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LDL Cholesterol is 430

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Richard - 02 Dec 2008 00:04 GMT
My LDL Cholesterol is 430 and I'm 61 years old. My doctor is mailing me meds
for it. She said to lower my carobs. She didn't say anything about weight,
celeries, fats, etc. So I really don't want to die and I'm a good candate
for a heart attack or a stroke. I got the info tonight and I'm even afraid
to eat. So I guess I should change my diet big time like eat fresh fruits
and veggies for a month and nothing else. I don't think much of doctors when
it comes to things like this but I do know I can't go to taco bell or eat
Sundays anymore. No bread, pasta, rice, or potatoes. Any advice would be
appreciated.

Richard
Susan - 02 Dec 2008 00:21 GMT
> My LDL Cholesterol is 430 and I'm 61 years old. My doctor is mailing me
> meds
[quoted text clipped - 9 lines]
>
> Richard

The author of this web site www.phlaunt.com/diabetes lost her father at
age 95 of non heart disease causes.  He'd had a lifetime of LDL of over
300.  My mother died of other causes with high LDL and not a speck of
plaque on her arteries.

It's not the LDL number that matters, it's the size of the particles;
large, bouyant ones are non atherogenic, small dense ones do oxidative
damage.  More important, what is your HDL and what are your
triglycerides?  High HDL/TGL ratio under 3, and ideally, under 1.5 or so
is highly indicative of non atherogenic LDL.

It's all about ratios and particle sizes, not numbers; that's just a
story drug sellers like to tell.

Your doctor is right about cutting carbs, though; they're what raise
TGLs, which are very predictive of CVD if they're high.

Susan
Walter - 06 Dec 2008 01:46 GMT
> x-no-archive: yes
>
[quoted text clipped - 30 lines]
>
> Susan

Susan,

Here are my numbers:

LDL 258
HDL 54
TGL 74
CRP = .26

No statins, much to my doctors (and the drug companies) chagrin. :-)

I think that pretty much puts me at a low risk for CVD if I understand
correctly?

-Walter
Susan - 12 Dec 2008 19:26 GMT
> Susan,
>
[quoted text clipped - 9 lines]
> I think that pretty much puts me at a low risk for CVD if I understand
> correctly?

YES!  TGLs are the most predictive and yours are very low.  An HDL/TGL
ratio below three is good, and yours is 1.37!

That suggests your LDL is the large, bouyant, non atherogenic stuff.
See if you can get a direct measurement of your LDL and VLDL particles.

Susan
Walter - 15 Dec 2008 03:41 GMT
> x-no-archive: yes
>
[quoted text clipped - 19 lines]
>
> Susan

Thanks Susan.
How do I do that? I get tests from a private lab sometimes, but don't see
particle size testing as an option or a component of cholesterol testing.
Susan - 15 Dec 2008 03:49 GMT
> Thanks Susan.
> How do I do that? I get tests from a private lab sometimes, but don't see
> particle size testing as an option or a component of cholesterol testing.

I think the med labs call it a VAP, IIRC.  Just ask your doc to write
VLDL and LDL particle size and the lab will know how to code it.

Susan
Pramesh Rutaji - 15 Dec 2008 15:30 GMT
> x-no-archive: yes
>
[quoted text clipped - 7 lines]
>
> Susan

VAP is for particle size.  Does direct count of LDL particle size, HDL
subfractions, VLDL subfractions, IDL, LP(a) and a few other things.
   
The NMR LIPO Profile is for particle count.  The smaller your LDL
particles, the higher your particle count, and the worse the predictive
outcome cardiovascular wise.  The larger your LDL particle size, the
lower your LDL particle count, and the better the outcomes.

Both tests to some degree provide similar information but the VAP has
more details of other cholesterol types.

One can order both with a doctor here:

https://www.directlabs.com/Default.aspx?TabId=55

Or better yet if you can get your doctor to order.  Four years go I
couldn't get a cardiologist to order a VAP after a heart attack.  They
were clueless about a NMR LIPO Profile.

Signature

Pramesh Rutaji

p297tongue6221@newsguy.com - remove tongue to reply

Pramesh Rutaji - 15 Dec 2008 15:33 GMT
> x-no-archive: yes
>
[quoted text clipped - 7 lines]
>
> Susan

Treating thyroid and adrenals can often lower cholesterol and trigs and
lower LDL particle size, even when TSH is within the normal range (under
2.0).  The TSH is unreliable since cellular resistance to T3 (sometimes
because of higher rT3) is undetected by TSH, T3, Free T3, T4, or free T4
tests.  Thyroid hormones, in my opinion, should always be dosed by
patient symptoms, not blood work.

