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    Old 09-22-2004, 03:51 PM   #1
    rahod
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    Is LDL of 100 low enough?

    I put this up previously, but thought I would start a new thread on this topic. Should we be shooting for LOWER LDL levels? I decided to set my goal to 70 (did it)...especially after the *Clinton event* several weeks ago (I'm his age ). Here is some background material (again).

    Optimal low-density lipoprotein is 50 to 70 mg/dl: lower is better and physiologically normal.

    O'Keefe JH Jr, Cordain L, Harris WH, Moe RM, Vogel R.

    "The normal low-density lipoprotein (LDL) cholesterol range is 50 to 70 mg/dl for native hunter-gatherers, healthy human neonates, free-living primates, and other wild mammals (all of whom do not develop atherosclerosis). Randomized trial data suggest atherosclerosis progression and coronary heart disease events are minimized when LDL is lowered to <70 mg/dl. No major safety concerns have surfaced in studies that lowered LDL to this range of 50 to 70 mg/dl. The current guidelines setting the target LDL at 100 to 115 mg/dl may lead to substantial undertreatment in high-risk individuals."

     
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    Old 09-22-2004, 05:55 PM   #2
    ARIZONA73
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    Re: Is LDL of 100 low enough?

    The three key words you used here are "high-risk individuals", whatever your interpretation of that may actually mean. Surely you're not suggesting that everyone needs to lower their LDL all the way down to 70, are you? I certainly hope not, because for most people it's totally unnecessary. Besides, lipoprotein(a) is far more dangerous than LDL. In fact, it may be as much as ten times as dangerous. I would much rather have an elevated LDL and a low lipoprotein(a) level than a low LDL with an elevated Lp(a).

     
    Old 09-22-2004, 06:26 PM   #3
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    Re: Is LDL of 100 low enough?

    Recent data would suggest that its difficult to have LDL that is too low, and that the 70's is a good place to be.

    One of the reasons why the 70's is a good place to be is that we know that a total cholesterol to HDL ratio of less than 3 is optimal, and we aren't very good at raising HDL.

    Let me make a false statement for the sake of argument: suppose everyone's HDL and LDL are equally efficient and equally bad respectively.

    Given the above, if I have tc of 200 and HDL of 80 my tc/HDL ratio is 2.5.

    Now lets say you have a tc of 150, and your HDL is 60. Your tc/HDL ratio is also 2.5.

    Who's in better shape? Well, on paper you look better than me because you have lower cholesterol, but in fact, your health risk is more or less the same given the above suppositions.

    The above example would be hampered by discussion of the efficacy of each individuals HDL, and the negative/positive makeup of their LDL.

    At the end of the day, we've few tests that can accurately describe the nature of our LDL, and at present we know f*** all about raising HDL, so in general lowering LDL as much as possible is a good idea, and 70 is certainly a measurement I'd like to have, and in fact hope to have.

    For instance, my current HDL reading is 34, so if I could raise it to 40, and lower my HDL to 70, I'd be sitting in tall cotton, and I might add that at that low level of LDL I probably wouldn't be fretting much over its constituants.

    So is 70 great? Sure, I'm in, but I've a friend who very much fits the above example. Her tc is about 200, but her HDL is about 75. My cholesterol is 178, but my HDL is 34. Who's shoes would you rather be in?

    Her's if you're interested in living.

    mark

     
    Old 09-22-2004, 07:22 PM   #4
    ARIZONA73
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    Re: Is LDL of 100 low enough?

    Mark,

    You're right. You can't simply look at a single LDL number. It makes absolutely no sense. You need to look at ratios, and the entire equation in general. But what I said still stands. Lipoprotein(a) is a real serious risk marker. This aberrant form of LDL, which easily deposits as plaque, due to its adhesive nature, has been largely ignored by the medical profession. In fact, Pauling has thus far been the only one to seriously address this threat. Most of what is deposited in arteries is Lp(a), not ordinary LDL.

    Last edited by ARIZONA73; 09-22-2004 at 07:25 PM.

