3

votes

Doctor wants to put me on statins - 24 y.o. male (Updated with VAP Results)

Answered on September 12, 2014
Created January 08, 2013 at 8:56 PM

Update: VAP results below

Age: 24 years old

Sex: Male

Height: 6'0"

Weight: 165 lbs

Total Cholesterol: 367 mg/dL

HDL: 73 mg/dL

Cholesterol/HDL Ratio: 5.03

VLDL: 10 mg/dL

LDL: 284 mg/dL

Triglycerides: 52 mg/dL

My doctor was VERY concerned about my extremely high total cholesterol and LDL (the highest she's ever seen). I mentioned to her that LDL particle size is what matters, but she thinks LDL is too high for it to be mostly fluffy, buoyant particles. She says I should start taking statins ASAP.

My diet is pretty much Perfect Health Diet. I get sufficient exercise and was in a fasted state for all tests. Based on my late dad's results, as seen below, it's very clear he was at risk for a heart attack. What should I do if it is Familial Hypercholesterolemia? I refuse to take statins.

Here are some of my other test results:

CBC WITH PLATELET AND DIFFERENTIAL:

WBC: 4.3 K/uL

Red Blood Cell Count (RBC): 5.27 M/mm3

Hemoglobin (Hgb): 15.7 gm/dL

Hematrocrit (HCT): 47.5%

MCV: 90.2 fL

MCH: 29.8 pg

MCHC: 33.0 g/dL

RDW: 14.4%

Platelet Count: 145 K/cumm

DIFFERENTIAL AUTOMATED

Neutrophils: 57%

Lymphocytes: 34%

Monocytes: 8%

Eosinophils: 1%

Basophils: 0%

COMPREHENSIVE METABOLIC PANEL (CMP)

Sodium: 138 mEq/L

Potassium: 4.1 mEq/L

Chloride: 101 mEq/L

CO2: 28 mEq/L

Glucose: 95 mg/dL

BUN: 15 mg/dL

Creatinine: 1.1 mg/dL

Calcium: 9.7 mg/dL

Protein: 6.9 g/dL

Albumin: 4.7 g/dL

Alkaline Phosphatase: 50 IU/L

ALT (SGPT): 30 IU/L

AST (SGOT): 27 IU/L

Bilirubin, Total: 0.7 mg/dL

GLOMERULAR FILTRATION RATE

GFR/Black: >60 ml/min/1.73m2

GFR/White: >60 ml/min/1.73m2

OTHER

C-Reactive Protein (CRP): <0.5 mg/dL

Thyroxine (T4): 7.2 ug/dL

TSH: 2.66 mU/L

Vitamin D 25-Hydroxy: 26.8 ng/mL

My late dad's cholesterol numbers before medication:

Total Cholesterol: 313 mg/dL

Triglycerides: 431 mg/dL

HDL: 40 mg/dL

LDL: Unable to be calculated because Triglycerides number was so high

Here are my VAP results:

alt text

Should I be concerned about my numbers, even though the LDL particles seem to be mostly of the large, buoyant variety?

32123f4f25bdf6a7b70c9c2a719386ed

(396)

on January 14, 2013
at 08:10 PM

Your TSH is a little high....I would look into this as a cause of your high cholesterol. You should have Free T4, Free T3 and Reverse T3 done before considering any other course of action. Also antibodies to see if you have an autoimmune thyroid problem developing.

B3173217a49b5b0116078775a17eb21d

(11488)

on January 10, 2013
at 07:56 PM

Hmmm, not sure, some of them thoughtlessly "follow the company line" and are unable to think idependently. The statin pushers and those that prescribe high-carb diets to diabetics are among the worst.

De267f213b375efca5da07890e5efc25

(3747)

on January 10, 2013
at 05:37 PM

I don't always agree with the opinions of doctors but try to keep in mind that most of the time they are giving you an honest of opinion. The ones you should fear are the ones who will give you what they think you want to hear. That's where antibiotics and cat scans come into play.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on January 10, 2013
at 03:13 PM

Geez, not just awful, but god-awful! Your HDL/trig ratio is great, your LDL isn't that high. Get a second opinion, check for familial hypercholesterolemia.

