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    Old 10-12-2007, 06:52 PM   #1
    Suzy-Q
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    Elevated hs-CRP- How Bad Is It?

    Hello,
    I've had high cholesterol for a long time. Tried Zocor but got very sick with myalgic and neurological symptoms. Since being taken off of that (Jan 2007), I've tried Tricor (muscle pain), Zetia (digestive upset), and Niaspan. I just stopped the Niapsan a week ago as flushes had become rashes and I was having dizziness and so on. I take omacor (Rx fish oil) and plant stanols with no problems. Doc wants me try Crestor on new sub-therapeutic dosing - 2.5 mg once per week. She says there's mounting evidence that even very low doses can lower LDL but the once per week dosing avoids side effects (for most people).
    I was planning on telling the doc to forget any more Rx meds. My cholesterol numbers aren't really bad (TC=250, Tri-195, HDL - 60, LDL 152). I am not diabetic, don't have HBP or a history of heart disease. I'm good and tired of meds that make me sick, too.
    But here's the down side: I do have valvular insufficiency (mitral and aortic) and my hs-CRP is high - 7.8 mg/L and has been for a while now. I've had quite a spell of illness for the past 4 years and a few major surgeries. I've been hoping the high value was indicative of something to do with these issues. But it isn't coming down at all, in fact the level is increasing despite taking aspirin.
    My doc feels I can't overlook the significance of the high LDL and this CRP level. She thinks its a deadly combo no matter what is causing the inflammation. What do you think? Do you believe the latest guidance that hs-CRP is a very important indicator of heart disease risk? My doc has made it clear that she thinks I am at a very high risk but I'd like your opinion hoping to get some perspective. Thanks and take good care - Suzy-Q

     
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    Old 10-12-2007, 08:11 PM   #2
    Guy1_USA
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    Re: Elevated hs-CRP- How Bad Is It?

    It's a quality of life issue... quality vs. longevity. I'd take quality every time.

    I've had Tot-C of 250 to 300 for 16 years... and if it were not for Niaspan, I would not be taking any medications at all.

    I say to you, the heck with it, and live your life instead of the life your Doctors want you to live. I know I do.

     
    Old 10-13-2007, 06:17 PM   #3
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    Re: Elevated hs-CRP- How Bad Is It?

    Thanks VM,
    Howq true. Quality is the thing. I'm going to give the Crstor sub-dosing a try but at the first signs of myalgic pain - I'm done with it. It's hard to accept certain illness as a way of reducing the risk of a someday, maybe illness. Take care - Suzy-Q

     
    Old 10-13-2007, 06:54 PM   #4
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    Re: Elevated hs-CRP- How Bad Is It?

    Suzy-Q,

    Your triglycerides are a bit high - if you could drop them, your overall numbers would be fine. Cut back on sweets, white carbs, and alcohol if that applies to you.

    I'd try the low-dose Crestor - it helps fight inflammation. I'd also try Folic Acid and a B-Complex to help drop your CRP level.

    Take some CoQ10 with the Crestor - it should eliminate the possibility of muscle aches.

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    Old 10-13-2007, 07:43 PM   #5
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    Re: Elevated hs-CRP- How Bad Is It?

    Bypasses and stents are always an option... if you ever need them... no proof you will or that your particular high cholesterol will have any effect on your health. Kind of a crap shoot if you ask me.

     
    Old 10-13-2007, 08:06 PM   #6
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    Re: Elevated hs-CRP- How Bad Is It?

    I would ask the Dr. for a lipoprotein test so you could really see whats happening with your cholesterol. This will get you a more accurate assesment of risk plus help you to determine what treatment would be most effective. An LP(a) test might be a good idea also.

    Another suggestion I would make would be to have your Vitamin D levels checked. Then supplement to get them to the upper limits. Vitamin d can have a direct impact on the CRP levels. There is also a possibliliy it could play a roll in the calcification of the valves common to your valvular insufficiency. It's not going to be a cure all but I think if you research it a little you'll be amazed at the possible benifits of a good vitamin D status.



