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sblair
09-02-2003, 09:59 PM
I was wondering, I know my LDL is a little high but is my HDL O.K.? Can anyone tell me if my HDL is high enough to help the LDL not be so bad. Why is the HDL/TC so important?

Total 197
LDL 116
HDL 62
Tri 95
HDL/TC 3.2

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ARIZONA73
09-02-2003, 11:25 PM
Your HDL is quite favorable. The LDL/HDL ratio should be 2.5 or less. Yours is 1.87, which is very good. In fact, all of your numbers look great. HDL is the good cholesterol, and that is why it is expressed as a ratio against TC, LDL, and triglycerides. HDL is protective because it is believed to prevent the formation of plaque in the arteries, and even to help remove existing plaque. All in all, your numbers place you at low risk.

cutup
09-04-2003, 03:03 PM
Originally posted by sblair:
I was wondering, I know my LDL is a little high but is my HDL O.K.? Can anyone tell me if my HDL is high enough to help the LDL not be so bad. Why is the HDL/TC so important?

Total 197
LDL 116
HDL 62
Tri 95
HDL/TC 3.2

Your HDL is excellent. As for the LDL, my cardiologist recommended it to be below 100 and if there has already been a cardiac episode they want it in the 70 range.
I've been hearing that a low HDL combined with a high triglyceride level is a risk. That is what happened in my situation.

ARIZONA73
09-04-2003, 11:05 PM
I don't think that everyone needs to keep their LDL under 100. That is an overkill as far as I'm concerned. It's just another excuse to prescribe statins and make more money.

cutup
09-05-2003, 11:12 AM
Originally posted by ARIZONA73:
I don't think that everyone needs to keep their LDL under 100. That is an overkill as far as I'm concerned. It's just another excuse to prescribe statins and make more money.


According to my cardiologist who specializes in heart disease in women the newest recommendations are LDL below 100 for every woman. My last reading was LDL 83 and I take 40 mg Zocor with no problems. My LDL had been 125. Cholesterol 153 down from 183, HDL 43 up from 33, can't remember trigs right off hand but they were excellent. They were 183 when I had my cardiac episode. I don't believe she told me that to make more money. I was a 41 yr old woman with few risk factors when this all began and I believe she was trying to give me the best chance at life.



------------------
Doctors comments on patient charts:

"The patient refused an autopsy."

"Patient has chest pain if she lies on her left side for over a year."

ARIZONA73
09-05-2003, 12:36 PM
Cutup,

Yes, but your situation is different than Sblair's. You had a very low HDL, and your LDL/HDL ratio was 3.79. If you were unable to increase your HDL so that the ratio was below 2.5, then the next step would be to lower the LDL. So now your LDL/HDL ratio is more satisfactory at 1.93. In Sblair's case, there is no reason at all to further lower the LDL, since the HDL is high enough to yield a favorable ratio of 1.87. To further hammer away at the LDL would be overkill and unnecessary.

pcovers
09-05-2003, 01:31 PM
Originally posted by ARIZONA73:
In Sblair's case, there is no reason at all to further lower the LDL...

In my relentless pursuit to trash the whole LDL calculation formula, the irony here is that if sblair wanted to lower her LDL, all she would have to do is RAISE her trigs. Crazy! I just don't buy this whole calculated LDL business.

ARIZONA73
09-05-2003, 01:50 PM
pcovers,

You're right, LDL is only calculated, not actually measured. LDL is really composed of two different types; small dense particles(bad), and light fluffy, larger size particles(benign). I believe they're referred to as Pattern A and Pattern B. Statistically, it has been shown that Pattern B(bad) LDL correlates more strongly with low HDL and high triglycerides. Of course, the only way to tell for sure is to have it measured instead of calculated. Either way, I don't think I'd want to increase triglycerides in order to lower LDL. It would probably shift the balance more toward that of the small dense variety, which isn't good. Probably one reason why niacin favorably increases LDL particle size is because it has an HDL elevating effect.

sblair
09-05-2003, 08:31 PM
So do you think I need to be on a medication to lower my LDL? Some think I do. I've heard that if your HDL is up (which I don't know what high is) it is a good protector no matter what the LDL is. Also, doesn't cholesterol vary easily? How often should one get their screening done? Once a year, once every 5 years? Thanks for advice.

ARIZONA73
09-05-2003, 09:46 PM
sblair,

Your HDL is ABOVE average, your numbers are all within the acceptable range, and your ratios are all very favorable. No, you do not require drugs to lower an LDL that is only 116.

