Another Statin-Pushing Doctor

      215 Comments on Another Statin-Pushing Doctor

The Older Brother’s oldest son (a.k.a. my nephew Eric) recently annoyed his (morbidly obese) doctor by refusing to take statins after a lab test flagged his total cholesterol as “elevated.”

Some snippets from an email Eric sent me:

The nurse called last night while I was driving home and only gave me my triglycerides and cholesterol readings, followed by the doctor’s (5 feet tall and a good 275lbs) recommendation to take a statin.

After verifying that she heard me correctly that “I’m not going to take a statin” and then informing me that cholesterol can lead to heart disease and stroke, I again declined and told her I would talk further with the doctor, recommending your movie and a couple books.

I called this morning to have the full results faxed to me.  After getting that fax from the machine with my greasy, McMuffin-without-the-muffin fingers (didn’t have time to make eggs this morning or a protein shake), I plugged them into excel to share.

Eric is 26 years old and (like his younger brother the Ranger) a strong, muscular guy who’s in excellent shape.  Here are the cholesterol numbers that prompted the obese doctor to recommend a statin:

Total Cholesterol:   219
HDL: 61
Triglycerides:  55
LDL:  147

The LDL, of course, is a calculated figure.  For those of you who don’t already know, LDL is usually calculated using something called the Freidewald Equation, which looks like this:

LDL = Total cholesterol – (HDL + (Triglycerides/5))

As Dr. Mike Eades explained in one his posts, the Freidewald equation has been shown to over-estimate LDL levels in people whose triglycerides are low.  The Freidewald equation also “rewards” you for having higher triglycerides – not something you want — by producing a lower calculated LDL figure.   Let’s create a couple of fictional examples to demonstrate:

Patient One
Total Cholesterol: 200
HDL: 45
Triglycerides:  150
Calculated LDL:  125

Patient Two
Total Cholesterol: 200
HDL: 50
Triglycerides:  70
Calculated LDL:  136

The most useful indicator of heart-disease risk you can extrapolate from a lipid panel is the ratio of Triglycerides/HDL.  You want that ratio below 2.0, because a ratio below 2.0 is a pretty good indicator that you’re mostly producing large, fluffy LDL.  At 3.0 or above, it’s more likely you’re producing small, dense LDL.

Patient One’s ratio is 3.33 — not horrible, but certainly not what I’d consider good, either.  Patient Two’s ratio is 1.4 —  pretty darned good.  Patient Two clearly has a much better cholesterol profile.  But because Patient Two’s calculated LDL (which is likely overestimated anyway) is above the supposed magic number of 130, she’s the one who’ll get a lecture from her doctor along with a recommendation to go on a low-fat diet – which will probably reduce her HDL and raise her triglycerides.

Eric’s Triglycerides/HDL ratio is 0.90 … in other words, it’s outstanding.  Even if his LDL is really and truly elevated, it’s almost certainly mostly the large, fluffy LDL.  That type of LDL not only isn’t dangerous, it protects us against infections and cancer, at least according to Dr. Uffe Ravnskov’s reading of the data.

And yet a doctor wants this strong, active, sports-nut of a 26-year-old man to go on statins because his total cholesterol is 219 and his calculated LDL is 147.  If Eric did go on statins, the only beneficiaries would be

  • Pfizer
  • The pitchers on opposing softball teams who would no longer have to watch Eric belt their fastballs over the fences

It’s a sad situation when we have to ignore our doctors’ advice in order to stay healthy.

Share

215 thoughts on “Another Statin-Pushing Doctor

  1. Susan

    @Dana

    “The alternative is forcing a patient to take medication they don’t want to take.”

    Remember, just because the doc suggests it, or even prescribes it, that doesn’t mean you have to take it.

    My PCP has suggested I need statins in the past. Personally I think he’s crazy (I’m a 61-yr-old woman — right there, his argument is toast). My most recent lab work translated to a Trig/HDL ratio of 1.8. Could be better, but hey, I’ll take it for now.