    Quote:
    HubbleRules Suzy-Q,

    Your triglycerides are a bit high - if you could drop them, your overall numbers would be fine. Cut back on sweets, white carbs, and alcohol if that applies to you.
    That sounds like a good idea to me also. If possible attempt to get the TGs down into the 50s. How much Omacor are you using and it prescribed to lower your TGs? Will the doctor up your dose? One doctor that I follow has made the comment that the only thing better in treating CHD than fishoil is more fishoil.

     
    Old 10-14-2007, 08:12 AM   #7
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    Re: Elevated hs-CRP- How Bad Is It?

    Thanks so much for the replies. I don't eat any sugar, no sweets, no alcohol, and no processed food. I am, in fact, on an Atkins diet so my saturated fats are the issue, I think, with my high LDL. I should also add that my cholesterol numbers are better this last 2 months and all due to the Niaspan. Without it, I think I can predict an increase. Considering my diet, the high TGs are not easy to understand. Prior to Niaspan my TGs 254. My doc did increase my omacor to 4,000 mg/day and the plant stanols to 3,000/day. I'll be taking 2.5 mg of Crestor/WEEK! I will begin to look into the other supplements on your advice. I already take multi's, B-complex, and folic and aspirin - which is why my doc feels the increasing c-Reactive Protein level so ominous. But we haven't looked into Vit D so I am still open to possible improvements. Finally, I am going to investigate going to a vegetarian diet. But I have reservations. I feel best on Atkins and control my weight better. I don't do well with carbs at all. I don't care for fish. I did a very low-fat diet for years and I was always hungry and always weak. But I'm trying to keep an open mind.
    HubbleRules - I appreciate the explanation for why the CoQ10 is spoken of so frequently here. I didn't know it was useful in preventing the muscle issues with statins. It's always an education on these boards. Many thanks. Suzy-Q

     
    Old 10-14-2007, 06:43 PM   #8
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    Re: Elevated hs-CRP- How Bad Is It?

    Quote:
    Originally Posted by Suzy-Q View Post
    ... My doc feels I can't overlook the significance of the high LDL and this CRP level. She thinks its a deadly combo no matter what is causing the inflammation. What do you think? ...
    CRP is an inflammation marker. It is only a problem if it is caused by inflammation of your artery linings and plaque is being laid down to fix it. It sounds like there could be other causes of the inflammation. How about having a heart scan done. You should be able to see what is happening to your arteries and whether you should be concerned.

    As far as the diet goes, saturated fat is not inflammatory. So how can that be the problem? Going on a vegetarian diet means that you will be getting most of your calories from carbs, which IMHO is not healthy. It sounds like you are doing very well on the Atkins diet. Don't let the doctor browbeat you ....

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    Last edited by Mark1e; 10-14-2007 at 06:49 PM.

     
    Old 10-14-2007, 07:17 PM   #9
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    Re: Elevated hs-CRP- How Bad Is It?

    Quote:
    Originally Posted by Mark1e View Post
    CRP is an inflammation marker. It is only a problem if it is caused by inflammation of your artery linings and plaque is being laid down to fix it. It sounds like there could be other causes of the inflammation. How about having a heart scan done. You should be able to see what is happening to your arteries and whether you should be concerned.

    As far as the diet goes, saturated fat is not inflammatory. So how can that be the problem? Going on a vegetarian diet means that you will be getting most of your calories from carbs, which IMHO is not healthy. It sounds like you are doing very well on the Atkins diet. Don't let the doctor browbeat you ....

    Mark
    Heart Scan would be the way to go if you can get one

     
    Old 10-15-2007, 09:34 AM   #10
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    Re: Elevated hs-CRP- How Bad Is It?

