4

votes

Appropriateness of statins for 21 year old?

Answered on August 19, 2014
Created May 08, 2010 at 7:39 AM

I'm twenty one years old, lean and six months paleo. After a blood test which yielded:

Total Cholesterol - 250 Triglycerides - 53 HDL - 62 LDL - 174

My GP prescribed Crestor and advised that I would have to take it to reduce my cholesterol. She advised that cardiovascular disease was inevitable if I did not do so. I asked about alternatives and she said that it must be genetic and as such there were none.

I would love another take on the numbers from the paleo community, opinions on possible alternatives and some insight into the potential downsides of statins at my age. Links for further reading for myself or my GP would be much appreciated.

Thanks in advance.

EDIT: Typically I eat a great deal of kangaroo, eggs, pastured lamb, butter and cream. With staple veggies being pumpkin, carrots, zucchini, cabbage and mushrooms. No nuts or fruit. Little bit of Greek yogurt.

Medium avatar

(39821)

on August 31, 2011
at 07:13 PM

I couldn't say which number would be better or worse, but some people may have to, at least temporarily, lower their cholesterol for insurance purposes or whatever.

11838116de44ae449df0563f09bd3d73

(655)

on August 31, 2011
at 06:48 PM

I'd take the slightly worse number with the butter and cream :)

11838116de44ae449df0563f09bd3d73

(655)

on August 31, 2011
at 06:47 PM

niacin as a statin replacement is not necessarily harmless. I see no need for him to improve his numbers, as it's not really well understood what those numbers mean.

Medium avatar

(19479)

on August 31, 2011
at 06:36 PM

Plus one for a common sense and non-alarmist response.

Medium avatar

(19479)

on August 31, 2011
at 06:36 PM

Agreed and upvoted for use of the word "malpractice" in reference to the dangerous, unwarranted, and unproven prescription of statin drugs to a (likely) perfectly healthy 21 yr old.

F4d04667059bc682540fdfd8b40f13a7

on August 31, 2011
at 06:45 AM

Judging by the kangaroo, I guess you're in Australia? There are a few Paleo doctors based over here, got to be worth a second opinion!

C56baa1b4f39839c018180bf63226f7d

(3499)

on August 31, 2011
at 06:11 AM

Hear hear. As a person with TC ~=250, the cholesterol paranoia rampant in the medical community offends me greatly.

77732bf6bf2b8a360f523ef87c3b7523

(6157)

on May 10, 2010
at 02:04 AM

Find a new doctor....

93f44e8673d3ea2294cce085ebc96e13

(10502)

on May 09, 2010
at 02:26 AM

@Tim Fleming -- My 2 cents: Stay the fuck away from statins. :) PS Check out how Richard of Free the Animal analyzed my cholesterol levels here: http://freetheanimal.com/2009/03/nmr-lipoprofile.html

Be23b9ccd6bb9226c94501ed4bea0ee3

on May 08, 2010
at 11:04 AM

As above - been paleo six months Matthew. Edited in what I eat for clarity.

0bc6cbb653cdc5e82400f6da920f11eb

(19245)

on May 08, 2010
at 10:13 AM

Could you add what foods you are currently eating and for how long you have been eating paleo?

Be23b9ccd6bb9226c94501ed4bea0ee3

on May 08, 2010
at 08:23 AM

Fairly sure the LDL was not measured as it was a just general bloods and the name on the test was HDL. I asked about particle size and she didn't seem to know what I was talking about.

Be23b9ccd6bb9226c94501ed4bea0ee3

on May 08, 2010
at 08:22 AM

Fairly sure the LDL was not as it was a just general bloods and the name on the test was HDL. I asked about particle size and she didn't seem to know what I was talking about.

1f70da0b737e9c6e7679a248f4228a01

on May 08, 2010
at 08:11 AM

Is the LDL count actually measured, or just calculated? If measured, was the particle size considered?

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11 Answers

13
5db563a5c94e73644be798fd16101cb8

on May 09, 2010
at 02:53 PM

ABSOLUTELY NOT!