    Besides, as Dr. Davis pointed out recently, losing weight can mess up your cholesterol results. That doesn’t mean you need medications. After all, is losing weight bad for your health??

    I usually just refuse the idea of statins. If the doctor continues to insist, I figure I can use a three-step process:
    1. refuse the prescription; if that fails,
    2. take the prescription and refuse to fill it; if that fails,
    3. fill the prescription (thank goodness for $4 generics!) and refuse to take them.

    I wouldn’t even bother with going to the doc, but he holds my thyroid prescription hostage if I don’t go at least once a year. I’m looking for a new doc, but I have a fear of trading the frying pan for the fire.

    Reply
  2. PG

    After a couple months of low-carbing, had a lipid panel done recently. The recent scores, compared to my lipid panel of about a year and a half earlier,
    Trigycerides: Down to 35 from 47
    LDL: Up to 149 from 129
    HDL: Up to 78 from 66
    Total cholesterol: Up to 239 from 201

    Of course there are flags against my TC and LDL as high..my doctor opined that we need to discuss my cholesterol levels, but thankfully she said that we do not need to go for medications “as of now” ;D

    As of never with those numbers.

    Reply
  3. Sabine

    There is a telling phrase in one of Dana’s posts: “Her doc was reasonable, and let her TRY to tackle it with diet first.” (Emphasis mine.)
    We need to remember that doctors are our medical advisers, not our masters.
    Granted, it would be great if they were up to date on the science. But we don’t need to take their advice if we know better. Let’s hope that someday, they all will know better, and work towards that end.
    Question everything, even yourself!

    Unfortunately, most people assume their doctors already know better.

    Reply
    1. Wendy

      Unfortunately, doctors seem to have trouble remembering that they are medical advisors, NOT our masters. I was dismissed from a medical group, without being given a reason. I feel it may be because I DID question their insistence of my undergoing excess tests, or taking statins. I am not a guinea pig, I’m a human being with concerns about blindly doing what I’m told.

      Reply
      1. The Older Brother

        I wouldn’t wait for a medical group that insisted on my taking a statin to dismiss me — I’d already be out the door looking for a new doctor. Fortunately, they’re getting somewhat easier to find.

        The Older Brother

        Reply
      2. Drew @ Cook Like Your Grandmot

        I’m ambivalent about this one. The advice to take statins is clearly wrong (most of the time). But when a doctor advises the current standard of care and a patient refuses to follow it, shouldn’t the doctor have the right to say, in essence, “If you are not willing to take care of yourself I can not be responsible for your health”?

        Reply
  4. Janknitz

    I think it would be good to send the doctor a copy of your blog post. He might learn something from it, although he might find the remarks about his own weight a little embarrassing.

    Eric is planning to hand the doctor a book or two.

    Reply
  5. Marilyn

    I’ve read Graveline’s books on statins. Now whenever I fly, I always hope the pilot doesn’t have a statin “moment” until he gets us safely back down on the ground. That’s what copilots are for, but he’s probably on a statin, too.

    I saw my dad have what I now believe were statin moments. Not something you’d want a pilot to have.

    Reply
  6. Midwest Housefrau

    Talked my husband into throwing out the statins a while ago. Between the very mainstream news articles on corrupt pharma practices and other articles of about their muscle dissolving side effects, he finally decided they weren’t necessary. Funny thing is our doctor is actually pretty informed and very respectful of our opinions. He gave hubby the statins for high cholesterol but outright told him he was better off cutting out the sugars than the butter bc its not dietary cholesterol that causes the problem. See, there is hope after all. Hubby is still too afraid to admit to the doctor he isn’t taking his medicine. Cracks me up. As a teenager he used to go over to Jaurez to drink and pick bar fights but he’s intimidated by the authority figure in a lab coat.

    So put on a lab coat and tell him to fess up to the doctor.