There are other people who have unfavorable lipid profiles and/or have already had a heart attack or had been diagnosed with heart disease. These people need to be monitored more frequently. In your case, you should not need to have it monitored as frequently. I don't know your overall state of health, but whenever you do visit your doctor to undergo a physical exam, you should have your blood checked as well.

pcovers
09-06-2003, 08:31 AM
Originally posted by sblair:
So do you think I need to be on a medication to lower my LDL? Some think I do. I've heard that if your HDL is up (which I don't know what high is) it is a good protector no matter what the LDL is. Also, doesn't cholesterol vary easily? How often should one get their screening done? Once a year, once every 5 years? Thanks for advice.

1. Numbers can vary considerably day to day, week to week, month to month. Your cholesterol numbers are not like your height - fixed, and consistent. They do change and any given set of numbers on any given day may be different tomorrow. Do don't go crazy over any one set of numbers.

2. I take Zocor. I am not opposed to pharmaceuticals as an intervention in lowering cholesterol. Like hundreds of thousands of other people that take Zocor, I experience no side effects. Those few that do experience unfortunate side effects find themselves seeking out forums such as this and thus skewing considerably the perception of statin side effects. With that being said, I think any doctor that prescribes a drug for you to lower your cholesterol, given your numbers, should themselves be medicated for over prescribing. Your numbers and, more importantly, your ratios are very good. If you medicated to lower your LDL you could find yourself also lowering your HDL in the process. You don’t want to do that.

If you or your family have a history of heart disease, one must be more cautious with other risk factors, such as cholesterol. If you have no other risk factors - well, you have very good numbers. Consider yourself fortunate.

Of course, you are taking folic acid…aren’t you? Living as stress free a life as you can? Research shows that these two preventatives are capable of reducing heart disease to a greater extent than cholesterol modification.

sblair
09-06-2003, 09:46 AM
I am taking a folic acid. What does folic acid do exactly? The only risk I have is my father had bypasses in his fifties and my brother had a stint at forty. Their cholesterol was opposite of mine. Low HDL. All in all, I think the best belief is to trust in my Lord Jesus to take care of me and He will!!

ARIZONA73
09-07-2003, 12:33 AM
Sblair,

Folic acid, in combination with vitamin B-6 and B-12, will help lower homocysteine, another risk factor.

pcovers is right in that cholesterol numbers will vary considerably. For example, I have kept a record of my numbers over the last 15 years, and this is what I have found:


Highest total cholesterol 249
Lowest total cholesterol 196
Highest HDL 113
Lowest HDL 68
Highest Triglycerides 144
Lowest Triglycerides 57
Highest LDL 137
Lowest LDL 95

So you see, numbers can vary considerably. I must say, however, that since I cut out all the junk foods, and have added relatively high doses of nutritional supplements, such as antioxidants, that the numbers, and especially my ratios, have improved considerably. Most notably, my HDL has greatly improved, and my triglycerides have fallen sharply.


[This message has been edited by ARIZONA73 (edited 09-06-2003).]

sblair
09-07-2003, 10:55 AM
Are you controlling your cholesterol with diet and supplements only? That's what I am trying to do. In my case, I think I can. You have GREAT numbers.

ARIZONA73
09-07-2003, 12:28 PM
I have never used any medications to control cholesterol, just dietary changes and several different supplements.

Mainstream medicine has become so obsessed with aggressively attacking cholesterol with drugs that it has lost sight of what their true objective should be--to find out how and why cholesterol becomes deposited in the arteries in the first place. We have been beating this dead horse for so long that we seem to have forgotten that cholesterol is essential to our health and well being. I don't believe that plaque forms in arteries because of a Zocor or Lipitor deficiency. However, I do think that it has something to do with chronic deficiencies caused by an inadequate intake of certain nutrients. No two people are alike, and we all have our own nutritional requirements. Unfortunately, there is no way that our medical profession can determine what each individual's requirements should be in order to remain in good health. But I believe there is a very real connection between sub-optimal intake of various nutrients, especially the antioxidants, and the subsequent development of atherosclerosis. In time, however long that may take, I think this fact will become abundantly clear.

pcovers
09-07-2003, 04:32 PM
Originally posted by ARIZONA73:
But I believe there is a very real connection between sub-optimal intake of various nutrients, especially the antioxidants, and the subsequent development of atherosclerosis. In time, however long that may take, I think this fact will become abundantly clear.

Arizona, we have some differing opinions on a few matters, but probably agree in principle on most things. I do have a question regarding you comment above.