Signature

Pramesh Rutaji

p297tongue6221@newsguy.com - remove tongue to reply

Susan - 15 Dec 2008 15:38 GMT
> Treating thyroid and adrenals can often lower cholesterol and trigs and
> lower LDL particle size, even when TSH is within the normal range (under
> 2.0).  The TSH is unreliable since cellular resistance to T3 (sometimes
> because of higher rT3) is undetected by TSH, T3, Free T3, T4, or free T4
> tests.  Thyroid hormones, in my opinion, should always be dosed by
> patient symptoms, not blood work.

Treating wihtout a complete HPA axis evaluation using serology and
imaging would be irresponsible, though.

I don't believe any hormonal defect should be treated until the
underlying mechanism is detected.  Pitiuitary and adrenal abnormalities
are highly variable and complex.  It's never just one hormone that's a
problem, the feedback loop is complete and all are related.

Susan
Walter - 18 Dec 2008 03:35 GMT
> x-no-archive: yes
>
[quoted text clipped - 15 lines]
>
> Susan

Thank you for the info Susan and Pramesh. I will see if I can get my GP
to order the tests. They are a little pricey for private pay.
Pramesh Rutaji - 18 Dec 2008 17:53 GMT
> x-no-archive: yes
>
[quoted text clipped - 7 lines]
> Treating wihtout a complete HPA axis evaluation using serology and
> imaging would be irresponsible, though.

Except most endos won't do it.  They'll check TSH and if it is normal or
almost in range, they won't proceed and from reports of patients that
asked for additional tests, they have been ridiculed.  Thyroid
resistance is not generally recognized as a real problem while at least,
insulin resistance is getting some notice, not a lot.

> I don't believe any hormonal defect should be treated until the
> underlying mechanism is detected.  Pitiuitary and adrenal abnormalities
> are highly variable and complex.  It's never just one hormone that's a
> problem, the feedback loop is complete and all are related.
>
> Susan

Which explains why endos are practically useless. They only assert
simple solutions (for them) and then get you the hell out of their
office.  Asking questions and trying to get to the root of your problems
are likely to get you dropped as a patient.

Signature

Pramesh Rutaji

p297tongue6221@newsguy.com - remove tongue to reply

Susan - 18 Dec 2008 21:39 GMT
> Except most endos won't do it.  They'll check TSH and if it is normal or
> almost in range, they won't proceed and from reports of patients that
> asked for additional tests, they have been ridiculed.  Thyroid
> resistance is not generally recognized as a real problem while at least,
> insulin resistance is getting some notice, not a lot.

All you do when you treat one problem without diagnosing all hormones is
refer the problem back to the feedback loop, which will keep passing the
problem along.

> Which explains why endos are practically useless. They only assert
> simple solutions (for them) and then get you the hell out of their
> office.  Asking questions and trying to get to the root of your problems
> are likely to get you dropped as a patient.

That describes all doctors, mostly, but endos are especially
frustrating, since the HPA axis drives the whole body and its functions.

I had to fly across the country from metro NY to find a smart, complex
thinking, thorough endo.

Susan
Doug Freyburger - 18 Dec 2008 22:17 GMT
> All you do when you treat one problem without diagnosing all hormones is
> refer the problem back to the feedback loop, which will keep passing the
> problem along.

Yet I've been on synthetic for thyroid since the 1980s and it
seems to work.  My doc at the time took one glance at me,
saw that I had a gray color and lkow energy, prescribed the
tests, started me on the pills, no more gray color or low
energy.

It does make me wonder if the problem might be otherwise
and masked by these simple and effective pills.  How much
effort would it be to have a full panel work-over and see if the
real problem is elsewhere?
Susan - 18 Dec 2008 23:41 GMT
> Yet I've been on synthetic for thyroid since the 1980s and it
> seems to work.  My doc at the time took one glance at me,
[quoted text clipped - 6 lines]
> effort would it be to have a full panel work-over and see if the
> real problem is elsewhere?

It's so much effort and frustration that you may as well give up unless
something goes awry.

Really.  If I had to fly from metro NY to find a competent endo...

Susan
Doug Freyburger - 19 Dec 2008 15:58 GMT
> > Yet I've been on synthetic for thyroid since the 1980s and it
> > seems to work.  My doc at the time took one glance at me,
[quoted text clipped - 9 lines]
> It's so much effort and frustration that you may as well give up unless
> something goes awry.

Ah.  It seemed to work well and simply in my case.  So I'll
stick with it.

> Really.  If I had to fly from metro NY to find a competent endo...

