Hello everyone,
I'm new to these boards :)
I had a heart attack at 40 on Nov-17-01
I'm a vegan No milk, Eggs or meat, I have tryed to cut out all caffeine, I take about 32 pills daily most are vitamins and fish oil & red rice yest, 6 are pills the doc say's I will have to take for the rest of my life.
I use flaxseed meal in my cereal everyday. And my cholesterol is still to high
Total 217 again. I honestly don't know what more to do.......If anyone has anything they know to help, I will give it a try,,,,,,,,,:(
Happy Holidays everyone ~*

Welcome to the boards.

You say the doctor has you on six pills. Are any of those cholesterol-lowering medications?

Yes Lipitor 20mg.....

So what's wrong with 217. I'm at 222 and pleased. At one time it was much higher. I remember when 239 and below was the guideline. It was dropped to 200 for obvious reasons. We have been taught that we must achieve a goal of 200. This number has now become and obsession and is fixed in our brain. You didn't mention LDL, HDL, Trig and Ratio.

217 does sound good to me. I'm at 223 and I'm happy with it. I've tried a variety of cholesterol pills with different doses and what I'm taking now is the only thing that doesn't cause me back pain. I'm not trying anything else because I did try something new for 3 days and my back was in pain for a month.

SternFan,

Don't take red yeast rice if you are taking Lipitor...both are statin drugs and the more is definitely NOT the merrier.
What kinds of TC numbers were yoou getting before the Lipitor? Usually that amount of Lipitor will drop TC 100 or more points???

Hello everyone,
I'm new to these boards :) Welcome.

I had a heart attack at 40 on Nov-17-01Sorry to hear about that. What was your diet and physical condition like back then? Have you made any significant changes since?

I'm a vegan No milk, Eggs or meat, I have tryed to cut out all caffeine, I take about 32 pills daily most are vitamins and fish oil & red rice yest,...No offense, but how can you be a vegan and take fish oil? Just curious. Are you attempting a vegan diet for ethical or health reasons?

And my cholesterol is still to high Total 217 again. 217 is a perfectly normal cholesterol level. 217 mg/dl is not high cholesterol unless your HDL levels are low. With a total cholesterol of 217, as long as your HDL is > 55 (TC/HDL ratio <4.0) then you are fine. What is your HDL, LDL, and Triglyceride levels?

I honestly don't know what more to do.......If anyone has anything they know to help, I will give it a try,,,,,,,,,How much sugar (both natural and processed) and starch do you eat? Excess quantities of these can raise your insulin levels which can elevate the amount of cholesterol that your liver produces. You might try cutting back on the sugar and starch and eating more high fiber vegetables, legumes, nuts, and natural fats. Try to eat as much unprocessed food as possible since these often have added sugars, refined carbohydrates, and chemical additives. Also, exercise including weight training can improve your lipid profile by lowering insulin levels among other things.

After having a heart attack, They want my cholesterol at or below 150.....And the vegan part is due to my health not because I wana to be a vegan, It's just easier to say I'm vegan then running down the list of what I dont eat.....I also do eat Solmon on the advise of my cardioligest ok! When I had the heart attack I was going to the gym 5 days a week for 2 hours a day, and I have never eatin much red meat my whole life. I was in the best health I have ever been in when I had the heart attack. I quit smoking almost 2 years before the heart attack
So you see 217 is not good for anyone especially me or anyone who has had a heart attack
Total= 217
HDL= 42
LDL= 147
Risk ratio = 5.2
Everything I have learned is your cholesterol needs to be under 200
I had mine down to 150, I guess I will have to go back to taking 8 fish oil caps a day instead of 4 a day thats what got it down before. I just get so much heart burn with them. :)

Ref: Quote from a 25 page booklet written (1988) by Jacobus Rinse, PhD on improving circulation and preventing heart disease. "It should be remembered that low cholesterol levels double the risk of death from cancer, especially in men. This was based on a 10 year study of the medical history of 5,125 men and 7.363 women between the ages of 25 to 74. One of the startling conclusions by the researchers is that the risk of cancer increases the longer the low cholesterol levels are maintained." This conclusion was reported in the August 8, 1987 issue of Lancet, and recapped in a Bulletin from the National Cancer Institute. Comment: When this booklet was written 239 was considered fine for cholesterol and eventually it was lowered to 200. It's not indicated in the booklet what low is but again the range was up to 239 back when the study was taken. Draw your own conclusions. I plan to focus on cholesterol/hdl ratio which should be 4.0 or below for males.

