
I dont know if i should take statins or if these test im having done will mean the difference between having high choleterol and living a full healthy life with it or if the results will mean im in need of lowering it by means of statins.
So confused!!

I mean,you read about people dieing from heart related desease and there numbers are under 150,,,so whats that mean?
Im not sure what to beleive,,,and i hate how doctors automaticly wanna shovel statins down your throat!

Anyway,,,id love to hear from you on any of my concern's that i have

Thanks for your time..................

[robert501]

After high school, I turned into a pig. I used to drink, eat, and smoke all day. My numbers were pretty high when I had blood work done. Then I started doing lots of cardio and my numbers dropped signifigantly. I dropped about 50 lbs.


I gave blood today. the girl said depending what you been eating in the last week will affect your numbers as well.

hope you steer in the right direction man good luck.

[dinoiii]

Well, I agree that if cholesterol issues tend to run in the family, you should certainly consider what's known as getting your particle size analysis done (NMR analysis is preferred, do NOT invest in a VAP test or others), which is what I believe was being referenced by the AHA board though I'd have to read it in context to be sure. Be careful, however, in that while it will analyze your LDL particle size most appropriately, the HDL particles won't really give you the best of clue as some are pro-atherogenic and others are anti-athrerogenic. This topic gets much more complex than most primary care physicians will lend - in LDL = bad; HDL = good and calling it a day.

hs-CRP is a test that has gained a lot of acclaim but there is a lot of difficulty in reading the numbers for physicians and a lot of difficulty will most likely exist with yours given the fact that you work out. In order to be able to interpret the test correctly, you would most likely need to omit working out for about 2 full weeks and get the test done twice 2 weeks apart. Most studied values on CRP is a challenge two as they don't even get the appropriate 2 values at that distance so they are virtually unreadable.

I would be more satisfied if you obtained the following values (dependent if your lab will either do them and/or send them out):

- Lp(a)
- Apo B
- Apo A1
- Homocysteine
- Complete Fasting Lipid Panel
- 25 (OH) Vit D
- Test Panel (incl. Free, Total, SHBG)
- Estradiol and Estrone

While there is a place for NMR analysis, I wouldn't jump the gun in your case without those baseline values. I am not privy to a lot of your information to offer much more, but I would need a complete history to make more deductions of worthwhile value.

Please let me know if you are able to discuss this with your physician and I will do as I have done in the past, open up the opportunity for your physician to call me directly if need be to explain why those tests mentioned above should begin your analysis.

D_

[nilla]

Thank you very much for offering your help and replying

I have a blood order here in front of me and have yet to get it drawn do to the fact that i wanted to make sure it covered everything.

He has put on here,,,"the VAP as you stated as well as Comp Metabolic Panel,C-reactive protien,and Homocystiene.

I will now be going back to him and bringing a copy of this thread to ask for what you have suggested to me.

I will then do as you said and not work out for 2 weeks exc,,exc..and get tested.
I take this very serious and would love to see someone "myself" do what is really needed rather then take the statins and call it a day.
Dont get me wrong,,im sure they have a place but,id like to know if this is true with me.
I take what you say with the upmost respect and will take your advice..

Would like to make this a great thread,i will be updating and posting my labs/blood results as we move further.

Thanks for your time and concern

[nilla]

Please let me know if there is anything that i can tell you to better help analize the situation.

[dinoiii]

Originally Posted by nilla

Thank you very much for offering your help and replying

I have a blood order here in front of me and have yet to get it drawn do to the fact that i wanted to make sure it covered everything.

He has put on here,,,"the VAP as you stated as well as Comp Metabolic Panel,C-reactive protien,and Homocystiene.

I will now be going back to him and bringing a copy of this thread to ask for what you have suggested to me.

I will then do as you said and not work out for 2 weeks exc,,exc..and get tested.
I take this very serious and would love to see someone "myself" do what is really needed rather then take the statins and call it a day.
Dont get me wrong,,im sure they have a place but,id like to know if this is true with me.
I take what you say with the upmost respect and will take your advice..

Would like to make this a great thread,i will be updating and posting my labs/blood results as we move further.

Thanks for your time and concern

The VAP test is oftentimes inconsistent which is why I usually suggest NMR. The question is - do you really need a particle size analysis at all? The answer to that, I am unsure.

The issue with CRP is that you need two values, 2 weeks apart and what is it you'd plan to do if it is high? Now, I could certainly assist your physician if he's interested in strategies to lower it. It is important to understand that CRP is more a clinical expression of TNF-alpha and IL-6 activity; you can lower them with vitamin D and subsequently lower the CRP. I would suggest you add a bare minimum of 25-hydroxy-Vitamin D and if you are deficient, you at least have a plan of how you would approach something should it come back high.

Let me ask you this. When is the last time you did any style hormonal cycles: i.e. - PHs, PSs, Designers? This will drastically alter your lipid profile. If you have not done anything recently cycle-wise, and you're still not getting the clinical offering you desire despite cessation as reflected in your labs, then you may have to employ something at least temporarily, like a statin (which would work on the CRP because statins do have an anti-inflammatory component), but Vitamin D might be a better option as suggested above. Now, you would get benefit by going for 3 months before re-checking it IF you find you are in either of the three categories that fall below:

25(OH) Vit D of 0-10 ng/ml: Vit D Deficient
25(OH) Vit D of 11-20ng/ml: Vit D Insufficient
25(OH) Vit D of 21-30ng/ml: Hypovitaminosis D

(now, some labs like to make it a little more challenging in remembering those numbers and use: 0-10, 11-25, and 26-30 respectively...but either way, you are best aided by overt supplementation.

