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  • ATP III Guidelines say I do not need Statins.......but.....

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    Old 10-04-2004, 05:44 AM   #1
    jerry78
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    ATP III Guidelines say I do not need Statins.......but.....

    I'm a 44 yr old male currently not on statin medication.
    I see my Doc this Friday for my semi-annual physical.
    I obtained my most recent labs from last week, and here they are:
    TC-220
    HDL-56
    LDL(calculated)-113
    TRI's-253
    CHOL/HDL Ratio-3.9
    So, as I tend to analyize everything, and like to err on the side of caution, I figured these numbers are horrible, and that, come Friday, I'll be going on Statins.
    So, I researched the ATP-III guidelines, and here is what I found:
    Current recommendation is to treat the LDL until it is at goal. MY LDL goal is <130, so at 113 I'm within that goal.
    Next, if LDL is within goal, and Tri's remain above 200, next step is to obtain a Non-HDL goal.
    My Non-HDL goal, according to ATP-III, is <160(2 + risk factors, along with a Framingham risk score of <20 %) For the record, my risk factors are Hypertension (controlled), and being a male.....So, really, I have only 1 risk factor, as being a male does not add a risk until age 45, but I err on the side of caution. My Framingham Risk Score is 2 %, well, well below the <20 %.
    Anyway, my actual Non-HDL is 164, just 4 points above the ATP-III goal of 160; so I doubt my Cardio is going to put me on Statin Therapy.

    Should I rerquest to go on Statins? What are your opinions on it? I';m not opposed to Statins, but I'm not sure I should go on them if I'm falling within the guidelines, but then on the other hand, I would really like to get my lipids as low as they can go.......Jerry

     
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    Old 10-04-2004, 07:31 AM   #2
    ZippyDawg
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    First of all your numbers are not horrible. Your TG's are elevated - did you fast for 12-14 hours prior to the test? In any case statins have little or no effect on TG levels. Fish oil supplements and reducing carbohydrates in your diet will almost always result in lower TG's.

    Are you overweight? Do you exercise? Does you diet consist of 30% (or more) of carbohydrates? Do you exercise everyday? If your answer is no to all or some of these questions losing weight, exercising on a daily basis and reducing carbohydrates will all have a positive effect on cholesterol/lipid levels.

    The last thing you want to do is to needlessly take statins for the next forty years unless you can't achieve the results you are looking for with weight loss, exercise and diet.

     
    Old 10-04-2004, 09:00 AM   #3
    ty123
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    TC-220
    HDL-56
    LDL(calculated)-113
    TRI's-253
    CHOL/HDL Ratio-3.9

    Jerry, I agree with zippydawg that your numbers, while not good actually give you some positives to work with. Your HDL is significantly higher than the average male's, and that gives you a leg up. Your ratio of 3.9 isn't all that bad right now.

    Ignore advice about low carbohydraytes by the way, its voodoo dieting by Atkins and not scientific, but you may well be able to alter your diet and not go to statins.

    Consider a lower fat diet with a mix of complex carbohydrates, protein and very low in saturated fat, and as close to zero trans fat as you can get. Stay away from simple carbs...white bread, crispy cremes etc. It also means very little meat and dairy, and lots of veggies, whole grains, and legumes. This is what the AMA, AHA, and ALL major medical institutions recommend.

    Consider some nutriceuticals like Benecol margerine, and Psyllium.

    At the end of the day, I'd try dieting first if I were you, but it depends on whether you feel you can make significant diet change and live with it.

    Its hard to predict, but if you did go the statin route, you'd probably be fine with a low dose of Lipitor or Crestor, and you might even be a good candidate for some diet modification and only zetia...a non-statin. You might even be one of the lucky ones that can still slam the occasional donut.

    You've probably got some choices, and that's a good place to be.

     
    Old 10-04-2004, 11:19 AM   #4
    jerry78
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    Thanks ZippyDawg and TY for your opinions.
    TY: Yep-I must agree with you that this low-carb craze is just that-a craze. I used to folllow the Ornish-type diet, with great results, but then became non-compliant with it.
    In fact, at the end of this month, I am enrolling in the Ornish Advantage program at an area hospital, and am hoping to acheive those goals once again.
    Ornish is really not that difficult to follow, and one does not even need to enroll in the program for success....last time, I did it all on my own....but I decided to join the program this time in order to reap all the benefits.