After having a heart attack, They want my cholesterol at or below 150.....And the vegan part is due to my health not because I wana to be a vegan, It's just easier to say I'm vegan then running down the list of what I dont eat.....I also do eat Solmon on the advise of my cardioligest ok! When I had the heart attack I was going to the gym 5 days a week for 2 hours a day, and I have never eatin much red meat my whole life. I was in the best health I have ever been in when I had the heart attack. I quit smoking almost 2 years before the heart attack
So you see 217 is not good for anyone especially me or anyone who has had a heart attack
Total= 217
HDL= 42
LDL= 147
Risk ratio = 5.2
Everything I have learned is your cholesterol needs to be under 200
I had mine down to 150, I guess I will have to go back to taking 8 fish oil caps a day instead of 4 a day thats what got it down before. I just get so much heart burn with them. :)

It sounds like you are trying to follow a near vegetarian diet, not vegan (pronounced Vee Gan). Vegans are generally very strict and abstain from all animal products (even leather shoes and belts), usually for moral reasons more so than health concerns.

How many years did you smoke before you quit? Even though you quit 2 years prior to the heart attack, I wouldn't discount the damage done to your arteries by smoking.

A total cholesterol of <150 is too low in my opinion and places you at increased risk of mortality from other causes such as cancer previously mentioned. Like I said previously, your total cholesterol of 217 isn't that high and just a few years ago would have been considered normal (160-240 being normal). Your HDL (good cholesterol) is on the low side of normal, especially given your total cholesterol. Has your HDL always been 42 or was it lower in the past? Your risk ratio of 5.2 is your total cholesterol (217) divided by your HDL (42). The recommended risk ratio is <4.0. To get there, you can do one of two things, either lower your total cholesterol or raise your HDL. The problem with attempting to lower your total cholesterol, especially if you are trying to do it following a low-fat, high-carbohydrate diet is that your HDL will generally fall right along with the total cholesterol if you get any results at all such that your risk ratio rarely improves at all (often times it gets worse).

If the fat levels in your diet are too low then you risk futher lowering of your HDL. Although, there is one kind of fat that you really need to avoid, that being trans fatty acids found in partially hydrogenated vegetable oils. Trans fats tend to raise LDL while lowering HDL levels which can signficantly raise your heart disease risk. Partially hydrogenated vegetable oils are found in margarine, shortening, and almost all processed foods and snacks (just read the labels).

Fish oil is a good thing to take due to the Omega 3 essential fatty acids and the lack of these in most diets. If you get heartburn and/or fishy burps from the capsules, I suggest you try a different brand and I generally avoid the capsules. I have found that Carlson's Lemon Flavored Cod Liver oil is very easy to take (I even kinda like the taste) and gives me none of the fishy burps like the capsules did. It is also a high quality product that is high in EPA and DHA (the usable forms of Omega 3). The recommended dosage is 1000 mg to 3000 mg of EPA + DHA. With the Carlson's, this is 1 teaspoon to 1 tablespoon per day (I generally take 1 tablespoon and my HDL is 73).

Niacin therapy has been shown to improve HDL levels, so that would be worth considering.

SternFan,

I repeat, what kind of total cholesterol numbers were you getting BEFORE the Lipitor, and/or, heart attack.
Perhaps 40 mg. is necessary. Perhaps stay at 20 and add ezetimibe.

I agree with your cardiologists who want your numbers VERY low considering your proven heart disease. Your total cholesterol looks even worse when paired with a low HDL.

Sorry about not answering your question,
Anyway I have high cholesterol now for about 10 years

SternFan...