Thanks for the advice.  Good stuff from someone who knows the
topic better than the majority of MD internists out there ...
Susan - 19 Dec 2008 16:37 GMT
>>> Yet I've been on synthetic for thyroid since the 1980s and it
>>> seems to work.  My doc at the time took one glance at me,
[quoted text clipped - 15 lines]
> Thanks for the advice.  Good stuff from someone who knows the
> topic better than the majority of MD internists out there ...

I'd feel better about the compliment if it weren't so.  It scares the
bejeebies out of me to know just how ignorant and untrustworthy doctors
really are, since I may one day be unable to do my own research and
thereby avoid their mistakes.

One recco I have for you is the book "The Everything Guide to Thyroid
Disease by Theodore C. Friedman, M.D., PhD.

Susan
Doug Freyburger - 02 Dec 2008 14:20 GMT
> My LDL Cholesterol is 430 and I'm 61 years old. My doctor is mailing me meds
> for it. She said to lower my carobs. She didn't say anything about weight,
[quoted text clipped - 5 lines]
> Sundays anymore. No bread, pasta, rice, or potatoes. Any advice would be
> appreciated.

Just to start there's no problem doing the simple stuff on your own -
Drop
the starchy or sweet foods.  Go with plenty of veggies.  But don't go
to
the extreme of only veggies - You'll be hungry constantly and that
will
slowly sap your dedication.

Pick a popular low carb plan.  Buy and read the book.  Follow the
directions
for that plan as written including the parts you don't understand or
agree
with - The authors spent a decade or more figuring out non-obvious
stuff or
working out non-obvious actions that work better than the obvious.  It
is
*very* easy to think that since low carb is good, lower carb must be
better
and zero carb must be best.  It's obvious once you decide that low
carb is
good.  The trouble is it's a false notion.  Obvious does not equal
true.  And
sure enough no matter which plan and book you chose it will put you
through
a sequence that does not take you lower and lower in carbs.

My bias - I prefer Atkins.  The late good Dr A might or might not ever
have
understood the science behind how his process works, but his process
works very well indeed.  But don't fall into the trap of glancing at
the book
and doing your own thing.  Actually follow the instructions.  It is
fully
customized to you based on the reactions of your own body to specific
ingredients, specific gylemic loads, specific daily carb counts.  I
prefer a
fully customized process for a simple reason - "one size fits all"
doesn't
so I prefer a plan that isn't one-size.  Fully customized is more
work.

If you would rather use a "one size fits all" plan because it's
simpler you
may want to chose one of the books by Drs Eades with "Protein Power"
in their titles.  The later books in their series are updated so they
tend
to be better than the original title that just just "Protein Power".

Doctor Atkins told two tales of how he got into the low carb business.
One was about using it on himself to lose his weight and keep it off.
The other was about noticing that prescribing low fat to his heart
patients had poor adherence and the few who managed to stay on it
tended to do worse more than 6 months in.  I think both tales are
true - It's generally better to have multiple reasons for doing
something.

Anyways there's a lesson in what happens with the numbers - On
low fat they tend to drop soon then after 6 months end up worse than
when you started.  Trying low carb in his 2002 edition he claimed that
"most" see better numbers after 2 month.  In his 1993/1999 editions
he claimed that about 80% see better numbers after 6 months.  In
both editions he points out that most see worse numbers in the first
month or so.  He suggests getting tested before starting, then either
2 or 6 months later depending on the edition.  This pattern is likely
to happen if you chose some other plan so expect it.

On Susan's response - She knows her stuff on cholesterol, blood
sugar and so on.  She's also biased against Atkins.
Susan - 02 Dec 2008 15:12 GMT
> On Susan's response - She knows her stuff on cholesterol, blood
> sugar and so on.  She's also biased against Atkins.

I'm not biased against Atkins' eating plan, I'm a critic of his lousy
writings and unsupported assertions and constant self referencing in
place of good scientific citations.  And I loathed his marketing of
frankenfoods when he was alive.

The only popular diet plan authors I've ever read who are consistently
accurate wrt to the available metabolic science and who publish their
bibliography are the Eades, authors of the Protein Power books.

Susan
Becca - 02 Dec 2008 16:28 GMT
> I'm not biased against Atkins' eating plan, I'm a critic of his lousy
> writings and unsupported assertions and constant self referencing in
[quoted text clipped - 6 lines]
>
> Susan

One of these days, I will read Eades books.  One of my favorites, is a
book by Dr. Diana Schwarzbein, called The Schwarzbein Principle.  She is
an endocrinologist. Amazon has used copies that sell for 9 cents.