     
    Old 10-04-2004, 12:25 PM   #5
    ty123
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    Yes, I follow Ornish, although I deviate in that I take Take Control or Benecol, which is an oil, but one that specifically impedes the absorption of cholesterol. Ornish has yet to comment on it one way or the other.

    Also, in my own case I don't feel that Ornish addresses people with FH appropriately, but I think he's on the right track. Low fat appears to slow the advance of Athero., Lower seems to do better, and Lowest...Ornish seems to halt or reverse.

    Watch out for simple carbs! They're sneaky!

     
    Old 10-04-2004, 08:36 PM   #6
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    Quote:
    Originally Posted by jerry78
    I'm a 44 yr old male currently not on statin medication.
    I see my Doc this Friday for my semi-annual physical.
    I obtained my most recent labs from last week, and here they are:
    TC-220
    HDL-56
    LDL(calculated)-113
    TRI's-253
    CHOL/HDL Ratio-3.9
    The only lipid component above that I would be concerned with is your elevated triglycerides. This should be less than 150 mg/dl in my and many doctors' opinion, and optimally less than 100 mg/dl.

    Many here put down low carbohydrate diets, but my experience and many other's experiences have shown that this type of diet has a dramatic effect on triglyceride levels. Five years ago, my triglycerides were in the 150's and HDL was ~50 mg/dl. That is about the time I started following a low carbohydrate diet. I've been on it ever since and am currently 25 pounds lighter than when I started. A few months ago I had bloodwork done and my triglycerides were 36 mg/dl and HDL was 73 mg/dl. I'm a 38 y/o male by the way. My diet focuses on wholesome, natural, unprocessed beef, pork, fish, poultry, wild game, eggs, cheese, nuts, fiberous vegetables, and limited amounts of low sugar fruits with a supplemental tablespoon of cod liver oil every day. I cook with lard that I render at home and also use real butter melted on my vegetables and olive oil on my salads. I avoid processed foods whenever possible and in particular attempt to avoid foods containing partially hydrogenated vegetable oils, high fructose corn syrup, and enriched wheat flour (these are everywhere - just read a few labels on any baked goods). I'm not perfect but I do try to stick to that dietary philosophy the large majority of the time.

    And the science tends to support a diet low in carbohydrates being more effective at reducing triglyceride levels than a low fat diet. I researched this quite a bit before I jumped on this low carb diet. Just do a google or medline search for [triglycerides carbohydrate]. And to compound things, ultra low fat diets like Ornish's diet recommendations tend to reduce HDL levels which increases CHD risk, whereas diets higher in animal based protein and fats tend to raise HDL levels. This isn't just my opinion, but the scientific evidence is relatively easy to find on the net if you want to spend some time using a search engine.

    Here are a few recent relevant hits supporting a low carbohydrate diet for improvement in lipid parameters:

    http://cardiology.jwatch.org/cgi/content/full/2004/709/1

    The above link in part states "...low-carb dieters fared significantly better than low-fat dieters in changes in mean triglyceride levels (–58 mg/dL vs. +4 mg/dL)"

    http://www.annals.org/cgi/content/full/140/10/778

    http://www.annals.org/cgi/content/full/140/10/769

    And this review article >>> http://www.ccjm.org/pdffiles/Volek1102.pdf <<< states in part "The most dramatic and consistent lipid response to a very-low-carbohydrate diet is a moderate to large decrease in fasting triglycerides levels and postprandial triglycerides responses to a fat-rich meal, (14) both independent risk factors for cardiovascular disease. (15)(16)" – References shown in () at end of article.

    Quote:
    Originally Posted by jerry78
    Should I request to go on Statins? What are your opinions on it?
    No, not in my opinion. Statins treat the symptom (elevated cholesterol) rather than the root cause of the problem (poor diet). They may provide some other benefits such as a reduction in inflamation, but these benefits are not well established. The problem for someone of your age is that there is no end game with statins because they don't fix the problem. If you rely on them solely to artificially address your cholesterol abnormalities, then you are stuck with them for the rest of your life. Besides, statins have little effect on triglyceride levels and that is the only component you have that could be considered abnormal. And statins are not without risks themselves - just take a look at the postings on this board or do a *********** search for [statin risk]. Of particular concern is CoQ10 depletion.

    Good luck in your search for information.