WHAT numbers did you get in cholesterol readings BEFORE you started taking a statin drug?

I'm tryingl

SternFan...


WHAT numbers did you get in cholesterol readings BEFORE you started taking a statin drug?

I'm tryingl
It's been so long ......But I think it was around 255 .... The statin's do not help me very much

It sounds like you are trying to follow a near vegetarian diet, not vegan (pronounced Vee Gan). Vegans are generally very strict and abstain from all animal products (even leather shoes and belts), usually for moral reasons more so than health concerns.

How many years did you smoke before you quit? Even though you quit 2 years prior to the heart attack, I wouldn't discount the damage done to your arteries by smoking.

A total cholesterol of <150 is too low in my opinion and places you at increased risk of mortality from other causes such as cancer previously mentioned. Like I said previously, your total cholesterol of 217 isn't that high and just a few years ago would have been considered normal (160-240 being normal). Your HDL (good cholesterol) is on the low side of normal, especially given your total cholesterol. Has your HDL always been 42 or was it lower in the past? Your risk ratio of 5.2 is your total cholesterol (217) divided by your HDL (42). The recommended risk ratio is <4.0. To get there, you can do one of two things, either lower your total cholesterol or raise your HDL. The problem with attempting to lower your total cholesterol, especially if you are trying to do it following a low-fat, high-carbohydrate diet is that your HDL will generally fall right along with the total cholesterol if you get any results at all such that your risk ratio rarely improves at all (often times it gets worse).

If the fat levels in your diet are too low then you risk futher lowering of your HDL. Although, there is one kind of fat that you really need to avoid, that being trans fatty acids found in partially hydrogenated vegetable oils. Trans fats tend to raise LDL while lowering HDL levels which can signficantly raise your heart disease risk. Partially hydrogenated vegetable oils are found in margarine, shortening, and almost all processed foods and snacks (just read the labels).

Fish oil is a good thing to take due to the Omega 3 essential fatty acids and the lack of these in most diets. If you get heartburn and/or fishy burps from the capsules, I suggest you try a different brand and I generally avoid the capsules. I have found that Carlson's Lemon Flavored Cod Liver oil is very easy to take (I even kinda like the taste) and gives me none of the fishy burps like the capsules did. It is also a high quality product that is high in EPA and DHA (the usable forms of Omega 3). The recommended dosage is 1000 mg to 3000 mg of EPA + DHA. With the Carlson's, this is 1 teaspoon to 1 tablespoon per day (I generally take 1 tablespoon and my HDL is 73).

Niacin therapy has been shown to improve HDL levels, so that would be worth considering.

I think I'm more like a vegan because I do not eat meat, cheese, eggs, milk, No dairy products. Vegatarian do. So thats why I say, I'm more like a vegan, But I'm not here to debate whether or not I'm a vegan or vegetarian.
I'm starting to think this place is not so friendly :eek:

STernFan,

I am AMAZED that the only response you are getting with 20 mg. Lipitor is a lowering from 255 to 217. It's almost unheard of to get such a poor response. Are you taking it every evening without fail?

Try 40 mg. and see if you can get what you need.

Put it to your doctor exactly that way and see if he has any ideas. Perhaps a switch to Vytorin or Crestor will give you better control.

STernFan,

I am AMAZED that the only response you are getting with 20 mg. Lipitor is a lowering from 255 to 217. It's almost unheard of to get such a poor response. Are you taking it every evening without fail?

Try 40 mg. and see if you can get what you need.

Put it to your doctor exactly that way and see if he has any ideas. Perhaps a switch to Vytorin or Crestor will give you better control.

You see this is what I've been talking about!
I have never missed a pill. I take it everynight before I go to sleep.
I also take garlic, niacin, Flaxseed meal, folic acid, all the B vitamins, multi with minerals, C, coq10, and of course the RES-Q 1250.....I will talk to my doctor.
Thank's for your help Lenin :)

SternFan,

First let me start off by saying F-Jacky..

