ACE28
06-05-2009, 09:55 AM
I've been taking Niacin for approx. 7 years. I'm currently taking 3,000 mg a day and pravachol 10 mg day. My HDL has stayed at a level of between approx. 50 - 60, Total Chol. at around 200, and LDL about 100 - 130. My last CRP test was 0.16. My homocysteine has always been in the normal ranges.
I also know I could do alot more in regard to my weight/diet and other habits.
My doctor did not check my homocysteine last time, due to recent research suggesting that homocysteine has not been shown to to reflect either way the state of heart health. The homocysteine test has apparently been discontinued by most cardioloigists for lack of evidence. In regard to LPa, he reserves this test for patients with proven or suspected evidence of heart disease. There is also currently no medicine avialable to lower Lpa if it is elevated.
I also know I could do alot more in regard to my weight/diet and other habits.
My doctor did not check my homocysteine last time, due to recent research suggesting that homocysteine has not been shown to to reflect either way the state of heart health. The homocysteine test has apparently been discontinued by most cardioloigists for lack of evidence. In regard to LPa, he reserves this test for patients with proven or suspected evidence of heart disease. There is also currently no medicine avialable to lower Lpa if it is elevated.
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jenj770
06-05-2009, 10:01 AM
Ace,
Are you taking the Flush Niacin? That seems like a very high amount, but if that's what you need to keep your HDL up. I assume your having your liver enzymes checked regularly as well. I really think cutting carbs (the unhealthy ones) is a major factor in heart health.
J.
Are you taking the Flush Niacin? That seems like a very high amount, but if that's what you need to keep your HDL up. I assume your having your liver enzymes checked regularly as well. I really think cutting carbs (the unhealthy ones) is a major factor in heart health.
J.
ACE28
06-05-2009, 10:56 AM
Ace,
Are you taking the Flush Niacin? That seems like a very high amount, but if that's what you need to keep your HDL up. I assume your having your liver enzymes checked regularly as well. I really think cutting carbs (the unhealthy ones) is a major factor in heart health.
J.
Thanks for the update Jen... Yes, I take Immediate Release Niacin. I take a prescription Niacin called NIACOR (500 mg tablets). This is much cheaper for me because I only make a co-payment and I can purchase 90 days through MEDCO mail service. The carbs is something I have to definitely be more aware of. I love pasta, potatoes, rice, chocoate chip cookies etc... The list goes on and on.......
Are you taking the Flush Niacin? That seems like a very high amount, but if that's what you need to keep your HDL up. I assume your having your liver enzymes checked regularly as well. I really think cutting carbs (the unhealthy ones) is a major factor in heart health.
J.
Thanks for the update Jen... Yes, I take Immediate Release Niacin. I take a prescription Niacin called NIACOR (500 mg tablets). This is much cheaper for me because I only make a co-payment and I can purchase 90 days through MEDCO mail service. The carbs is something I have to definitely be more aware of. I love pasta, potatoes, rice, chocoate chip cookies etc... The list goes on and on.......
tjlhb
06-05-2009, 12:12 PM
I love pasta, potatoes, rice, chocoate chip cookies etc... The list goes on and on.......
Sugar intake tends to raise triglycerides / VLDL.
In general, it is better to choose carbs that are fibrous and of lower glycemic index most of the time (exception would be during or immediately after a long endurance exercise session). This means stuff like vegetables, whole fruits, and beans / lentils. When eating grains, prefer whole grains as much as you can.
Also, many foods combine bad carbs (sugar and refined grains) with bad fats (hydrogenated oils, saturated fats). Examples would be pasta in cream-based sauces, potatoes with butter and sour cream, most cookies and snack foods, etc.. That's a double whammy on your blood cholesterol levels, as well as making it easier for you to get fat (or harder to lose excess body fat) due to the high calorie density; being fat contributes to other risks like diabetes and high blood pressure, and itself contributes to bad blood cholesterol levels.
Carbs are often "carrier" foods; what they carry makes a significant difference in the healthiness of the meal. Whole wheat pasta with tomato based (with a little olive oil) marinara sauce is a lot healthier than white pasta with cream based alfredo sauce, for example. Baked potato (including the skin) with skim milk plain yogurt, salsa, or bean and vegetable chili is a lot healthier than baked potato with butter and sour cream.
Sugar intake tends to raise triglycerides / VLDL.
In general, it is better to choose carbs that are fibrous and of lower glycemic index most of the time (exception would be during or immediately after a long endurance exercise session). This means stuff like vegetables, whole fruits, and beans / lentils. When eating grains, prefer whole grains as much as you can.