There is nothing wrong with your numbers, as others have pointed out. Total LDL cholesterol is not a risk factor for cholesterol. Period. Anyone who is relatively current with the research can tell you that.

The primary risk factors in terms of lipids are small, dense LDL, high triglycerides (TG), and low HDL. Your TG are low-ish and your HDL is high-ish. When TG are low and HDL are high, we almost always see large, buoyant LDL (instead of small, dense LDL). If you really want to get this tested for peace-of-mind, order the VAP test. It will tell you whether you are Pattern B (small, dense LDL) or Pattern A (large, buoyant LDL). You don't need a doctor's order - you can get it yourself.

Here's the kicker. The recommendations made by doctors and the AHA actually increase the risk factors for heart disease. A low-fat, high carbohydrate diet 1) increases TG, 2) increases small, dense LDL, 3) decreases HDL. Nice, huh? On the other hand, a low-carb diet high in saturated fats 1) decreases TG, 2) decreases small, dense LDL and 3) increases HDL. So stick with paleo and you'll be fine! Read my article The Most Important Thing You Probably Don't Know About Cholesterol for more on this.

If you're still not convinced, you (and your doctor, for crying out loud) should know that statins have never been shown to reduce mortality for primary prevention patients. What does that mean? It means that statins don't reduce the risk of death for people who have no pre-existing heart disease.

It's absolute insanity for someone your age, with your numbers, to take a statin. I agree with Howard: this should be considered malpractice.

I have an entire series of articles on my blog addressing this issue, including this article on the truth about statins.

10
431274eafd914ee34d9c57262c1f617a

on May 08, 2010
at 02:44 PM

With those numbers, I wouldn't take statins! (disclaimer, I wouldn't take them under any circumstances!).

Your high HDL and low triglycerides are what should have meaning. Your HDL is well into the "beneficial" range....and your low triglycerides indicate your LDL is almost certainly large and fluffy.

Dr Eades also has some excellent posts on cholesterol numbers.

And remember this. Statins are not a short-term fix! Once you start them it is almost certain you will be on them for life! At 21 that's a lot of years of taking a drug that will artificially lower essential cholesterol (you need it for hormone production and cell maintenance among other things!)....and has the added danger of damaging your liver and destroying your muscles...and remember, your heart is a muscle!

6
485bcefe7f1f7a6df1a293a826bf6137

on May 08, 2010
at 07:57 PM

I would call it malpractice. At age 21 this is insanity. Your diet sounds great. Just keep eating that way and have your blood checked in another 6 months.

Medium avatar

(19479)

on August 31, 2011
at 06:36 PM

Agreed and upvoted for use of the word "malpractice" in reference to the dangerous, unwarranted, and unproven prescription of statin drugs to a (likely) perfectly healthy 21 yr old.

6
58a55f0986b8f49a8bc5666e10492569

on May 08, 2010
at 02:04 PM

Only 30 years ago, a total cholesterol level of 250 was considered perfectly fine. What's changed since then? I see no science, only a need to expand the market for cholesterol lowering drugs.

I try to be more cynical, but I just can't keep up.

-- Lily Tomlin

C56baa1b4f39839c018180bf63226f7d

(3499)

on August 31, 2011
at 06:11 AM

Hear hear. As a person with TC ~=250, the cholesterol paranoia rampant in the medical community offends me greatly.

6
Da9d20766ee0c96026244fd4afc26695

(90)

on May 08, 2010
at 01:42 PM

A lot of people think that it's the triglyceride to HDL ratio that's more important, and that it should be less than 2 (yours is under 1). With the numbers you have, it tends to indicate that the LDL portions are the good fluffy ones. Also, when TG are a lot less than 100, the formula that they use to calculate LDL is off.

This page http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm shows your LDL using the Iranian equation to be 143.

In any case, there is a growing consensus that total cholesterol is not a causal factor for anything. Given your great HDL and Trig, if I were you, I would not go on a statin.