Then let me say I feel your pain. As many know on these boards know I am an athlete and have been eating healthy for years, It scares me to death to hear that you were in the gym that consistant and had a heart attack anyway. I have a very important question here for you; Were you taking any ephedra or performance enhancing drugs over the counter or otherwise? Also I have high cholesterol and high bp all hereditary and have been told if I did not do all the healthy things I do it would be worse.

I have tried so many other alternatives rather than the drug company meds before finally giving in to them. As for the vitamins and supplements you are taking wow that is alot to be taking of anything. You sound alot like I was a few years ago. I was taking niacin, omega3 fatty acids and eating wild salmon not farm raised and I was taking C0q10 and flaxseed. Well my blood work came back liver enzymes were up and my cholesterol was high.

They sent me to an upper GI man and he told me to get a ct scan i did and it came back "fatty liver". I thought I'd die asking what the heck else is going to happen to me? I do everything right and now this. I went back to him with the results and he said get off the fatty acids and the niacin both were known to be bad for the liver. I did go off and went back for my bloodwork and it has been fine ever since. I also stopped the coq10.

I spoke with my husband who has a degree in nutrition and he has been a natural body-builder for years. He had been lecturing me for years not to take those things he said get your vitamins from the foods you eat because the vitamins and the supplements do not assimilate in your system as the foods do. Many of them go through your liver where you breakdown your fat in your body. Well this thought occurred to me that if my liver is working to breakdown all the supplements including the fatty acids and it is doing what it does to breakdown the foods I eat then how the heck can it give it's full attention to my cholesterol breakdown? Sorry if I sound like I am rambling but I hope you see my point here. I wish you all the best and hope you find your answer..Lisa :wave:

I spoke with my husband who has a degree in nutrition and he has been a natural body-builder for years. He had been lecturing me for years not to take those things he said get your vitamins from the foods you eat because the vitamins and the supplements do not assimilate in your system as the foods do. Many of them go through your liver where you breakdown your fat in your body. Well this thought occurred to me that if my liver is working to breakdown all the supplements including the fatty acids and it is doing what it does to breakdown the foods I eat then how the heck can it give it's full attention to my cholesterol breakdown? Sorry if I sound like I am rambling but I hope you see my point here. I wish you all the best and hope you find your answer..Lisa :wave:[/QUOTE]

Cool! are you a Stern fan?
To answer your question "Were you taking any ephedra or performance enhancing drugs" No! I was not, Also.. I had stopped taking any statins because I thought I was doing good on my own, But I guess that was not a good idea, thinking back.
I thank you for your input and I do get your point, But I think as long as my liver is doing it's job, I will continue to take whatever I think is gonna help me at least for now.
Take care Lisa
Lady~*

Yes Sternfan here..take care, Lisa

If you have active liver disease you are usually not a candidate for statin therapy. Taking vitamin/mineral supplements is not usually harmful at normal dosages. If you are taking mega amounts of fat soluble vitamins that can be harmful over a period of time.

Taking a fish oil supplement is not going to harm you except to cause some minor gastric distress if you over do it. If you have active gall bladder disease or an inability to process fats then you might be wise to avoid fish oil supplements. In any case eating fat or taking a fish oil supplement doesn't cause a "fatty" liver or liver disease.

I went back to him with the results and he said get off the fatty acids and the niacin both were known to be bad for the liver. I did go off and went back for my bloodwork and it has been fine ever since.

I don't know what dosage of niacin you were taking, but at the higher dosages, it functions as a drug. And just like going on a statin, one needs to exercise appropriate precautions. The recommendations I've read are that one should have a baseline liver function test before you start niacin therapy, to make sure you are a candidate for such therapy. Then have a repeat liver function test within say, 3 months, and again approx 3 months after increasing dosage, and thereafter the doctor may increase time between tests, depending on results.

I don't want to discourage anyone from niacin therapy. I am personally getting good results with virtually no change in liver function, no side effects, and at a fraction of the cost of a statin. But I do want to emphasize that at the higher dosages, it is a drug and needs to be respected as such.