Becca
Roger Zoul - 07 Dec 2008 19:50 GMT
"Susan" <susan@nothanks.org> wrote >

> I'm not biased against Atkins' eating plan, I'm a critic of his lousy
> writings and unsupported assertions and constant self referencing in place
> of good scientific citations.  And I loathed his marketing of frankenfoods
> when he was alive.

And who cannot agree with this?

(I'm not looking for an answer!)
jay - 02 Dec 2008 21:12 GMT
> My LDL Cholesterol is 430 ...
> Any advice would be appreciated.

My cholesterol on a normal diet:
In 2003, total 447, LDL 350, HDL 79, TG 92, BG 75.
In 2008, total 400, HDL > 99, TG < 50, BG 75.

On a high-fiber (beans & psyllium), low or no-fat, low or no-meat diet
with simply prepared veggies and limited fruits, total chol drops
below 180. Possibly you have been exposed to dioxin. Check for
chloracne as show in figure 2A at www.ehponline.org/members/2001/109p865-869geusau/geusau-full.html
. Also see related pubmed abstracts below:

Mechanism of action of dioxin-type chemicals, pesticides, and other
xenobiotics affecting nutritional indexes.
The most consistent toxic effects of dioxin-type chemicals are
hyperlipidemia, body weight loss (particularly body fat loss),
anorexia, changes in carbohydrate metabolism, and lipid peroxidation.
The biochemical systems particularly affected are lipoprotein lipases,
low-density-lipoprotein receptors, glucose transporter proteins
(GLUTs), vitamin C uptake, and insulin secretion. Some of these
biochemical changes occur at very low doses, and some effects can last
for long time periods. To provide a mechanistic explanation for such
actions of dioxins, available experimental evidence has been reviewed.
The most recent discovery indicates that 2,3,7,8-tetrachlorodibenzo-p-
dioxin (TCDD) directly acts with isolated cytosolic aryl-hydrocarbon
(Ah) receptor under cell-free conditions even without the presence of
the nucleus and is capable of activating key protein kinases that are
involved in the growth factor signal-transduction pathway. The
resulting activation of primary-response transcription factors in the
nucleus appears to play a key role in coordinating vital cell program
shifts, including lipid metabolism. PMID: 7879740

TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin) causes reduction in the low
density lipoprotein (LDL) receptor activities in the hepatic plasma
membrane of the guinea pig and rat.
Administration of 1 micrograms/kg (single intraperitoneal injection
and studied after 10 days) of 2,3,7,8-tetrachlorodibenzo-p-dioxin
(TCDD) to young male guinea pigs was found to cause a significant
reduction in binding of low-density lipoprotein (LDL) to its receptor
on the hepatic plasma membrane. This reduction in LDL binding is not
caused by the decrease of food intake by treated animals since pair-
fed control animals had significantly higher LDL binding than treated
animals. It was also found that primary hepatocytes from treated
animals had a reduced ability to internalize LDL than controls. Such a
change in the plasma membrane function may explain the resulting
hyperlipidemia particularly hypercholesterolemia which occurs in this
species as a result of TCDD administration. PMID: 6322751

Rabbit serum hypertriglyceridemia after administration of 2,3,7,8-
tetrachlorodibenzo-p-dioxin (TCDD).
TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin) caused a dose-dependent
decrease of adipose tissue lipoprotein lipase (LPL) activity and
caused a concomitant increase in serum triglyceride concentration in
the rabbit 10 d after single ip administration of either 1 or 50
micrograms/kg. Hepatic low-density lipoprotein (LDL) binding was
markedly depressed and serum cholesterol concentrations were modestly
increased relative to pair-fed control animals. Serum glucose
concentrations were significantly lower in the rabbit administered
TCDD compared to ad libitum or pair-fed control animals, although
little change was observed in serum insulin concentration. Electron
microscopic examination of aortic arches 20 d after a single ip
administration of 50 micrograms TCDD/kg revealed ruffling, denudation,
and sloughing off of the cell surface and the appearance of macrophage-
like structures in the intima and media of the endothelial cells.
These alterations resemble preatherosclerotic lesions typical in
animals with hyperlipidemia. It is proposed that TCDD causes
hyperlipidemia in the rabbit through suppression of LPL activity and
LDL receptor binding. PMID: 3199460
mikesmith9999@hotmail.com - 15 Dec 2008 06:26 GMT
Richard, you've on Lorazepam for 5 years. Why do you do that to
yourself? What problems do you have that you can't face without pills?
Don't you know that doctors are drug pushers? Sometimes the pills will
make you feel better, sometimes worse. One thing's for sure: They'll
make you go back to the doctor for as long as you take them. Stop the
dependance. It's time people realize what is being upon them. Wake up
or you'll never fully live life, Richard.
 
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