Also, many foods combine bad carbs (sugar and refined grains) with bad fats (hydrogenated oils, saturated fats). Examples would be pasta in cream-based sauces, potatoes with butter and sour cream, most cookies and snack foods, etc.. That's a double whammy on your blood cholesterol levels, as well as making it easier for you to get fat (or harder to lose excess body fat) due to the high calorie density; being fat contributes to other risks like diabetes and high blood pressure, and itself contributes to bad blood cholesterol levels.
Carbs are often "carrier" foods; what they carry makes a significant difference in the healthiness of the meal. Whole wheat pasta with tomato based (with a little olive oil) marinara sauce is a lot healthier than white pasta with cream based alfredo sauce, for example. Baked potato (including the skin) with skim milk plain yogurt, salsa, or bean and vegetable chili is a lot healthier than baked potato with butter and sour cream.
namelessme
06-05-2009, 01:36 PM
In regard to LPa, he reserves this test for patients with proven or suspected evidence of heart disease. There is also currently no medicine avialable to lower Lpa if it is elevated.
I really hate when doctors use this argument. It's almost like: 'Since drug companies can't make money from treating Lp(a), we won't test it'. It is a major hidden cause of heart disease. When you read about that so-called healthy marathon runner dropping dead from a heart attack, or the person with perfect cholesterol dying, it's quite often because they have super-high Lp(a).
And there is one medicine that does lower Lp(a). You are taking it already, Niacin. There are some other things that do help too. For doctors to dismiss testing it because a statin won't work to lower it, is foolish in my opinion.
Jen -- thanks for posting your regimen. Unfortunately, Niacin is not an option for me, but I am considering upping my krill dosage. Although considering I take fish oil already, not sure if it'll do much.
And yeah, low carb is the way to go. I sometimes think a glycated hemoglobin test would be of greater value than cholesterol testing. I know of one study that found a strong correlation between it & heart disease... even stronger than cholesterol (which is probably just a marker anyway).
I really hate when doctors use this argument. It's almost like: 'Since drug companies can't make money from treating Lp(a), we won't test it'. It is a major hidden cause of heart disease. When you read about that so-called healthy marathon runner dropping dead from a heart attack, or the person with perfect cholesterol dying, it's quite often because they have super-high Lp(a).
And there is one medicine that does lower Lp(a). You are taking it already, Niacin. There are some other things that do help too. For doctors to dismiss testing it because a statin won't work to lower it, is foolish in my opinion.
Jen -- thanks for posting your regimen. Unfortunately, Niacin is not an option for me, but I am considering upping my krill dosage. Although considering I take fish oil already, not sure if it'll do much.
And yeah, low carb is the way to go. I sometimes think a glycated hemoglobin test would be of greater value than cholesterol testing. I know of one study that found a strong correlation between it & heart disease... even stronger than cholesterol (which is probably just a marker anyway).
tjlhb
06-05-2009, 03:18 PM
And yeah, low carb is the way to go. I sometimes think a glycated hemoglobin test would be of greater value than cholesterol testing. I know of one study that found a strong correlation between it & heart disease... even stronger than cholesterol (which is probably just a marker anyway).
High levels of glycosolated hemoglobin, or HbA1c, indicate uncontrolled or poorly controlled diabetes. Diabetes, particularly uncontrolled or poorly controlled, is one of the major risk factors of heart disease. High LDL cholesterol may occur with or without diabetes and vice-versa.
Low carb? Depends on what kind of carbs you are currently eating. If your carb intake is mostly sugar and refined grain, lowering intake of that would help. But lowering intake of vegetables, whole fruits, and beans may hurt.
High levels of glycosolated hemoglobin, or HbA1c, indicate uncontrolled or poorly controlled diabetes. Diabetes, particularly uncontrolled or poorly controlled, is one of the major risk factors of heart disease. High LDL cholesterol may occur with or without diabetes and vice-versa.
Low carb? Depends on what kind of carbs you are currently eating. If your carb intake is mostly sugar and refined grain, lowering intake of that would help. But lowering intake of vegetables, whole fruits, and beans may hurt.
namelessme
06-05-2009, 03:51 PM
Yeah, when I say low carb, I mean low glycemic foods. Veggies are still important to eat, of course. Sugary fruits, not so much, but berries are good. Sugary snacks + most grains should be avoided.
I think HbA1c is worth getting tested even in non-diabetics. It can be high-ish, yet not in diabetes range, and still be a problem. If nothing else, it's a good way to keep track of your sugar intake.