. . . I also take garlic, niacin, Flaxseed meal, folic acid, all the B vitamins, multi with minerals, C, coq10, and of course the RES-Q 1250.....I will talk to my doctor. . .

What dosage of niacin are you taking, SternFan? And what form of niacin?

I take a flush free niacin cap at 200mg a day

Oatmeal works great for me I was 215 until I started having oatmeal for breakfast every day, and i only eat oatmeal cookies. I used fish oil and garlic cap also, but oatmeal worked best. Of course you may not get the high numbers from your diet. Your liver may be doing this to you.
More important what is your breakout. You are 217, but how much LDL and HDL?

I take a flush free niacin cap at 200mg a day

A therapeutic dose of niacin is 1000-2000 mg a day. A flush free niacin may not be the most effective therapy in any case. A better choice is Niaspan but that requires a prescription.

Oatmeal works great for me I was 215 until I started having oatmeal for breakfast every day, and i only eat oatmeal cookies. I used fish oil and garlic cap also, but oatmeal worked best. Of course you may not get the high numbers from your diet. Your liver may be doing this to you.
More important what is your breakout. You are 217, but how much LDL and HDL?
I posted all my numbers on page 2.

A therapeutic dose of niacin is 1000-2000 mg a day. A flush free niacin may not be the most effective therapy in any case. A better choice is Niaspan but that requires a prescription.
I find if I take to much niacin or niacin that is not flush free,
I feel like my skin is burning ofF of my body and I get very red..... it's aweful!!

There has been less research on the cholesterol-lowering effects of flush free niacin (Inositol hexanicotinate) than on the nicotinic acid form of niacin, so I'm not really sure how they compare. Nicotinic acid comes in both an immediate release form and a sustained release form. The flush is much reduced in the sustained release form. (I've had none at all after the first few days.) However, be aware that it is also more toxic than the immediate release form on a mg. for mg. basis, though a lower amount may be needed to achieve the same result.

Recommendations I've read to decrease the flush:
1. Start with a small dose daily, like 100 mg. regular or 250 mg. sustained release, and build up gradually over a period of weeks.
2. Take an aspirin 30 minutes before taking the niacin.
3. Take the niacin with meals.
4. Divide the dosage, so that each dose is taken with food.

Though the normal therapeutic dose of even the sustained release form is 1000-2000 mg., sometimes results can be obtained with less than this. I'm currently taking 750 mg. Endur-acin, taking 250 mg. with each meal. (I started with just 250 mg. daily for several weeks before increasing.) My TC decreased from 247 before starting any niacin therapy to 190 with my last test, my LDL from 158 to 101, trigs from 133 to 87, and my HDL increased from 62 to 72. Though most of my dietary changes were made before I started niacin therapy, I've made further changes since I started, so a part of those changes in numbers could be due to diet, though I suspect the major change was due to the niacin.

Though the sustained release niacin I'm taking is available without prescription, anyone considering taking it even in the amounts I'm taking should really have a liver enzyme test first and then regular liver enzyme tests while on it. I've been on it over a year and have had almost no change in my liver enzymes, but that might not be the case for everyone!

OOOP'S SORRY

But did you take the sustained release form with a meal? And start with no more than 250 mg.? I know what you mean because I once years ago took the regular niacin and I thought I was going to burn up.

It was a regular cap of 500 mg. Not a time release

I had stopped taking any statins because I thought I was doing good on my own, But I guess that was not a good idea, thinking back.
I missed this statement earlier. So when did you quit taking your Lipitor? Before that last blood test? If so, how long before the blood test? And did you have previous blood tests while on Lipitor that showed you were getting better results? Are you back on Lipitor now? Or is your goal to get your cholesterol down without a statin?

A therapeutic dose of niacin is 1000-2000 mg a day. A flush free niacin may not be the most effective therapy in any case. A better choice is Niaspan but that requires a prescription.

I find if I take to much niacin or niacin that is not flush free,
I feel like my skin is burning ofF of my body and I get very red..... it's aweful!!