     
    Old 09-22-2004, 08:16 PM   #5
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    Re: Is LDL of 100 low enough?

    Can you point me to an article about lipo A? The only component of that name I'm familiar with is apo A, which is a good and key component of HDL.

    amrk

     
    Old 09-22-2004, 08:47 PM   #6
    rahod
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    Re: Is LDL of 100 low enough?

    I understand that using a single # is simplistic. But, the synopsis I quoted stated that LDL of 100 is NOT NORMAL for our species (and other primates)..regardless of any other factors. They suggest that "we" (**** Sapiens) should be closer to 70. My take is that we might want to take a HARD LOOK at what our LDL was "meant to be" ....not what we would "like it to be". Sure "100" is a nice round #..but it may NOT be the optimal one. The reason why LDL is the name of the game is that HDL (and other factors) has a fairly limited range, albeit an important one. It's the high LDL that's run amok with our species...not the HDL being too low. Having LDL levels that we were MEANT TO HAVE ( 50-70) assures that normal HDL levels (50-60) are in sync (ratio LDL /HDL=1-1.5). Yes.. a ratio we were supposed to have..like it or not.

     
    Old 09-22-2004, 09:36 PM   #7
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    Re: Is LDL of 100 low enough?

    Blood chemistry is so individual, that I think its very difficult to peg a specific number. There probably is a typical number though, and it is probably under 100.

    However, I know of nothing to contradict the idea that safe LDL levels are partly a function of your HDL levels.

    mark

     
    Old 09-22-2004, 09:50 PM   #8
    rahod
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    Re: Is LDL of 100 low enough?

    Quote:
    Originally Posted by mhtyler
    Blood chemistry is so individual, that I think its very difficult to peg a specific number. There probably is a typical number though, and it is probably under 100.

    However, I know of nothing to contradict the idea that safe LDL levels are partly a function of your HDL levels.

    mark
    LDL is forever married to HDL...no doubt. So we both agree that the optimal LDL is under 100. My "theory" is that the LDL /HDL should be as close to "1" as possible. It would take an extraordinary HDL to make that cut...ERGO..LDL 70 is the goal.

     
    Old 09-23-2004, 07:23 AM   #9
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    Re: Is LDL of 100 low enough?

    mark,

    The studies on Lipoprotein(A) are indeed fascinating reading and all over the net (apoA is a component of it.)
    I like a summary in the Cleveland Clinic JM.
    Quote:
    LP(a) SCREENING: RECOMMENDATIONS

    Does the weight of the current evidence justify routine screening for Lp(a)? In my opinion, no. Until more consistent prospective trial data or interventional evidence accrues, knowing a patient's Lp(a) level provides insufficient additional assistance in predicting cardiovascular disease risk in the general population to warrant its inclusion in a standard screening evaluation.

    However, one should be aware of the Lp(a) level in special populations, ie, patients with premature coronary heart disease, those with a strong family history of cardiovascular disease, those who have undergone angioplasty or coronary artery bypass grafting, and those with documented cardiovascular disease in the absence of traditional risk factors. In addition to aggressive lowering of elevated levels of LDL-C, attempts to lower Lp(a) in these groups may be warranted on the basis of the epidemiological associations discussed above, especially in light of the efficacy and tolerability of the newer forms of niacin and of fenofibrate.

    Finally, suspect Lp(a) excess in patients with hypercholesterolemia that is refractory to standard statin therapy. Since the calculated value of LDL-C includes the LDL contained in Lp(a), and since Lp(a) will not respond to statin therapy, significant hidden elevations of Lp(a) may account for the treatment failure.
    I plan on testing for it next physical (long overdue) since I'm obviously one of those "special populations."
    What I'll DO with the info is anybody's guess.

    An aside:
    I actually DO know some people with HDL's higher than LDL's...two even with HDL's over 100!!!!!

    Put me in the camp that thinks that 100 LDL is just fine for those with undamaged hearts...maybe BETTER than fine!

    Last edited by zip2play; 09-23-2004 at 07:26 AM.

     
    Old 09-23-2004, 07:44 AM   #10
    ty123
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    Re: Is LDL of 100 low enough?