I think HbA1c is worth getting tested even in non-diabetics. It can be high-ish, yet not in diabetes range, and still be a problem. If nothing else, it's a good way to keep track of your sugar intake.
ACE28
06-05-2009, 07:23 PM
Sugar intake tends to raise triglycerides / VLDL.
In general, it is better to choose carbs that are fibrous and of lower glycemic index most of the time (exception would be during or immediately after a long endurance exercise session). This means stuff like vegetables, whole fruits, and beans / lentils. When eating grains, prefer whole grains as much as you can.
Thanks for the information......It seems that I sometimes let myself go too often and over-indulge in the wrong foods. I think mood swings and anxiety has a lot to do with my food habits. I believe that NIACIN, Vitamin C and Fish Oil have been the magic bullets to keep my blood lipids and CRP in the safer zone. When I took nothing about 10 years ago, my numbers were horrible. You are correct in the proper foods to consider for better health, besides their really is no magic bullet to substitute for better eating habits and weight management.
In general, it is better to choose carbs that are fibrous and of lower glycemic index most of the time (exception would be during or immediately after a long endurance exercise session). This means stuff like vegetables, whole fruits, and beans / lentils. When eating grains, prefer whole grains as much as you can.
Thanks for the information......It seems that I sometimes let myself go too often and over-indulge in the wrong foods. I think mood swings and anxiety has a lot to do with my food habits. I believe that NIACIN, Vitamin C and Fish Oil have been the magic bullets to keep my blood lipids and CRP in the safer zone. When I took nothing about 10 years ago, my numbers were horrible. You are correct in the proper foods to consider for better health, besides their really is no magic bullet to substitute for better eating habits and weight management.
ACE28
06-05-2009, 07:40 PM
I really hate when doctors use this argument. It's almost like: 'Since drug companies can't make money from treating Lp(a), we won't test it'.
I agree 100%, My doctor is against almost all supplements with the exception of Vitamin D, which he had me tested for. He can't understand why I waste my money on vitamins. He agrees that certain supplements like Magnesium are very good for you, but only if you need it. He claims I do not need this so I should not be taking it. As far as homcysteine is concerned, it annoys me that because some medical research studies have concluded that the research is inconclusive, does not completely negate the fact that homocysteine is not important. I think doctors are afraid to cross the lines between prescribing alternative medicines and the popular pharmaceutical medicines. Besides, the norm for doctors is to practice Medicine. Unfortunately, when something is not right with our health the first persons we rely on is our doctors, and with that comes the world of statins, fibrates, diuretics, beta blockers, calcium blockers etc.......If we don't adhere to their suggestions and guidelines, why bother going at all. It's a catch 22.
I agree 100%, My doctor is against almost all supplements with the exception of Vitamin D, which he had me tested for. He can't understand why I waste my money on vitamins. He agrees that certain supplements like Magnesium are very good for you, but only if you need it. He claims I do not need this so I should not be taking it. As far as homcysteine is concerned, it annoys me that because some medical research studies have concluded that the research is inconclusive, does not completely negate the fact that homocysteine is not important. I think doctors are afraid to cross the lines between prescribing alternative medicines and the popular pharmaceutical medicines. Besides, the norm for doctors is to practice Medicine. Unfortunately, when something is not right with our health the first persons we rely on is our doctors, and with that comes the world of statins, fibrates, diuretics, beta blockers, calcium blockers etc.......If we don't adhere to their suggestions and guidelines, why bother going at all. It's a catch 22.
tjlhb
06-05-2009, 10:03 PM
I agree 100%, My doctor is against almost all supplements with the exception of Vitamin D, which he had me tested for. He can't understand why I waste my money on vitamins. He agrees that certain supplements like Magnesium are very good for you, but only if you need it. He claims I do not need this so I should not be taking it.
To be fair, doctors (like non-doctors) do have disagreements on what the best thing to do is, when the available information on the subject is conflicting or inconclusive. You may find it better to find a doctor whose medical philosophy agrees more with your view on your medical care.
Supplementation is one of those topics. While most will agree on supplementing something where there is a known deficiency or high risk of deficiency (vitamin B12 for those eating a vegan or near-vegan diet, for example), or not supplementing when there is a greater risk of overload (iron for adults in rich countries other than women of childbearing age is the usual example), general supplementation does not have a great deal of agreement. Many people favor a multivitamin "just in case", but a recent study found that those taking multivitamin supplements were no healthier in terms of cancer, heart disease, or stroke than those who were given placebo pills.