O primitivo at http://www.canibaisereis.com/ did a really good post about a year ago showing country level data on cholesterol showing that the best levels in terms of total mortality for TC was between 200 and 250.

Good luck, Tony K

5
6426d61a13689f8f651164b10f121d64

(11478)

on May 08, 2010
at 02:28 PM

Statins are way-overprescribed. Your GP probably doesn't know the indications for statins, which are either someone with a previous heart attack, someone with known heart disease, or someone with multiple risk factors, such as family history, smoking and high blood pressure. Do you have those risk factors? She did get the male under 65 part right. Dr. Eades has an extensive archive on statins in his blog (among many other issues): http://www.proteinpower.com/drmike/category/statins/ .

Your lipid profile is probably not high risk, but you could get your LDL particle sizes checked to be sure.

If you want more insurance, you can improve your lipid profile further by taking niacin and fish oils.

Finally, get your vitamin D level checked if you haven't already. Vitamin D deficiency is a common risk factor for heart disease: http://articles.latimes.com/2010/mar/15/science/la-sci-vitamind16-2010mar16

11838116de44ae449df0563f09bd3d73

(655)

on August 31, 2011
at 06:47 PM

niacin as a statin replacement is not necessarily harmless. I see no need for him to improve his numbers, as it's not really well understood what those numbers mean.

4
1f70da0b737e9c6e7679a248f4228a01

on May 08, 2010
at 08:14 AM

Mercola has a good page of links regarding the dangers of statins - I sent this to my Uncle who had numbers like yours, and he stopped the drug, started eating paleo, and three months later his numbers were excellent. You're already eating paleo, so I'm not sure what your first steps would be - but from what I've read, there's no good reason to take statins since they seem to kill more people than they help...

3
25b139cc1954456d9ea469e40f984cd3

on August 31, 2011
at 05:36 AM

You need a new doctor.

Remember, YOU hire THEM. They work for YOU.

Google is your friend. Finding a good doctor should not be difficult in all but the most unusual circumstances.

2
Medium avatar

on August 31, 2011
at 06:27 PM

As mentioned, that's a terrible doctor with a terrible prescription. Your cholesterol is likely fine, however if you'd like to lower your cholesterol without drugs, just stop eating butter and cream.

11838116de44ae449df0563f09bd3d73

(655)

on August 31, 2011
at 06:48 PM

I'd take the slightly worse number with the butter and cream :)

Medium avatar

(19479)

on August 31, 2011
at 06:36 PM

Plus one for a common sense and non-alarmist response.

Medium avatar

(39821)

on August 31, 2011
at 07:13 PM

I couldn't say which number would be better or worse, but some people may have to, at least temporarily, lower their cholesterol for insurance purposes or whatever.

2
C56baa1b4f39839c018180bf63226f7d

on August 31, 2011
at 06:02 AM

DON'T DO IT. DON'T DO IT. DON'T DO IT.

I repeat.

DON'T DO IT.

As Dr. Eades points out with regularity, people who are in your demographic (male, under 65, no history of heart disease) receive no benefit from statin use, regardless of their cholesterol levels.

My lab values are similar to yours, though I'm 31 now and not 21, but I wouldn't let a statin nor red rice yeast (which some doctors will try to convince you to take if you resist the statin Rx because it has a naturally occurring statin) near me, and my opinion on it is this: at this stage of my life, I would not willingly pay money to risk damaging my mitochondria and my brain, in order to get an inaccurate lab value to a point where it increases my risk of dying from a heart attack, if I get a heart attack, which I likely won't.

Your TRIG is under 100, which means that your LDL isn't being correctly calculated by the Friedewald equation. Your LDL is probably closer to 160 [EDIT: 143 like e4e said in another answer] with a higher VLDL than expected, which is fine. Your TRIG/HDL is less than 1, which is stellar. This alone is an indicator that you're unlikely to have arterial plaque building up. If you are still concerned, get a VAP test on your blood from Atherolabs to find out your LDL particle size. Large fluffy LDL particles protect you from heart disease.

In case I wasn't clear at the top of this answer,

DON'T DO IT.

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