    Hi Mark, Hi Red,
    I'm due to have a repeat echo this winter so I'll ask about a heart scan then. My cardio was not at all concerned with my cholesterol numbers and never asked about them or mentioned them. I only saw him when I suddenly went into severe arrythmia (20 to 30K PVCs per day) a few months post-surgery and post-cortisone treatments. Out of the workup done at that time, I learned about the valvular insufficiency. But cardio wasn't very concerned at all. It was my GP that referred me to the lipidologist when my numbers continued to worsen over time.
    I agree that I shouldn't just toss out a diet and lifestyle that is working well for me. But doc tells me the guidance now says that a hs-CRP above 3.0 mg/L is an independent risk factor. I take that to mean that no matter what is causing the elevation - whether actual arteriosclerosis or some other cause - a high LDL will result in greater chance of arteriosclerosis and thus cardiac disease. I haven't read a thing that suggests what I can do to lower my hs-CRP since I am already taking 650 mg of aspirin and other anti-inflamms every day for my spinal conditions. Thus, I'm questioning if my only option is to go after the LDL. There's no doubt, I have a lot of saturated fat since I eat diary and plenty of meats.
    And Mark, I do wonder about your statement that saturated fats aren't inflammatory. If sat fats cause arteriosclerosis and arteriosclerosis in turn causes an elevated hs-CRP, isn't that the same as being inflammatory? At least, inflammatory to the arterial system? I'm sure there are complexities that I am unaware of. Anyway, I'm just thinkign outloud. I appreciate the discussion. Take care - Suzy-Q

     
    Old 10-16-2007, 05:06 AM   #11
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    Re: Elevated hs-CRP- How Bad Is It?

    Hello
    From what I have researched, hs-CRP is a strong risk factor and should be addressed. Also from my research I have learned that very low dose statins reduce the inflammation. This is done without visible impact or lowing of the LDL value. At this very low dose the risk of statin related problems are very low. My hs-CRP is very low and I practice this approach. I was surprised by the once a week approach your doctor recommended.

    Good luck

     
    Old 10-16-2007, 05:51 PM   #12
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    Re: Elevated hs-CRP- How Bad Is It?

    Hi Rig,
    I'm very glad to hear an endorsement of this plan. My doc is very aware of just how sick I was on the statins so I feel she'll not push the dosing up or insist upon my taking it if I do have symptoms.
    I, too, am reading plenty of stuff that indicates this high hs-CRP is nothing to scoff at. It's got my attention and that's a fact. Thanks for the input and take care - Suzy-Q

     
    Old 10-17-2007, 12:29 AM   #13
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    Re: Elevated hs-CRP- How Bad Is It?

    Quote:
    Originally Posted by Suzy-Q View Post
    ... Mark, I do wonder about your statement that saturated fats aren't inflammatory. If sat fats cause arteriosclerosis and arteriosclerosis in turn causes an elevated hs-CRP, isn't that the same as being inflammatory? ....
    How does saturated fat cause arteriosclerosis? That is a new one on me. It is not clear what causes the inflammation. One theory is that high insulin and cortisol levels are behind it. There are also numerous causes of oxidative stress that could be the culprits - smoke, pollution etc. If saturated fat caused inflammation and heart disease, the human race and carnivourous species would have surely become extinct long ago. Instead, they have risen to the top of the food chain.

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    Old 10-17-2007, 06:37 AM   #14
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    Re: Elevated hs-CRP- How Bad Is It?

    Hi Mark,
    I sure have an open mind and perhaps you are trying to force me to be more scientific? I have found no less than 13 scientific sources that link dietary saturated fats with relatively high blood cholesterol and specifically high LDL. In turn, saturated fats (and a high LDL) are named as a risk factor for CAD (caused by artherosclerosis) in many publications. High cholesterol (high LDL) is listed as a risk factor for CAD in every publication I have seen.
    I do appreciate the difference between a correlation and a cause. It is this that I am trying to assess. When do we cross over from saying that high LDL is a risk factor to a causitive factor?
    As for the species or human race, it's not really my issue. I've no agenda beyond my own health. Goodness knows I enjoy eating saturated fats but I won't lift a finger to defend them if I decide the science warrants a change in my diet. It's all rather complicated so i do truly appreciate the discussion. Take care - Suzy-Q

     
    Old 10-17-2007, 02:13 PM   #15
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    Re: Elevated hs-CRP- How Bad Is It?