    Reply
  7. Peggy Cihocki

    @John King, and yet, I have a bunch of women friends who are on statins as per doctors’ orders and I can’t convince them (I’ve tried, believe me) that they shouldn’t be on them. They believe their doctors over me, of course.

    Reply
  8. Glynis

    NM whereabouts in the UK is this polish doctor, I am longing to find one who has a modicum of sense and isn’t horrified by high total cholesterol. Also, I discovered that all dotors in the UK get a little bonus for every patient they put on a statin – scary stuff.

    Reply
  9. Patricia

    @ Dave, RN site for calculating cholesterol. It gives so many mixed messages, no wonder doctors and people get confused about the information.

    Calculated total as HIGH RISK (oh, no! statin time?)
    LDL is BORDERLINE (better watch it!)
    HDL as OPTIMAL
    Won’t accept trigs any lower than 50 (mine are 45) IDEAL

    Your Total Cholesterol/HDL ratio is: 2.71 – (preferably under 5.0, ideally under 3.5) IDEAL
    Your HDL/LDL ratio is: 0.625 – (preferably over 0.3, ideally over 0.4) IDEAL
    Your triglycerides/HDL ratio is: 0.556 – (preferably under 4, ideally under 2) IDEAL

    So I have IDEAL ratios, but I’m at HIGH RISK according to Total Cholesterol. Unfortunately, many doctors won’t look past the total number and start handing out statins like candy.

    Reply
  10. Dorian

    Curious to know what my LDL number would be using the Iranian method:

    TC: 245
    HDL: 81
    TRI: 31
    LDL: 158 (CALC)

    My TRI/HDL is 0.38 which sounds good. And yes, the MD wants me on statins (but I won’t take them).

    Btw, I had heard that a heavy workout (1 hour cycling) before drawing blood can reduce the TRI count, so I did. I don’t know if the TRI is artificially low, but it looks good to me!

    Unless the exercise reduced your triglycerides by a whopping amount, I’d say you’re safe.

    Reply
  11. Sabine

    There is a telling phrase in one of Dana’s posts: “Her doc was reasonable, and let her TRY to tackle it with diet first.” (Emphasis mine.)
    We need to remember that doctors are our medical advisers, not our masters.
    Granted, it would be great if they were up to date on the science. But we don’t need to take their advice if we know better. Let’s hope that someday, they all will know better, and work towards that end.
    Question everything, even yourself!

    Unfortunately, most people assume their doctors already know better.

    Reply
    1. Wendy

      Unfortunately, doctors seem to have trouble remembering that they are medical advisors, NOT our masters. I was dismissed from a medical group, without being given a reason. I feel it may be because I DID question their insistence of my undergoing excess tests, or taking statins. I am not a guinea pig, I’m a human being with concerns about blindly doing what I’m told.

      Reply
      1. The Older Brother

        I wouldn’t wait for a medical group that insisted on my taking a statin to dismiss me — I’d already be out the door looking for a new doctor. Fortunately, they’re getting somewhat easier to find.

        The Older Brother

        Reply
      2. Drew @ Cook Like Your Grandmother

        I’m ambivalent about this one. The advice to take statins is clearly wrong (most of the time). But when a doctor advises the current standard of care and a patient refuses to follow it, shouldn’t the doctor have the right to say, in essence, “If you are not willing to take care of yourself I can not be responsible for your health”?

        Reply
        1. The Older Brother

          I’m okay with that. Unfortunately, the average doctor seems oblivious that the “current standard of care” is defined by the drug manufacturers. That’s the beauty of what’s left of the free market — each party has the option of refusing to do business with each other. Where it’s going to get ugly is as Obamacare rules start dictating that doctors must certify that they’re treating to the standard of care in order to get reimbursement. So if I say I’m not going to take a statin with 220 cholesterol and my doctor acquiesces, she won’t get paid.

          The Older Brother

          Reply
  12. Janknitz

    I think it would be good to send the doctor a copy of your blog post. He might learn something from it, although he might find the remarks about his own weight a little embarrassing.