8f2d9842fdfec224a425c0f77c4ee34d

(1241)

on January 10, 2013
at 02:18 PM

My doctor said that because my LDL was so high, change in diet and exercise would in fact not be enough, so I shouldn't even bother with it.

7fc82eebafd44badc73c520f44660150

(3275)

on January 09, 2013
at 09:44 PM

I thought fish oil lowered triglycerides, not LDL. Please confirm.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on January 09, 2013
at 08:05 PM

I didn't think statins were first line of care for elevated blood lipids... after all every lipitor commercial seems to say "when diet and exercise aren't enough..."

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 09, 2013
at 04:25 PM

I agree, of course, but until the standard of care is changed, unfortunately all the docs just have to "CYA." If they *don't* prescribe a statin and something happens... (But then again, it seems like patients have no recourse when they *do* go on a statin and *still* have a cardiac event. *Sigh.*)

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 09, 2013
at 04:24 PM

And remember: just because a doctor writes a prescription doesn't mean you have to get it filled! (I'm not telling you to ignore your doc, just pointing out that *you* are the customer, and it's *your* body. You are employing him, not the other way around.)

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 09, 2013
at 04:21 PM

Good to hear you're getting the VAP. I wouldn't worry too much until you know more details about the breakdown of the LDL particles. And comparing your dad's #s and yours, your TGs are way lower, and your HDL is higher -- both very good signs. Dr. Thomas Dayspring did an encore podcast with Jimmy Moore on 12/31. Worth listening to -- so much of what we think we know about cholesterol -- even LDL particle size -- is misleading. (You can get it free on iTunes of here's a link.) http://www.thelivinlowcarbshow.com/shownotes/7177/635-encore-week-2013-dr-thomas-dayspring/

8f2d9842fdfec224a425c0f77c4ee34d

(1241)

on January 09, 2013
at 03:55 PM

Thanks for all of the replies! I have placed an order for the VAP test and will report back the results in a few days.

8f2d9842fdfec224a425c0f77c4ee34d

(1241)

on January 09, 2013
at 03:29 PM

Thanks for giving a place where I can get the tests. I purchased the VAP from Directlabs for $98.

4a3611b0503cbc5ee14d8d1d566c7f44

(124)

on January 08, 2013
at 09:57 PM

Good point about thyroid issues causing elevated cholesterol. My LDL and triglycerides were extremely high before I was diagnosed and treated for autoimmune hypothyroidism.

4a3611b0503cbc5ee14d8d1d566c7f44

(124)

on January 08, 2013
at 09:53 PM

Ken, Dan just asked for recommendations for where he can order a VAP test, so that would suggest that he has not had one done yet. Also, he stated that he was following the Perfect Health Diet and getting sufficient exercise. Please don't be in such a hurry to help, that you forget to read the entire question.

56bc750affa41124e1142a6e8e239e3d

(145)

on January 08, 2013
at 09:29 PM

Those look like my numbers! My VAP looks pretty good, and I feel good. My doc tried to prescribe them and then keeps upping the dose even though I tell her I'm not taking them because of my own research and the good HDL/TG ratio, particle size, etc. I've also had issues with statins and muscle/tendon weakness. Not fun!

0a819d945f30ae46a104d7a14e50e739

(105)

on January 08, 2013
at 09:22 PM

Get retested, make sure you have fasted. Couldn't hurt.

197651282ddd8d675b974ee811d2269e

(1836)

on January 08, 2013
at 09:19 PM

Interestingly enough, your trigs is low!

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on January 08, 2013
at 09:07 PM

He can only do it, if you allow it.

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19 Answers

best answer

10
3491e51730101b18724dc57c86601173

(8395)

on January 08, 2013
at 09:09 PM

I just read The Great Cholesterol Myth by Bowden and Sinatra. They believe that the only people who should be on statins are men under 65 who have already had one cardiovascular event.