    Alan
    __________________
    The tragedy of science is the slaying of a beautiful hypothesis by an ugly fact. T H Huxley

     
    Old 10-05-2004, 05:17 AM   #7
    zip2play
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    jerry,

    Your numbers are fine with the singular exception of the triglycerides.
    Why not have them redone after 24 hours with zero sugars or alcohol and a high fiber day and see what kind of triglyceride reading you get. (Of course adhere to the 12 hour FAST rule before the blood draw.)

    I agree with everyone that you don't need a statin with these numbers. Get the triglycerides down and they won't be borderline, they'll be superb.

     
    Old 10-05-2004, 08:13 AM   #8
    ZippyDawg
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    Quote:
    Originally Posted by jerry78
    Yep-I must agree with you that this low-carb craze is just that-a craze.
    Reducing carbohydrates in your daily diet has nothing to do with with a "low-carb craze." There is nothing crazy about reducing your caloric sugar intake from the "non-crazy" 55%-65% sugar level to the 30% or less "crazy" level.

    Carbohydrates are chains of sugar molecules. The only difference between simple sugars (carbohydrates) and complex sugars (carbohydrates) are the length of the chains. The shorter the chain the sweeter the sugar. Your digestive system is extremely efficient at snipping the chains and the glucose that enters the blood stream is identical whether it is derived from simple or complex carbohydrates. There is nothing magical about eating a potato or a grain like corn or any other “complex” carbohydrate. The sugar molecules are rapidly broken down by the digestive process and end up in the blood stream as glucose. In fact a starchy food like some varieties of potato have a higher glycemic index and will raise blood sugar more rapidly then sucrose (table sugar.)

    If you are eating large amounts of carbohydrates you are eating large amounts of sugar. If your diet consists of the "heart healthy" AHA/ADA 55%-65% carbohydrate diet then 55%-65% of your calories are coming from sugar. You can rag on Dr. Atkins, Dr. Eades, Dr. Schwarzbein, Dr. Bernstein and numerous other low-sugar advocates but that is a scientific fact that can't be disputed.

    I guess Dr Schwarzbein a endocrinologist who actually treats patients in a clinical setting is just another low-carb kook.

    “Dr. Diana Schwarzbein has achieved the reputation as the cutting-edge expert on hormone replacement therapy and reversing type II diabetes. Her practice specializes in endocrinology, metabolism, diabetes, osteoporosis, menopause and thyroid. She lives in Santa Barbara, California with her husband where she conducts workshops and private sessions. She completed nine years of training in endocrinology and metabolism at the University of Southern California in 1990, and spent the first few years of her practice at a medical clinic in Santa Barbara treating Type II diabetics.”

    Basic Philosophy:

    After a few year of watching these patients get worse on the standard low-calorie, high-carbohydrate, low-fat, low-protein diet, she began to experiment with a lower carb way of eating. She discovered to her surprise that a diet that included red meat, butter, eggs, real cream, lots of low-carb vegetables and moderate amounts of unrefined carbohydrates brought the patients' blood sugar levels down to acceptable levels in an amazingly short time, and, improved their lipid levels as well.

    The book is the outcome of these successes and the resulting research she has done in the past ten years. The emphasis is on healthy eating -- simple, unprocessed foods, and no stimulants (alcohol, caffeine, drugs). She discusses aging, cholesterol and fat (and why it is necessary to eat both), heart disease, eating disorders, and how to achieve a balanced diet.
    Another important aspect of her philosophy is that you stay on the diet and will either gain or lose until your body stabilizes at its optimum weight - bearing in mind that what you think is an optimum weight for you may not be what your body settles at.

    Dr. Schwarzbein believes that the ADA diet is killing diabetics. That isn't what the whole book is about, of course. She speaks out against the AMA and the FDA "food pyramid". The book is geared toward women, but the principles are applicable to men as well. She discusses the "low-serotonin state" and the problems associated with it: depression, addiction, obesity. Dr. S. gives a wonderful, lay person description of insulin resistance its effect on the body.. The Schwarzbein Principle Cookbook is fabulous! I haven't yet tried anything that wasn't delicious!

    By the numbers:

    In terms of numbers, an inactive person can have up to 15g of carbohydrates at every meal. The more active you are, the more you get - she maintains that carbohydrates are an important source of glycogen for muscles.There are no calorie restrictions.