    Eric is planning to hand the doctor a book or two.

    Reply
  13. Marilyn

    I’ve read Graveline’s books on statins. Now whenever I fly, I always hope the pilot doesn’t have a statin “moment” until he gets us safely back down on the ground. That’s what copilots are for, but he’s probably on a statin, too.

    I saw my dad have what I now believe were statin moments. Not something you’d want a pilot to have.

    Reply
  14. Peggy Cihocki

    @John King, and yet, I have a bunch of women friends who are on statins as per doctors’ orders and I can’t convince them (I’ve tried, believe me) that they shouldn’t be on them. They believe their doctors over me, of course.

    Reply
  15. FormerTNGuy

    Had a friend (and unfortunately now me) that have a statin pushing Dr. He gave him a whole stack of studies showing how carbs are bad and fat is good and that the Cholesterol testing they do isn’t the whole story. The Dr. never read a 1 of them. My friend then asked his Dr. where he gets his information from and the Dr produced a whole stack of Rx info pamphlets.

    My current labs are
    TC 218
    HDL 46
    TRI 72
    LDL 156
    (also i am 6’2″ and now weight 208)

    Not bad but not great (1.5). They have been improving a lot since i have gone LCHF. Before this my HDL was never over 40 and my TRI where way high (last check they where 180). Dr wants me on statins but i say no since my numbers are improving and i feel i am on the right track now.

    Thanks for getting me on that track.

    Fat raises HDL, so your HDL may go up now that you’re on a LCHF diet.

    Reply
  16. Glynis

    NM whereabouts in the UK is this polish doctor, I am longing to find one who has a modicum of sense and isn’t horrified by high total cholesterol. Also, I discovered that all dotors in the UK get a little bonus for every patient they put on a statin – scary stuff.

    Reply
  17. Patricia

    @ Dave, RN site for calculating cholesterol. It gives so many mixed messages, no wonder doctors and people get confused about the information.

    Calculated total as HIGH RISK (oh, no! statin time?)
    LDL is BORDERLINE (better watch it!)
    HDL as OPTIMAL
    Won’t accept trigs any lower than 50 (mine are 45) IDEAL

    Your Total Cholesterol/HDL ratio is: 2.71 – (preferably under 5.0, ideally under 3.5) IDEAL
    Your HDL/LDL ratio is: 0.625 – (preferably over 0.3, ideally over 0.4) IDEAL
    Your triglycerides/HDL ratio is: 0.556 – (preferably under 4, ideally under 2) IDEAL

    So I have IDEAL ratios, but I’m at HIGH RISK according to Total Cholesterol. Unfortunately, many doctors won’t look past the total number and start handing out statins like candy.

    Reply
  18. FormerTNGuy

    Had a friend (and unfortunately now me) that have a statin pushing Dr. He gave him a whole stack of studies showing how carbs are bad and fat is good and that the Cholesterol testing they do isn’t the whole story. The Dr. never read a 1 of them. My friend then asked his Dr. where he gets his information from and the Dr produced a whole stack of Rx info pamphlets.

    My current labs are
    TC 218
    HDL 46
    TRI 72
    LDL 156
    (also i am 6’2″ and now weight 208)

    Not bad but not great (1.5). They have been improving a lot since i have gone LCHF. Before this my HDL was never over 40 and my TRI where way high (last check they where 180). Dr wants me on statins but i say no since my numbers are improving and i feel i am on the right track now.

    Thanks for getting me on that track.

    Fat raises HDL, so your HDL may go up now that you’re on a LCHF diet.

    Reply
  19. Adi

    Good thing to know. Last week my doc didn’t want to give me blood test because my last one was on may and she said it’s too close. My last test was Tc 196.6 tri 96 hdl 39 LDL 138.9. Been doing the lc for that past month and feeling great, still I stopped eating gluten two years ago. Hope to improve the cholesterol and not get scared with the doc advice. The doc says that I’m borderline all the time so they almost gave med for the cholesterol.