You are not in that category, but there are some other things to consider:
1. Do you have familial hypercholesterolemia? If so, you need to be seeing a lipidologist, hopefully one on board about the paleo diet. 2. Have you had a full thyroid panel? Thyroid issues can elevate LDL. But the standard panel is inadequate. And even when the standard panel shows there may be a problem (TSH over 3.0) many primary care doctors don't recognize it because the lab norms say TSH can be normal up to 5.0. So they'll tell you your thyroid is normal when it is NOT.
3. Have you had other tests to measure your relative risk like a VAP or NMR? Heart scan and test of your arterial diameters and flexibility (sorry I can't think of the name of the test at the moment). If all the other risks are low, how much does the LDL number mean? Bowden and Sinatra say LDL-C alone is pretty meaningless--you have to look at the whole person.

4a3611b0503cbc5ee14d8d1d566c7f44

(124)

on January 08, 2013
at 09:57 PM

Good point about thyroid issues causing elevated cholesterol. My LDL and triglycerides were extremely high before I was diagnosed and treated for autoimmune hypothyroidism.

8
B3173217a49b5b0116078775a17eb21d

(11488)

on January 08, 2013
at 10:07 PM

Tell her to fuck off.

De267f213b375efca5da07890e5efc25

(3747)

on January 10, 2013
at 05:37 PM

I don't always agree with the opinions of doctors but try to keep in mind that most of the time they are giving you an honest of opinion. The ones you should fear are the ones who will give you what they think you want to hear. That's where antibiotics and cat scans come into play.

B3173217a49b5b0116078775a17eb21d

(11488)

on January 10, 2013
at 07:56 PM

Hmmm, not sure, some of them thoughtlessly "follow the company line" and are unable to think idependently. The statin pushers and those that prescribe high-carb diets to diabetics are among the worst.

6
0b73cdbd0cb68aeeda14dafeebb2f828

on January 09, 2013
at 08:48 PM

Many of the beneficial effects of statins are also provided by MAGNESIUM.

Most of us don't get the Recommended daily intake for magnesium and the magnesium RDA is not an optimal intake but the MINIMUM for good health.

This paper explains the science "Comparison of Mechanism and Functional Effects of Magnesium and Statin Pharmaceuticals" http://www.jacn.org/content/23/5/501S.long It concludes "Both statins and normal Magnesium levels prevent clotting, reduce inflammation and prevent atherosclerotic plaques, but statins raise liver enzymes, can cause myopathy and have many other side effects, whereas Mg supplements tend to protect against myopathy and have temporary diarrhea or mild GI distress as the only side effect."

No one has a NATURAL STATIN DEFICIENCY state but most of us, because of changes in plant breeding and fertilizer use, have less magnesium in our diets than 50 yrs ago. More here Magnesium: Novel Applications in Cardiovascular Disease http://content.karger.com/produktedb/produkte.asp?DOI=000339380&typ=pdf

In conjunction with correcting magnesium deficiency by restoring a natural magnesium status

We should all consider improving Vitamin D3 status. We see from "Cardiovascular disease, statins and vitamin D". http://www.ncbi.nlm.nih.gov/pubmed/22398934

Many of the "pleiotropic effects of statins may be attributable to the vitamin D effect" and it is reasonable to ask "Are statins analogues of vitamin D?" http://www.ncbi.nlm.nih.gov/pubmed/16815382

Birmingham NHS path lab, CITYASSAYS offer postal vitamin D testing for ??25 (??20 if you bulk buy and share with family friends) and this link takes you to a chart that explains how much more additional vitamin D you may require daily based on your weight.

https://www.dropbox.com/s/gaks6lm0z4fmta3/chart-serum-level-intake-5-by-3-ngmla-both-charts-single.pdf

One of the important actions of statins is their anti-inflammatory action. Vitamin D3 is most effective as a natural anti-inflammatory agent at 125nmol/l (50ng/ml) How Vitamin D Inhibits Inflammation http://www.sciencedaily.com/releases/2012/02/120223103920.htm

Do bear in mind "Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l." = 46ng/ml If we lived as human DNA evolved our vitamin d levels would naturally increase with age and while pregnant/breast feeding, Human milk is only Vitamin D replete at natural levels around 50ng/ml 125nmol/l. Attaining and maintaining a natural vitamin D level throughout the year reduces our risk of infection and improves our ability to resolve stress induced inflammation. Vitamin D3 works more efficiently in conjunction with omega 3 DHA and magnesium.