     
    Old 10-05-2004, 10:56 AM   #9
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    I can only attest to what the other posters are saying. I have been on a (OK - I'll call it) modified carbohydrate diet for over three years and have the same success. Not a fad and has been around for decades. The low fat craze is what is killing America over the last twenty years - now that's a fad diet. And, quite frankly if you do the research on Ornish and his studies you will be amazed at what you will find.

     
    Old 10-05-2004, 01:05 PM   #10
    ty123
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    "Google lipitor problems, statin problems, lipitor side affects and be prepared"

    Google Bigfoot, and alien abductions while you're at it...lots of material there to.

     
    Old 10-05-2004, 02:15 PM   #11
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    Quote:
    Originally Posted by ty123
    "Google lipitor problems, statin problems, lipitor side affects and be prepared"

    Google Bigfoot, and alien abductions while you're at it...lots of material there to.
    Just for grins, I did google big foot
    Bigfoot telephones
    Bigfoot Truck
    and of course the the mysterious animal

    Funny thing, I didn't see any licensed Md's claiming to see the creature, but there are plenty of Md's and Research Scientists making a fuss about statin inaffectiveness, including Harvard.

    I'm sure many people have already seen it, but probably discounted it because it doesn't agree with the preconcieved perception.

    [url]http://www.thincs.org/pressrelease82004.htm[/url]

    "Statin drugs have been aggressively promoted by the pharmaceutical industry and medical opinion leaders," says THINCS member Paul Rosch, MD, President of the American Institute of Stress. "The new guidelines were not written by disinterested scientists, but by members of the medical community who have received major grants from the pharmaceutical industry.24 The recommendations are based on distorted statistical analysis of relative risk reduction that mislead doctors and the public. They are designed to turn healthy people into patients."

    Last edited by phil58; 10-05-2004 at 02:15 PM.

     
    Old 10-05-2004, 03:08 PM   #12
    ty123
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    Phil, the point of this particular thread is to help Jerry, not promote your religion. You're working very hard to convince who...yourself?

    And for the record Harvard Medical School DOES recommend statins for high cholesterol along with a low fat diet, just like Yale Medical School, just like the Mayo Clinic, just like Johns Hopkins, and every other legitimate medical organization.

    These foot long folderol discussions about "links to a wealth of information" is so much SHASH, as is the VERY TIRED argument that medical authority and drug companies are conspiratorial.

    This is a board about lowering cholesterol NOT about fad diets. Must you infect every thread with a discussion of Atkins where people are trying to discuss a serious issue?

    Last edited by ty123; 10-05-2004 at 03:19 PM.

     
    Old 10-05-2004, 03:34 PM   #13
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    Ty, When you said to Google 'Bigfoot', I thought you had a sense of humor.
    Phil is not preaching a religion, he doing the research that everyone should be doing today, especially when it comes to statins.
    Phil brought up an excellent point about CoQ10 depletion from statins.
    Our doctors seem oblivious to the fact that statins deplete this necessary nutrient.
    And we are trying to help Jerry.
    If I can prevent one person from taking statins, I consider it a good day.

    Frankie

     
    Old 10-05-2004, 04:54 PM   #14
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    Yes, there's no question that statins deplete CoQ10. In addition, the more you lower LDL, the greater the depletion. Not very smart, is it?

    As far as Jerry is concerned, I think he has already been given excellent advice by Arkie6. So Jerry, please listen to what Arkie6 said. He knows what he's talking about.

     
    Old 10-05-2004, 06:55 PM   #15
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    Re: ATP III Guidelines say I do not need Statins.......but.....

    Quote:
    Originally Posted by arkie6
    . Besides, statins have little effect on triglyceride levels and that is the only component you have that could be considered abnormal. And statins are not without risks themselves - just take a look at the postings on this board or do a *********** search for [statin risk]. Of particular concern is CoQ10 depletion.

    Good luck in your search for information.

    Alan
    Statins actually have a significant effect on lowering TRIGS, especially Lipitor and Crestor....I can't recall the exact# but I think it's over 20% (?). Now, I'm not advocating using statins as a *first line* strategy, but in fact, they DO reduce TRIGS significantly. Secondly, on Q-10..... True, but no one really has a good handle on the *Q-10 issue* and statins. In any event, I take a highly soluble form of Q-10 with my Crestor and would advise all those who take a statin to do so as well.

    Last edited by rahod; 10-05-2004 at 07:33 PM.

     
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