...As you may have observed, I tend to be a very analytical person. Until I saw an improvement in my cholesterol from a low GI diet, I really didn't think to hard about why my cholesterol was high. This board has really enlightened my knowledge and has stimulated my desire to learn more about this process.
...I have learned that cholesterol is the foundation of a lot if not all of our gland's steroids or hormones, however you wish to speak of them. I got to thinking that maybe the mechanism by which the Low GI diet lowered cholesterol was that it takes the stress off of the panceras, therefore decreasing the need for insulin, the hormone of the pancreas, thereby decreasing the need for cholesterol to make the hormone.
...With my other chronic condition, I found that the adrenal gland played a big role. I was taking corticosteroids and found out the hard way that steroids will suppress the adrenal gland. Basically the brain sees the extra steroids floating around and tells the adrenal gland to back off because there's enough. The reason that caused problem is that the adrenal gland is the back up system to prevent low glucose levels and if it's not reacting, the glucose levels can get low.
...I got to thinking that if the adrenal gland is suppressed, then the need for cholesterol would also be decreased drastically since it wouldn't need the cholesterol to make any hormones. I also figured that there has probably been some studies done in regards to prednisone (corticosteroid) and cholesterol. Prednisone while being a medicine is also used in a lot of studies to suppress the adrenal gland.
...In the three studies I found, HDL levels rose sharply in the test subjects that were given prednisone. Given that, I would think that if the opposite was true and the adrenal gland was being called on to make a lot of hormones, that the HDL would go lower than normal, which leads me to the belief that any type of chronic stress that efects the adrenal system can lower HDL. This could be Mental stress, metabolic stress, or prolonged physical exertion. Since exercise helps cholesterol levels, it could be theorised that intermitant stress couldbe a good thing. But that seems to go with life, a little is good, but when it becomes chronic things go bad.
...I would be interested in your thoughts and here's the study:
The effect of prednisone therapy on plasma lipoproteins and apolipoproteins A-I, A-II, and E levels was studied prospectively in a heterogeneous group of six male and six female subjects. All patients were in a good general condition. The patients had normal hepatocellular, renal, and thyroid functions. During the first month of therapy, the following changes were noted: Plasma triglyceride (TG) levels increased slightly in female patients only. In the entire group, plasma cholesterol level increased (17.3% of initial value, P less than 0.01). Plasma high-density lipoprotein cholesterol (HDL-C) level increased by 68% (P less than 0.001), while plasma low-density lipoprotein cholesterol (LDL-C) level increased by only 10.9% (not significant), resulting in an increased ratio of cholesterol in the two (P less than 0.01). No change in levels of plasma apolipoproteins A-I, A-II, and E was evident. The ratio of HDL-C to plasma apolipoprotein A-I increased (P less than 0.01), indicating an increased lipid to protein ratio for this lipoprotein. Most of these changes were already apparent and significant 48 hours after initiation of treatment and persisted throughout the follow-up period (up to 18 months in some patients). Our results show that in patients with no major metabolic abnormality, prednisone induces significant changes of the lipoprotein system, especially in HDL.
I guess this goes to show that each of us finds different parts interesting...
What struck me was that the Apo A1, A2, and E remained at the same level while HDL increased. The reason that I focused in on those findings is because for the transport form of VLDL, it needs the ApoE from HDL, so it would seem reasonable that if HDL increased, so would the level of ApoE (and ApoC2 which was not measured?) Thinking of it that way, you would expect a direct correlation. Same applies to A1, which is believed to help transport the HDL to lesions. As for the A2 protein, I am not sure that there is a definitive answer yet on it's true role--other than it seems to exert an effect opposite of A1 with respect to binding and cholesterol uptake. I suppose what I notice as "interesting" is that this part of the mechanism is unaffected by the prednisone.
Oh, another thing about stress and exercise...there are some who would argue that exercise reduces stress. Here comes my own speculation, perhaps unfounded because I have not spent any time to look this up at all: I think that one physiological effect of stress is elevated blood pressure, and if not mistaken, elevation of both systolic and diastolic pressures. However, when healthy individuals exercise (well those w/o CAD/CHD, unlike me), the normal? response is that the systolic pressure rises and the diastolic maintains or drops slightly during exertion. Perhaps there is some truth to what I heard many years ago: the diastolic pressure is the more critical of the two? Anyway, just throwing that out there since your mentioning stress had me thinking about that situation.
Though interesting there are too many imponderables here.