Niaspan is less prone to flushing and if you do experience them they should diminish over time. If you have health/prescription insurance because Niaspan is a prescription drug your insurance should pay for it and the follow up cholesterol/lipid and liver enzyme blood tests. That may be a consideration for you.

I missed this statement earlier. So when did you quit taking your Lipitor? Before that last blood test? If so, how long before the blood test? And did you have previous blood tests while on Lipitor that showed you were getting better results? Are you back on Lipitor now? Or is your goal to get your cholesterol down without a statin?
When I stoped taking lipitor>>>>>I was talking about when I had a heart attack Nov-17-01.....Since my heart attack I have been taking a statin and I'm sure I will for the rest of my life.
I have gotten some results from statins not very much

It is hard to say what your doctor will want to do. Perhaps he will want to change the statin. Perhaps he will want to add niacin to the statin. Perhaps he'll want you to give Niaspan a try. But if you are taking any niacin in addition to other medication, be sure to let your doctor know.

It looks to me that 500 mg. Niaspan is the lowest dosage available, so it might not be possible to start lower and build up. I strongly suspect that even that amount will give one a major flush, even though it may not be as bad as an immediate release niacin. In addition, I see that it is recommended that it be taken at bedtime. I recall someone else on these boards saying that after taking niacin the first time at bedtime, he woke up with such flushes he thought it was spontaneous human combustion! I don't know what dosage he was taking.

I agree with ZippyDawg that it might be better to go with Niaspan than an OTC product if you have prescription insurance coverage or if cost is not an issue, should niacin therapy be in your future. If cost is a major issue, however, you might look into the Endur-acin. There were clinical trials on the product at both Harvard and the U of Minnesota, showing good tolerance (only 4% drop-out rate due to side effects). To me, getting the cholesterol-lowering results at less than one-tenth the cost is a big thing, since I'm on a limited income with no insurance. But if you are thinking of going that route, too, take copies of some of the research results, etc. off the website with you when you see the doctor. Doctors have a habit of getting nervous about OTC niacin products, as there have been some problems in the past. If you went that route, I'd start with 250 mg. daily with a meal for a week or two before increasing, to minimize flushing.

Oh, some other things you can do to get your cholesterol down in the meantime. The oatmeal suggestion Ed_Hoffman offered back on page 5 was good. Oat bran is about 50% better. I'm not an oatmeal person, but I make oat bran biscuits and muffins and use those instead of toast, bread, or crackers. Any soluble fiber helps to escort cholesterol out of the blood. In addition to oat products, legumes and certain fruits are high in soluble fiber. You can probably find a chart of foods high in soluble fiber to help. There have been various studies which have shown people being able to lower their blood cholesterol 7-12% through eating relatively large amounts of specific foods high in soluble fiber.

If you can stomach it, drink three glasses per day of water in which you've dissolved a teaspoon of Metamucil. The psylliam it contains has enough soluble fiber to lower blood cholesterol substantially. I can't find the figures right now, but recall that it was somewhere in the 7-10% range, according to one study.

...Any soluble fiber helps to escort cholesterol out of the blood...I don't think soluble fiber can directly affect cholesterol in the bloodstream since it can't be digested and can't cross from the intestines into the bloodstream. My understanding is that what is claimed of soluble fiber is that it binds with some of the cholesterol in the digestive tract and helps eliminate it out of the digestive tract so that it can't be carried into the bloodstream. But I don't think this will help the original poster lower his cholesterol via the mechanism discussed above since he claims that he is eating virtually no animal products, so he is eating virtually no cholesterol and therefore has none to bind with the fiber. His slightly elevated cholesterol level is most likely the result of cholesterol production in the liver.

Where fiber can help him is if he eats it in whole foods by replacing lower-fiber sugary and starchy carbohydrates with higher-fiber whole foods which will result in a lowering of his bloodsugar levels and hence a lowering of his insulin levels. Since insulin has a direct effect on cholesterol production in the liver (it stimulates, for lack of a better word, the same enzyme that statins try to block), lowering his insulin level would likely result in a lowering of his blood cholesterol level.

Very good points, arkie! Thank you for that correction.