You note that cholesterol is a natural substance and I agree. However, large doses of vitamins and antioxidants are not a natural part of any known culture’s diet. How do you figure in this need to take high levels of various supplements when it is not a naturally occurring phenomenon? I am inclined to think that some supplements in some high dose may in fact aid in warding off an otherwise detrimental process. But is it not an extension of your philosophy on getting to the central issue to ask the question, why do we need to take unnaturally high doses of supplements. Should we not be looking at what is going on that these supplements are positively effecting or warding off? For example, if high dose Vitamin C helps to keep the lining of arteries smooth, should we not be asking what it is that is causing the walls to arteries to not remain in that smooth state. Isn't taking a supplement to prevent this similar to taking a drug to prevent some other phenomenon? In principle, how are these different?

Just for the record, I know Pauling's opinions regarding how prehistoric man made his own Vitamin C and that this capacity evolved away. I just don’t buy this as a reasonable scientific justification for his requirements of large dose Vitamin C.

cutup
09-07-2003, 06:51 PM
Originally posted by sblair:
I am taking a folic acid. What does folic acid do exactly?

There have been findings that perhaps folic acid does not give the protection they once thought it did and in fact some believe that it may increase the chance of restenosis.

ARIZONA73
09-07-2003, 10:10 PM
pcovers,

From what I have heard about the nutritional content of our foods today, it is apparent that many of them are of inferior quality compared to what people were eating in the past. I heard a doctor discussing this issue on the radio not too long ago. For example, he said that an orange may have contained as much as 250mg vitamin C fifty years ago. Today, however, that orange would most likely contain only between 30-50mg. The same is true for many other crops, and it holds true for not only vitamins, but several essential minerals as well. This phenomenon is largely attributed to soil depletion. In addition, most of the foods we eat aren't even fresh, and most of the vitamin E has been processed out of those foods that once afforded us a more optimum intake.

Also, let's not forget about the enormous stress that goes hand in hand with modern day living, in all its shapes and forms. Stress further increases the body's requirement for a number of nutrients. As a result, it can also lead to chronic diseases.

Linus Pauling may have aimed high when he recommended such high doses of vitamin C. Perhaps not everyone needs to take such high doses. However, given the relative safety of vitamin C, even in very high doses, it may be better to err on the high side. Pauling based these dosage recommendations on animals which produced their own vitamin C, and then scaled it according to the human equivalent.

Nutritional supplements alone may not be a panacea for every known form of heart disease, but I think they have the potential of affording us a considerable degree of protection.

Here is some information which I have found to be quite interesting on the subject of today's foods and the need for dietary supplements.
http://www.orkneyorganicmeat.co.uk/special%20reports.htm

CobaltBlue
09-08-2003, 08:09 AM
Originally posted by cutup:
There have been findings that perhaps folic acid does not give the protection they once thought it did and in fact some believe that it may increase the chance of restenosis.



cutup:

Do you remember where you read that and if so, was it based on published studies?

Ulrich

CobaltBlue
09-08-2003, 08:17 AM
Originally posted by sblair:
I am taking a folic acid. What does folic acid do exactly? The only risk I have is my father had bypasses in his fifties and my brother had a stint at forty. Their cholesterol was opposite of mine. Low HDL. All in all, I think the best belief is to trust in my Lord Jesus to take care of me and He will!!

Here are two links to a scientific journal (Nature-Structural Biology) that contains an editorial and studies that examine how folic acid impacts homocysteine levels:

http://www.nature.com/cgi-taf/DynaPage.taf?file=/nsb/journal/v6/n4/full/nsb0499_293.html

http://www.nature.com/cgi-taf/DynaPage.taf?file=/nsb/journal/v6/n4/full/nsb0499_359.html

cutup
09-08-2003, 11:29 AM
Originally posted by ubernier:
cutup:

Do you remember where you read that and if so, was it based on published studies?

Ulrich

Yes I read it at another internet site for questions about heart disease. Yes I do believe it was based on published studies. Will try to find the information again and forward it The information came from Heart Center On Line. I believe it is one of the best information sites on the latest research.

phja
09-08-2003, 11:44 AM
hey cutup....its jack...how are you?

cutup
09-08-2003, 12:17 PM
I'm not sure what all I can post without getting into trouble with both sites, but Heart Center On Line had at least two articles about folic acid and b vitamins and studies that have been done which rejects the earlier findings on homocysteine levels and heart disease. European studies suggest that taking a B-vitamin cocktail may boost the risk of artery renarrowing in patients with stents. They believe that folic acid may boost cell growth and cell duplication in arteries. There were controlled studies done on 636 patients with stents. Of the ones treated with B-vitamin treatment the restenosis rate was 35% compared with 27% who were not treated with the vitamins. The rate of major complications was 16% in those treated with the vitamins compared to 11% in those not treated with vitamins. That study was published Apr, 2003

Jun 18, 2003 Folic acid supplements do not appear to prevent heart attacks, strokes or deaths in at risk people. They admit that homocysteine is in fact a risk factor but correcting it doesn't seem to reduce future events. Liem said that it's possible that homocysteine is a symptom of heart disease and correcting it does not result in a cure. As such doctors should not widely recommend folic acid supplements for heart patients at this time. )June 18th issue of Journal of American College of Cardiology. The researchers reported that the study may not have been long enough to see a big effect and results of other ongoing tials with longer follow up periods should provide more answers. In the article it states that the American Heart Association does not recommend widespread use of folic acid supplements to reduce the risk of heart attack and stroke.