    Tnx
    Adi

    My guess is that your HDL would be higher now than you’re on a low-carb diet.

    Reply
  20. Adi

    Good thing to know. Last week my doc didn’t want to give me blood test because my last one was on may and she said it’s too close. My last test was Tc 196.6 tri 96 hdl 39 LDL 138.9. Been doing the lc for that past month and feeling great, still I stopped eating gluten two years ago. Hope to improve the cholesterol and not get scared with the doc advice. The doc says that I’m borderline all the time so they almost gave med for the cholesterol.

    Tnx
    Adi

    My guess is that your HDL would be higher now than you’re on a low-carb diet.

    Reply
  21. darMA

    My previous doctor (now deceased) was late in getting on the statin bandwagon years ago but after he did he tried several different ones on me, all with a different side effect. The last straw was one that had me so constipated I told him I would end up cholesterol free but full of !@#$!@. I told him “no more statins!” and he started the standard “experts say”.speech. I interrupted him and said “doc, you can quote me all the experts in the world but in this case, my body is the expert and it’s saying stop giving me this crap!” He thought a minute, said okay, and never brought them up again.

    By the way, I’m wondering if the pharm companies are starting to see a downturn in people accepting the statins because yesterday I was reading where several pharm companies have gotten together and are saying blood pressure of 120/80 is “pre-hypertension” which needs to be treated with drugs. Gotta get everybody on some kind of drug, I guess.

    Statins aren’t going out of use (unfortunately) but the patents are expiring. So yes, they’ll be looking for more ways to drug us up.

    Reply
  22. Roby

    Wow… i just turned 26 a couple of months ago. I didn’t know people my age where starting to take statins. That’s crazy!

    I don’t have insurance so I only go to the doctor when I really need to. Its more of a blessing in disguise if it means staying away from doctors who will just try to give me pills.

    No wheat/gluten, no sugar, no processed oils = good affordable health insurance

    It’s worse than that … some doctors want to give statins to kids.

    Reply
    1. Wendy

      Which is stupid. Kids NEED cholesterol for their development. Don’t these medical people know that LOW cholesterol can also be dangerous?

      Reply
  23. Brooke

    I’m curious to know if there are ANY instances when statins should be taken.

    They appear to provide a minor benefit for men under 65 with existing heart disease. However, I believe the same benefits could be derived through a change in diet, without the nasty side effects.

    Reply
  24. darMA

    My previous doctor (now deceased) was late in getting on the statin bandwagon years ago but after he did he tried several different ones on me, all with a different side effect. The last straw was one that had me so constipated I told him I would end up cholesterol free but full of !@#$!@. I told him “no more statins!” and he started the standard “experts say”.speech. I interrupted him and said “doc, you can quote me all the experts in the world but in this case, my body is the expert and it’s saying stop giving me this crap!” He thought a minute, said okay, and never brought them up again.

    By the way, I’m wondering if the pharm companies are starting to see a downturn in people accepting the statins because yesterday I was reading where several pharm companies have gotten together and are saying blood pressure of 120/80 is “pre-hypertension” which needs to be treated with drugs. Gotta get everybody on some kind of drug, I guess.

    Statins aren’t going out of use (unfortunately) but the patents are expiring. So yes, they’ll be looking for more ways to drug us up.

    Reply
  25. Roby

    Wow… i just turned 26 a couple of months ago. I didn’t know people my age where starting to take statins. That’s crazy!

    I don’t have insurance so I only go to the doctor when I really need to. Its more of a blessing in disguise if it means staying away from doctors who will just try to give me pills.

    No wheat/gluten, no sugar, no processed oils = good affordable health insurance

    It’s worse than that … some doctors want to give statins to kids.

    Reply
    1. Wendy

      Which is stupid. Kids NEED cholesterol for their development. Don’t these medical people know that LOW cholesterol can also be dangerous?