    "Finally, suspect Lp(a) excess in patients with hypercholesterolemia that is refractory to standard statin therapy. Since the calculated value of LDL-C includes the LDL contained in Lp(a), and since Lp(a) will not respond to statin therapy, significant hidden elevations of Lp(a) may account for the treatment failure."

    Wow! That may be why I'm not getting the statin response that Rahod assures me I should be getting...lol.

    So....what do you do to reduce elevations of Lp(a)? Hmmmmmmm?

    oh ... niacin.

    mark

    Last edited by mhtyler; 09-23-2004 at 07:45 AM.

     
    Old 09-23-2004, 09:28 AM   #11
    rahod
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    Re: Is LDL of 100 low enough?

    "Wow! That may be why I'm not getting the statin response that Rahod assures me I should be getting...lol."

    Somone call me? ...Well, I assume you haven't tested yet while taking the Lipitior and Zetia combo? Three weeks should do it..when did you start?

     
    Old 09-23-2004, 09:34 AM   #12
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    Re: Is LDL of 100 low enough?

    Rahod,

    I'd like to back up a little and address something you mentioned in your initial post. You stated that most animals do not develop atherosclerosis. That is quite true. Linus Pauling was aware of this, and came up with a theory as to why that is. First of all, most animals, with very few exceptions, are capable of manufacturing their own vitamin C, and they manufacture it in rather large quantities. Humans, as you know, cannot, and must depend entirely on dietary sources. Furthermore, animals which make their own vitamin C do not have any lipoprotein(a) in their blood.

    Pauling did an experiment using guinea pigs. Guinea pigs, as you know, are one of the few animals which cannot manufacture vitamin C. He divided the guinea pigs into two groups. Both groups received an identical diet, which provided approximately the human equivalent of 90mg vitamin C, which is the human RDA. However, half of the guinea pigs were given additional vitamin C, the human equivalent of about 2000mg/day. Eventually, all of the guinea pigs which received just the standard diet containing 90mg vitamin C developed atherosclerosis. The group which received the supplemental high dose vitamin C remained free of atherosclerosis, and their lipoprotein(a) levels were lower than that of the control group. Interesting, isn't it?

     
    Old 09-23-2004, 11:02 AM   #13
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    Re: Is LDL of 100 low enough?

    Quote:
    Originally Posted by zip2play
    An aside:
    I actually DO know some people with HDL's higher than LDL's...two even with HDL's over 100!!!!!
    Zip,

    I told my GF I was jealous of her because I have to eat like a Saint, run daily 5Ks, and ingest high doses of niacin for my LDL to be 67 and my HDL 70 mg/dL (~43 TG) , while all she does nothing of the sort and her last lab results showed an identical TG to mine, yet her LDL was 84 and HDL 104! Without niacin, my last results were 113 mg/dL (TG: 47, HDL: 49, LDL: 55). Something to keep in mind is that her and I were eating the same kind of foods--eating about every meal together, yet even without exercise, her body is more capable of producing HDL than mine.

    I think it would be interesting to have her get a particle size test done (+Lp(a), hs-CRP, homocysteine) for comparison to mine, when I do my next one in a few months.

     
    Old 09-23-2004, 12:13 PM   #14
    ty123
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    Re: Is LDL of 100 low enough?

    Rahod, I started on Lipitor less than 3 weeks ago. I'll retest at the 8 week mark. I'm expect slightly improved levels, but nothing to get excited about.

    That is interesting about the vitamin C, arizona. I see that Dr. Cooper recommends 1000mg per day.

    mark

     
    Old 09-23-2004, 01:18 PM   #15
    rahod
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    Re: Is LDL of 100 low enough?

    Quote:
    Originally Posted by mhtyler
    Rahod, I started on Lipitor less than 3 weeks ago. I'll retest at the 8 week mark. I'm expect slightly improved levels, but nothing to get excited about.
    Wow..that's right around the time I added the Zetia. What were you taking prior? I think you'll find your levels substantially reduced with the combo.

    RON (AKA "RAHOD")

     
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