    Suzy-Q,

    Quote:
    Originally Posted by Suzy-Q View Post
    .... I have found no less than 13 scientific sources that link dietary saturated fats with relatively high blood cholesterol and specifically high LDL. In turn, saturated fats (and a high LDL) are named as a risk factor for CAD (caused by artherosclerosis) in many publications. High cholesterol (high LDL) is listed as a risk factor for CAD in every publication I have seen....
    If you look for studies that support the sat. fat/cholesterol/heart disease idea you will find lots of them! This notion has become entrenched in contemporary conventional wisdom. But, interestingly, most believers have a limited understanding of the issue. Doctors, dieticians, Diabetes Educators and nurses, who dispense prolific amounts of fat phobic advice, typically don't really understand the science behind it. This is the nature of information cascades. See Gary Taubes new book, Good Calories, Bad Calories for a fascinating explanation of this phenomenon.

    Big business has jumped on the bandwagon too. The anti-fat/cholesterol position is now being backed by massive food and pharmaceutical industry vested interests. The statin business alone is worth over $30 billion a year. Most of the research you see has been funded by big pharma. So it is really not surprising that this myth is being perpetuated.

    Quote:
    Originally Posted by Suzy-Q View Post
    .... I do appreciate the difference between a correlation and a cause. It is this that I am trying to assess. When do we cross over from saying that high LDL is a risk factor to a causitive factor? ...
    You have hit the nail on the head there. Lots of claims are made about the link between saturated fat and heart disease. But causality, based on rigorous scientific method, has never been proved. All the hype surrounding this issue is essentially speculation, much of which is highly emotive. It is almost like a religion.

    Coming to an informed view on the issue requires looking at both sides of the arguement. Mary Enig, who is a highly respected academic at Maryland University, gives an insight into the science involved. Malcolm Kendrick does a good job dispelling the anti-fat myth, with references to the various studies that have been done on this. Gary Taubes' the award winning scientific journalist, pulls it all together in his New York Times article What if it's all been a Big Fat Lie? . A search on these names will give you lots of info.

    Quote:
    Originally Posted by Suzy-Q View Post
    .... As for the species or human race, it's not really my issue. I've no agenda beyond my own health. Goodness knows I enjoy eating saturated fats but I won't lift a finger to defend them if I decide the science warrants a change in my diet.
    Scientific method is supposed to be all about dis -proving hypotheses. If you can't disprove a hypothesis, it must be valid. It is interesting that the medical research community has taken the opposite approach with this one. Huge amounts of resources have been put into supporting the notion that fat is bad. And this is being masqueraded as "scientific evidence". I only mentioned the role saturated fat has played in our evolutionary past as this clearly disproves the hypothesis that eating fat is bad for us.

    By way of background, as a type 1 diabetic and under the advice of supposed medical experts, I persevered with the traditional high-carbohydrate diet for many years. My glycemic control continued to be problematic under this dietary regimen, and I eventually decided to look for alternatives. I soon discovered that a low-carb/high-fat diet worked much better for me. After researching the topic independently of my medical team, I concluded that a high saturated fat diet would be much healthier for me. I was heavily influenced by the work of Richard Bernstein, an endocrinologist with very non-mainstream ideas. He has been a type 1 diabetic for 60+ years and has been on a high fat diet for the last 30 of them. He has reversed all his diabetic complications and he has the lipid profile of an olympic champion.

    I have been eating this way for about 4 years and I am also getting very good results. My LDL of 152 is borderline high, but it has been like that for many years. My HDL of 81 is good, as is Triglycerides at 101. According to the numbers, my heart attack risk is lower than it has ever been. So, in spite of the repeated warnings from my medical team, I am not going to change anything. As they say in the classics, the proof of the pudding is in the eating!

    Mark
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    Last edited by Mark1e; 10-17-2007 at 02:29 PM.

     
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