      Reply
  26. Brooke

    I’m curious to know if there are ANY instances when statins should be taken.

    They appear to provide a minor benefit for men under 65 with existing heart disease. However, I believe the same benefits could be derived through a change in diet, without the nasty side effects.

    Reply
  27. Robinowitz

    This is very interesting, since 2 days ago I got almost the exact same lipid results from my NP.

    Total: 220
    HDL: 61
    Triglycerides: 62
    Calculated LDL: 147

    (My specs: I’m 31, lift weights and dance and am very close to my ideal weight.)

    I was quite pleased with the results, but the new NP at my Doc’s office who called me was a bit concerned about the total and the LDL, which didn’t surprise me. They’ve told me they don’t check the LDL particle size because they don’t see the validity in it. Go figure.

    At least she didn’t recommend statins, or I’d be shopping for a new doctor’s office right now. I just think it’s so sad that we really do have to just ignore these doctors and nurses who only diagnose things one way and never think outside the box about health.

    They don’t see the validity of particle size?!!

    Reply
  28. Robinowitz

    Yes. Both my husband and I asked to have the particle size tested but it seems they consider that kind of ‘extra’ test to be unnecessary and not useful. I wasn’t pleased that they wouldn’t even order the test when I asked especially for it…so I guess I need to find a lab here in town that would test it for me. It’s unfortunate that my health insurance probably wouldn’t cover tests like this if the doctors in our system don’t even think particle size means a thing. Guess I’ll have to pay out of pocket for it, IF I can even get a lab test without my doctor’s consent. Needless to say, I’m not pleased with the new Nurse Practitioner at my clinic– when i requested particle size testing she looked at me like I was nuts! I bet they hate it when patients presume to tell them what tests to do, but since they work for me I’d say it’s my right to have any tests I choose.

    All the more reason for me to avoid doctors.

    Frankly, I think educated patients annoy them.

    Reply
  29. Stacie

    Prior to 2005, statins showed a feeble benefit for men under age 65 with heart disease. By feeble I mean reducing your risk of dying over a 5.5 year period by about two percent. You can get similar results from taking an aspirin, and better results from fish oil.
    Since 2005, when the FDA instituted stricter guidelines for clinical trials, all statin trials (primary and secondary prevention) were failures. Amazingly (NOT!!), after these guidelines were instituted, pharmaceutical companies continued to be deceitful regarding some trials. They did not release the results from ENHANCE for two years. (patients in drug use fared worse). Also, we must remember that statin trials are run, paid for, interpreted, etc. by the drug companies. So, there is huge conflict of interest and bias. Dr. Michel de Lorgeril (cardiologist and researcher) has really challenged the Lipid Hypothesis and the use of statins for anyone.

    Bingo. Since the standards were tightened, they haven’t been shown to help.

    Reply
  30. Robinowitz

    This is very interesting, since 2 days ago I got almost the exact same lipid results from my NP.

    Total: 220
    HDL: 61
    Triglycerides: 62
    Calculated LDL: 147

    (My specs: I’m 31, lift weights and dance and am very close to my ideal weight.)

    I was quite pleased with the results, but the new NP at my Doc’s office who called me was a bit concerned about the total and the LDL, which didn’t surprise me. They’ve told me they don’t check the LDL particle size because they don’t see the validity in it. Go figure.

    At least she didn’t recommend statins, or I’d be shopping for a new doctor’s office right now. I just think it’s so sad that we really do have to just ignore these doctors and nurses who only diagnose things one way and never think outside the box about health.

    They don’t see the validity of particle size?!!