Of course (more relevant to this forum), how to handle potentially risky blood lipid levels is another topic where there may be gray areas. Some doctors may favor more emphasis on cleaning up one's diet and exercise habits before recommending drugs, compared to other doctors, for example. And if it comes to drugs, different doctors may favor different drugs for whatever reason (and drug companies market to both doctors and patients to try to get their drugs to be more preferred).
If you do go looking for another doctor, you may find that some larger medical groups put up physician profiles listing their philosophy of care and additional medical interests. That may help you find one whose interests match what you are most concerned about (perhaps helpful due to being more likely to be up to date with the latest research, guidelines, and controversies on those topics). Also, a primary doctor of the same gender and similar or slightly older age may be more likely to have the same personal health issues and concerns that you do (a male doctor might have personal experience with prostate issues, while a female doctor might have personal experience with pregnancy, for example).
To be fair, doctors (like non-doctors) do have disagreements on what the best thing to do is, when the available information on the subject is conflicting or inconclusive. You may find it better to find a doctor whose medical philosophy agrees more with your view on your medical care.
Supplementation is one of those topics. While most will agree on supplementing something where there is a known deficiency or high risk of deficiency (vitamin B12 for those eating a vegan or near-vegan diet, for example), or not supplementing when there is a greater risk of overload (iron for adults in rich countries other than women of childbearing age is the usual example), general supplementation does not have a great deal of agreement. Many people favor a multivitamin "just in case", but a recent study found that those taking multivitamin supplements were no healthier in terms of cancer, heart disease, or stroke than those who were given placebo pills.
Of course (more relevant to this forum), how to handle potentially risky blood lipid levels is another topic where there may be gray areas. Some doctors may favor more emphasis on cleaning up one's diet and exercise habits before recommending drugs, compared to other doctors, for example. And if it comes to drugs, different doctors may favor different drugs for whatever reason (and drug companies market to both doctors and patients to try to get their drugs to be more preferred).
If you do go looking for another doctor, you may find that some larger medical groups put up physician profiles listing their philosophy of care and additional medical interests. That may help you find one whose interests match what you are most concerned about (perhaps helpful due to being more likely to be up to date with the latest research, guidelines, and controversies on those topics). Also, a primary doctor of the same gender and similar or slightly older age may be more likely to have the same personal health issues and concerns that you do (a male doctor might have personal experience with prostate issues, while a female doctor might have personal experience with pregnancy, for example).
ACE28
06-07-2009, 07:49 PM
If you do go looking for another doctor, you may find that some larger medical groups put up physician profiles listing their philosophy of care and additional medical interests. That may help you find one whose interests match what you are most concerned about (perhaps helpful due to being more likely to be up to date with the latest research, guidelines, and controversies on those topics). Also, a primary doctor of the same gender and similar or slightly older age may be more likely to have the same personal health issues and concerns that you do (a male doctor might have personal experience with prostate issues, while a female doctor might have personal experience with pregnancy, for example).[/QUOTE]
It would be very difficult to consider another doctor at this point unless I had to. He is a very sharp cardiologist and internist, with almost 50 years experience. He is very calm and considerate, aside from also being a gentlemen. He has a great bed side manner and is often consulted by other top doctors in the New York area. A disagreement about my vitamin regimen is not enough to consider another doctor. Let's be honest, many doctors are quacks, including some alternative doctors. My mom's cardio doctor recommended Coenzyme Q10, Vitamin B6, Folic Acid etc... meanwhile he misdiagnosed my uncle twice for a very serious heart condition. He was later taken for another opinion to another old cardio-family doctor who checked him into a hospital immediately with 4 artery blockages. In other words, knowing your profession and having all the required skills is the primary consideration, in my opinion.
It would be very difficult to consider another doctor at this point unless I had to. He is a very sharp cardiologist and internist, with almost 50 years experience. He is very calm and considerate, aside from also being a gentlemen. He has a great bed side manner and is often consulted by other top doctors in the New York area. A disagreement about my vitamin regimen is not enough to consider another doctor. Let's be honest, many doctors are quacks, including some alternative doctors. My mom's cardio doctor recommended Coenzyme Q10, Vitamin B6, Folic Acid etc... meanwhile he misdiagnosed my uncle twice for a very serious heart condition. He was later taken for another opinion to another old cardio-family doctor who checked him into a hospital immediately with 4 artery blockages. In other words, knowing your profession and having all the required skills is the primary consideration, in my opinion.