In any event, I am opening a lipid clinic through the hospital I am at, and am usually very content on discussing the concepts with physicians who may not be very familiar with all the emergent concepts I have discussed throughout this thread due to the relative lack of national guidelines. Just let me know.

D_

[nilla]

I have not run a cycle in a few months (last was hdrol).

I see doc the 7th of August to talk to him about your aproach.
So,are you saying i should be taking a statin until i get this all figured out?
I have quite them thinking i needed to to find where im at without them and going from there.
I do have some "Simvastatin" here now.
Should i be on this till i see doc again?
Would being on them effect the test you mentioned any?
If not i kinda feel like a fool being off them so long.

Now i have the feeling ive caused dammage to myself that coulda been avoided..?

I just wanna do whats best for me,,if i need statins so be it but if there is another way "id like to know".
Is it right for doc to assume someone with high numbers should just be put on statins and end of story?
Is this just a "lazy" approach?
Am i over thinking the whole thing "or" is the way were talking the "proper" way of doing things in my case?

[dinoiii]

Originally Posted by nilla

I have not run a cycle in a few months (last was hdrol).

I see doc the 7th of August to talk to him about your aproach.
So,are you saying i should be taking a statin until i get this all figured out?

Well, I have no idea what your cholesterol levels were to begin except I think total approximation. I respect your physician's decision to employ a statin and must assume you have not met NCEP ATP III guidelines at present point on either LDL or TGs. Still, if you ran a cycle, even 3 months ago - you may have not undergone appropriate recovery and this could be a signal. See, there are a LOT of intrinsic measures to lipid regulation and testosterone (androgen/steroid molecule) levels and when you threw that out of whack, also went your own levels. Sometimes cessation of the offending agent is enough. In your case, you may very well have not seen full recovery - hence, why your lipid levels remain problematic. Again, it is very difficult to tell from a computer.

I have quite them thinking i needed to to find where im at without them and going from there. I do have some "Simvastatin" here now. Should i be on this till i see doc again? Would being on them effect the test you mentioned any?
If not i kinda feel like a fool being off them so long.

Again, I must punt as this is not an internet diagnostic system. Look, you must trust your physician to some level; assuming he has the pharmaceutical companies in his back pocket, et al... is not appropriate. But, if this is, in fact, the first time you have had inappropriate lipid levels, you are entitled an attempt at lifestyle modification before you embark on therapy.

Take advantage of this time: If you smoke...stop! If you drink...stop (although drinking in moderation may have some benefits; again, this tends to be of the increasing estrogen/decreasing testosterone variety, I am afraid and just assuming alcohol will be the best in assistance is VERY inappropriate). If you have abandoned exercise...start! If your diet still suffers in any capacity...bring it in line! If you are overweight...drop some! And so on...

Now i have the feeling ive caused dammage to myself that coulda been avoided..?

This is possible; but...the wrong-doing is if you were to avoid doing something about it now. I am not estimating from your responses that your plan is to just lie down and play dead - so as with any potential mistake in life, the ball is in your court. How will you deal with it?

I just wanna do whats best for me,,if i need statins so be it but if there is another way "id like to know". Is it right for doc to assume someone with high numbers should just be put on statins and end of story? Is this just a "lazy" approach? Am i over thinking the whole thing "or" is the way were talking the "proper" way of doing things in my case?

Again, as your doc must have trust in you; you must have trust in him/her. This is not necessarily "lazy" per se. Understand what doctors are up against - you are talking about most patients who harbor a measly 2% compliance rate with diet/exercise.

I ask you...should we send you away for 3 months with that low statistic and assume you will abide by exercise/diet recommendations? Should we let your vasculature take a hit in the interim? This is a very complex situation and if we are to honor any sort of Hippocratic Oath, would it be inappropriate for us to send you on your way and still consider ourselves as "doing no harm" first?

I am unsure that overall there is any way to settle on an answer to this question and say it is the end all, be all way. There are a number of ways you could approach this.


D_

[nilla]

I can tell you,,i did get tested before diet/exercise and #'s were 350-400!
Then i did diet/exercise and no change,,maybe went up a tad!
So,i think its safe to assume its hereditary.
With statins as said before went down to 150-200...

When exactly does working out have to cease prior to testing again?
And will taking the statins be a bad idea if im to get the labs to read well?

Just trying to get this all ready for another go.

[dinoiii]

Originally Posted by nilla

I can tell you,,i did get tested before diet/exercise and #'s were 350-400!
Then i did diet/exercise and no change,,maybe went up a tad!
So,i think its safe to assume its hereditary.
With statins as said before went down to 150-200...

When exactly does working out have to cease prior to testing again?
And will taking the statins be a bad idea if im to get the labs to read well?

Just trying to get this all ready for another go.

Again, by your numbers, I am assuming we are talking TOTAL cholesterol, not LDL Cholesterol. But still, is there any way you could post your entire lipid (cholesterol) panel? Total / LDL / HDL / VLDL / TG

When you use hormonal agents, this will throw this off. If you had not had it checked the last time and used anything, that would alter the final numbers.

Stopping working out about 48-72 hours prior to the test is SOLELY for your CRP measurement, not the lipid panel.

Taking statins is not a bad idea in some cases, but again, I do not know your numbers individually to the above 5 values I expressed.

Do you take niacin?

D_