    Reply
  31. Robinowitz

    Yes. Both my husband and I asked to have the particle size tested but it seems they consider that kind of ‘extra’ test to be unnecessary and not useful. I wasn’t pleased that they wouldn’t even order the test when I asked especially for it…so I guess I need to find a lab here in town that would test it for me. It’s unfortunate that my health insurance probably wouldn’t cover tests like this if the doctors in our system don’t even think particle size means a thing. Guess I’ll have to pay out of pocket for it, IF I can even get a lab test without my doctor’s consent. Needless to say, I’m not pleased with the new Nurse Practitioner at my clinic– when i requested particle size testing she looked at me like I was nuts! I bet they hate it when patients presume to tell them what tests to do, but since they work for me I’d say it’s my right to have any tests I choose.

    All the more reason for me to avoid doctors.

    Frankly, I think educated patients annoy them.

    Reply
  32. Stacie

    Prior to 2005, statins showed a feeble benefit for men under age 65 with heart disease. By feeble I mean reducing your risk of dying over a 5.5 year period by about two percent. You can get similar results from taking an aspirin, and better results from fish oil.
    Since 2005, when the FDA instituted stricter guidelines for clinical trials, all statin trials (primary and secondary prevention) were failures. Amazingly (NOT!!), after these guidelines were instituted, pharmaceutical companies continued to be deceitful regarding some trials. They did not release the results from ENHANCE for two years. (patients in drug use fared worse). Also, we must remember that statin trials are run, paid for, interpreted, etc. by the drug companies. So, there is huge conflict of interest and bias. Dr. Michel de Lorgeril (cardiologist and researcher) has really challenged the Lipid Hypothesis and the use of statins for anyone.

    Bingo. Since the standards were tightened, they haven’t been shown to help.

    Reply
  33. Pieter

    In January 2008 when eating a “normal” diet (lots of bread, soda, vegetable oils, pizza … well everything basically :-p), my total cholesterol was around 150 (LDL around 90 I think, HDL 40+, Tri 65, FBG around 89).
    Everybody happy.

    In January 2010 while still eating bread (with some butter), some eggs, less sugar, less vegetable oils, my total cholesterol was around 190 (don’t know what my LDL was, HDL 60+, Tri 45, FBG again around 89).
    Everybody happy.

    I changed my diet in August 2010: No more bread, pasta, pizza, soda, vegetable oils. Yes, I ate more eggs, more butter, but nothing really extreme. I still eat fruit, potatoes, white rice, so I’m not really low carb, I have just cut out the trans fats, wheat, fructose, linoleic acid, …

    In March 2011 I had my blood values checked for the first time since I changed my diet:
    Total 252, LDL 150, HDL 94, Tri 36, FBG 89. The risk factor that is mentioned on the lab test stayed the same (2.7).

    This is the first time my doctor mentioned my cholesterol being on the high side. He was a little worried: “… especially since it is mainly the bad LDL that went up”.

    I have not tried to explain why I think these values are ok. In the end, he’s the doctor, I have just read some books/blogs. I just told him I ate less sugar and more fat.

    I’m curious though what will happen next year if my cholesterol is still this high. A suggestion for statins? We’ll see.

    In 2009 I asked about particle size and count, but my cholesterol was fine so “it was not necessary”. I forgot to ask this at my last checkup. I will try this again if I receive a prescription for some statin.

    Or maybe I have to go back to eating all that crap again …

    Don’t go back to the crap. Your HDL is now screamin’ high and your triglycerides are way down. If you’re producing lots of large, fluffy LDL, that’s good for you.

    Reply
  34. Pieter

    In January 2008 when eating a “normal” diet (lots of bread, soda, vegetable oils, pizza … well everything basically :-p), my total cholesterol was around 150 (LDL around 90 I think, HDL 40+, Tri 65, FBG around 89).
    Everybody happy.

    In January 2010 while still eating bread (with some butter), some eggs, less sugar, less vegetable oils, my total cholesterol was around 190 (don’t know what my LDL was, HDL 60+, Tri 45, FBG again around 89).
    Everybody happy.