First off, a definition of STRESS is required. it's one of those words that two people can use to mean almost the opposite, i.e, is exercise STRESS, or does exercise RELIEVE STRESS?
What is clear is that a dose of a synthetic cortisone raises blood cholesterol components, HDL more than LDL. Also it's clear that cortisone suppresses adrenal function.
Since the adrenals pour out hormones of various types with various functions, you would need a hypothesis about which hormone is being supressed that would normally lower these cholesterol components. Perhaps it's as simple as the fact that absent the adrenal hormones we become extremely sluggish and thus aren't able to burn off blood lipids as readily and perhaps the liver isn't able to deal with them as readily.
I believe that Exercise is a "Stress" (slowly growing to hate that word) and is dependent on lots of adrenal outpouring. Since the "common wisdom" has it that exercise raises HDL there seems to be a paradox (since adrenal shutdown raises cholesterol levels, HDL and LDL.)
My solution to the paradox is from my own personal observation that hard, regular exercise DOES NOT raise HDL so all seems well in my universe!
An aside,
Do you have any figures on the exact number of the cholesterol raise with prednisone...my reason, if a person has an HDL of 30 and an LDL of 200 and raises both by 20 points with prednisone, you'd get HDL increasing 67% and LDL increasing 10%...just musing (trying to avoid the gym!)
You two confuse me to death. LOL Well I have a problem that I can't get off my mind and could not in a million years put it into those kind of words (I am the artistic type) here go's: Would having severe pancreatic damage due to a car accident cause my high cholesterol and fatty liver?
Background: Car accident 1989 Pancrea's was shredded (the Dr's words not mine) Hospitalized 9 weeks just barely escaped Whipple procedure (where they remove part or all of pancrea's) only after effects have been inability to drink alcohol and eat much pork or fatty meats. Some pain. Never been checked for diabetes since I left hospital do have severe hypoglycemia that actually wakes me up at night shaking.
Thyroid cancer 1991 total thyroidectemy taking .115 synthroid, possible reocurrance waiting for a scan. Through old lab reports I discovered that my tsh was never suppressed enough to prevent cancer reoccurance.
Having lots of pain in the kidney region (both sides) this just started 4 days ago. A CT done in early Dec. showed attenuation of liver to spleen possibly because of fatty infiltration.
Having more pain than usual from area of pancrea's.
Having nausea bouts off and on mostly if I am thinking about eating or actually eating.
After the car accident my cholesterol sky rocketed to 550 which I controlled (by diet) down to where it now runs between 287 and 305. PCP just wrote prescription for Lipitor which I have not filled yet.
My blood pressure is low runs about 100 or 60 normal and if I stand up it drops to about 90 over 56
I have never been overweight, I can't drink and can't eat fatty foods so I am wondering if my pancrea's has decided to go south and mess up my liver. I am also concerned about adrenal fatigue and have started to notice my skin is getting darker no matter how much sun screen I wear. PS don't spend any time in the sun except from house to car ect.... I am exhausted all the time, crave salt like there is no tomorrow. ( it actually makes me feel better to eat a lot of salt) always thirsty (small wonder), nightsweats and low grade evening fevers, my joints and muscles hurt all the time. Have a continuous headache. bouts of anxiety if I have do do anything (like go to grocery store) I have not lost weight. My thyroid tests are coming back ok. Not Hypothyroid. Any guesses? Does it sound like adrenal fatigue? I also had a hysterectomy in Feb last year and thats when all of this started. I am not on estrogen and I am 47 yrs old. I would be grateful if anyone can help with this I am almost at then end of my rope and I think my PCP is starting to think I might be losing it. I just can not bear to ask him any more questions right now.
Gotta take this in little bites...
First off, I'd say your intolerance to fats is from an undersupply of bile, the caustic detergent that emulsifies fats after they leave the stomach. Most likely your gallbladder or the common duct (with the pancreas might be partially blocked.)
Quote:
attenuation of liver to spleen possibly because of fatty infiltration
Could you amplify that; on face value it sounds like the liver has shrunk in relationship to the spleen or the spleen has grown too large? Usually fatty infiltration refers to the liver and causes a larger rather than a smaller liver.
With the hysterectomy, the thyroidectomy and the pancreatic shredding, it sounds like you need to be under the watchful eye of a good endocrinologist. Your hormones have GOT to be messed up and replacement therapy always leaves lots to be desired.
I wouldn't dwell on the adrenals, it would just add another couple variables to an already VERY complicated picture.
I would DEFINITELY take the Lipitor to avoid throwing cardiac problems into your mix.
!
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