------------------
Doctors comments on patient charts:

"The patient refused an autopsy."

"Patient has chest pain if she lies on her left side for over a year."

CobaltBlue
09-08-2003, 01:56 PM
cutup:

Thanks for listing that info. Maybe the composition of the cocktail plays a large role in whether it swings from beneficial to detrimental with respect to restenosis? (rhetorical)

cutup
09-08-2003, 02:04 PM
Originally posted by phja:
hey cutup....its jack...how are you?

Hey jack. Good to see you over here. I check out a few different message boards. Really like this one though. Not a lot of fighting like at some of the others.

cutup
09-08-2003, 02:59 PM
Originally posted by ubernier:
cutup:

Maybe the composition of the cocktail plays a large role in whether it swings from beneficial to detrimental with respect to restenosis? (rhetorical)

You may be right. The study states that the B-vitamin group took a cocktail of folate,B6,B12 first through IV during surgery, then orally for 6 months. Also the restenosis occured in those who had undergone coronary stenting. I took the folic acid, B6, B12 combination following my stent and did have restenosis which caused me to need bypass surgery. Whether the folic acid and B vitamins had anything to do with I don't know. Another interesting statement made was that it's possible that homocysteine is a symptom of CAD and just like fever in patients with pneumonia, correcting the fever does not result in a cure. I believe the facts remain to be seen.

phja
09-08-2003, 06:18 PM
this was the first board i checked out...about 1 year ago.

CobaltBlue
09-09-2003, 08:53 AM
Originally posted by cutup:
I took the folic acid, B6, B12 combination following my stent and did have restenosis which caused me to need bypass surgery.

Hopefully, I am not doing myself harm rather than good--not like we need any help making matters worse. I have also been taking a B6/B12/Folic acid cocktail daily now since my 2nd stent in July 2002. I just changed the dosages slightly (dropping the B12/B6 downwards a bit). I started the cocktail based on two published studies (manuscripts are at home).

Unfortunately, I have no baseline homocysteine to compare my current values to because I did not have the plasma homocysteine checked until after I started on the B-vitamin cocktail. It could be possible that I am taking these to lower a homocysteine value for which I previously had one within a lower risk range...?

Maybe I am lucky so far, because both stents (non-drug eluting) seem to be holding up great so far (18 and 14 months, respectively). I guess time will tell--my next Tl/Tc stress test is scheduled for November 3.

cutup
09-09-2003, 11:28 AM
Ubernier, If you've gotten along thus far without restenosis I think you probably are going to be fine. Mine happened within the 3 month period that approx. 33% will have the same problem. Like I said, I don't know if folic acid had anything to do with it at all, but when I began reading the research I began to question whether it was right for me. Good luck with your upcoming tests.

ARIZONA73
09-09-2003, 11:49 PM
What kind of dosages are you talking about? I've read in one of Atkin's books where he routinely prescribed the following regimen for elevated homocysteine:

100mg vitamin B-6
2,000mcg vitamin B-12
10mg folic acid (that's right, 10,000mcg)

He further stated that a program with only 5mg folic acid and only 500mcg B-12 failed to reduce homocysteine levels nearly one-third of the time.

CobaltBlue
09-10-2003, 06:52 AM
Arizona:

I only take 1200 ug folic acid, coupled with 100 mg B6 and 500 ug B12. I am still digging through the papers at home to find the one particular reference that listed the improvements to homocysteine and the exact levels used--I think it was 1000 ug folic acid, 400 ug B12 and 500 mg B6 in the manuscript. As we found out though, some of those values are not able to be attained by practical combination of common supplements, due to different dosages.

I have seen some places state high levels of folic acid. My endocrinologist recommended only 1000 ug folic acid. I have seen my homocysteine drop over time. However, I would not be suprised if my lifestyle changes have also contributed significantly to the decrease.

sblair
09-10-2003, 07:47 PM
What is the homocysteine level and lipoprotein a? Why are these important? What are normal levels? My Lp(a) was 0 and homocys. level was 6.6.





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