    I changed my diet in August 2010: No more bread, pasta, pizza, soda, vegetable oils. Yes, I ate more eggs, more butter, but nothing really extreme. I still eat fruit, potatoes, white rice, so I’m not really low carb, I have just cut out the trans fats, wheat, fructose, linoleic acid, …

    In March 2011 I had my blood values checked for the first time since I changed my diet:
    Total 252, LDL 150, HDL 94, Tri 36, FBG 89. The risk factor that is mentioned on the lab test stayed the same (2.7).

    This is the first time my doctor mentioned my cholesterol being on the high side. He was a little worried: “… especially since it is mainly the bad LDL that went up”.

    I have not tried to explain why I think these values are ok. In the end, he’s the doctor, I have just read some books/blogs. I just told him I ate less sugar and more fat.

    I’m curious though what will happen next year if my cholesterol is still this high. A suggestion for statins? We’ll see.

    In 2009 I asked about particle size and count, but my cholesterol was fine so “it was not necessary”. I forgot to ask this at my last checkup. I will try this again if I receive a prescription for some statin.

    Or maybe I have to go back to eating all that crap again …

    Don’t go back to the crap. Your HDL is now screamin’ high and your triglycerides are way down. If you’re producing lots of large, fluffy LDL, that’s good for you.

    Reply
  35. John King

    where did the total cholesterol 200 level come from anyway? I can’t find anything in the reading anywhere.

    The National Cholesterol Education Program people plucked that one out of thin air back in the 1980s. I think they chose that number because the average cholesterol was 220 at the time. So they created millions of instant customers for their paymasters at Pfizer, Merck, etc.

    Reply
  36. Walter B

    You said about statins, “They appear to provide a minor benefit for men under 65 with existing heart disease. However, I believe the same benefits could be derived through a change in diet, without the nasty side effects.”

    The benefit IIUC is limited to a small reduction in heart problems without a decline in deaths. After adjusting for so called side effects, I evaluate the benefit as negative.

    Perhaps the reduction of cholesterol by statins is a side effect.

    Any small benefit they provide is likely due to reducing inflammation.

    Reply
  37. Phyllis Mueller

    As I understand it, calculated LDL is the “industry standard” for blood lipid measurement. There also may be a follow-the-money aspect as more sophisticated equipment (and perhaps higher skilled workers) may be needed for particle size or direct measurement lab work. That would mean investing in better equipment and/or personnel or sending blood samples to an outside lab.

    I remember my husband’s (former) cardiologist explaining this in a conversation about being tested for CRP and homocysteine (tests his in-house lab did not do).

    Sure, the extra time and expense of a direct LDL measurement (with particle size) no doubt figures into it. I’m sure the pharmaceutical reps aren’t pushing for those either, since a lot of people with “high” cholesterol might end up deciding they don’t need statins.

    Reply
  38. Jason

    It’s not that most doctors/NPs don’t see the validity of particle size. It’s just that they don’t know what to DO with the numbers.

    My doctor is warming up to my repeated attempts to get him to read Good Calories/Bad Calories. A good friend had given him the book a few weeks before I scoffed at his recommendation to take statins and showed him the book. I had asked for an NMR, and his comment when telling me I should take statins was “well, I asked the rep when they were pushing the NMR: ‘what do we do differently, based on these numbers’ and the rep couldn’t tell me.”

    I told him that _I_ knew what to do: eat more fat, fewer to no carbohydrates, test and correct blood vitamin d3 levels, and take fish oil twice a day–which I’ve been doing for only about three months before the NMR.

    He nodded and said that we should redo the test in a few months and see if I’m right. I hope my numbers improve because I’ve almost got a convert.

    Glad he’s being open-minded about it.

    Reply
  39. John King

    where did the total cholesterol 200 level come from anyway? I can’t find anything in the reading anywhere.

    The National Cholesterol Education Program people plucked that one out of thin air back in the 1980s. I think they chose that number because the average cholesterol was 220 at the time. So they created millions of instant customers for their paymasters at Pfizer, Merck, etc.

    Reply

Leave a Reply

Your email address will not be published.