Another cheap and effective strategy to reduce Vldl, LDL while increasing HDL is to use the supplement TAURINE.

Taurine and atherosclerosis. http://link.springer.com/content/pdf/10.1007%2Fs00726-012-1432-6

Cardioprotective effects of cysteine alone or in combination with taurine in diabetes http://www.biomed.cas.cz/physiolres/pdf/prepress/932388.pdf

The effect of taurine on cholesterol metabolism. http://www.ncbi.nlm.nih.gov/pubmed/22648615 "The elevated plasma cholesterol level, in particular, LDL cholesterol is regarded as an important risk factor for the development of atherosclerosis and coronary artery disease. A number of studies provide the evidence that taurine has the efficient action to reduce plasma and liver cholesterol concentrations, especially to decrease VLDL and LDL cholesterol in hypercholesterolemia animal induced by high cholesterol diet. Cholesterol lowering effect of taurine is actually involved in the regulatory mechanism of cholesterol and bile acid homeostasis that mediated by CYP7A1, which has become a biomarker for cholesterol metabolism and itself is also regulated by several factors and nuclear receptors. This review summarizes the change of cholesterol concentration in metabolism observed in feeding studies of hypercholesterolemia animal dealing with taurine, and then, addresses the possible metabolic and molecular mechanisms of cholesterol lowering effect by taurine in three aspects, cholesterol clearance from blood circulation, bioconversion of cholesterol to bile acid in liver, and excretion of cholesterol and bile acid from intestine."

For those interested in reading the full text of above paper this link downloads a copy https://www.dropbox.com/s/39i35oegqgiiwpn/taurine%20cholesterol%20lowering.pdf

Do bear in mind that it took a long time to get to your current state of health and correcting magnesium, omega 3, vitamin D and taurine levels also takes time. Using EFFECTIVE amounts of Vitamin D3 daily will take 3~5 months to reach 125nmol/l and similar time scales for the others but the benefits start to accrue within days. I've put a sample of Taurine research papers at this link if you want to look into the benefits of taurine in more detail.

TAURINE Improving Mitochondrial function, lipid profile exercise performance. http://www.theharcombedietclub.com/forum/showthread.php?16620-TAURINE-Improving-Mitochondrial-function-lipid-profile-exercise-performance

4
32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on January 08, 2013
at 10:38 PM

First suggestion is statins? What an awful doctor.

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on January 09, 2013
at 04:25 PM

I agree, of course, but until the standard of care is changed, unfortunately all the docs just have to "CYA." If they *don't* prescribe a statin and something happens... (But then again, it seems like patients have no recourse when they *do* go on a statin and *still* have a cardiac event. *Sigh.*)

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on January 09, 2013
at 08:05 PM

I didn't think statins were first line of care for elevated blood lipids... after all every lipitor commercial seems to say "when diet and exercise aren't enough..."

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on January 10, 2013
at 03:13 PM

Geez, not just awful, but god-awful! Your HDL/trig ratio is great, your LDL isn't that high. Get a second opinion, check for familial hypercholesterolemia.

8f2d9842fdfec224a425c0f77c4ee34d

(1241)

on January 10, 2013
at 02:18 PM

My doctor said that because my LDL was so high, change in diet and exercise would in fact not be enough, so I shouldn't even bother with it.

4
7f8bc7ce5c34aae50408d31812c839b0

(2698)

on January 08, 2013
at 09:18 PM

It can't hurt to make sure you are not deficient in certain micronurients like choline, selenium, and copper which a lack of can cause high LDL. Check out here for more info: http://perfecthealthdiet.com/category/biomarkers/hdlldlcholesterol/

3
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on January 08, 2013
at 08:59 PM

I recommend that you get a VAP panel and find out what your LDL actually is and not go on medication based on a cheap, but flawed algorithm.

2
Bdb603fa3b1e2761c98047260f34b0e8

(94)

on January 09, 2013
at 02:57 AM

Here are three online sources to get the NMR Lipoprofile test done for around $127 and VAP test for $145:

http://www.privatemdlabs.com

http://www.directlabs.com

Edit: Found third source for NMR Lipoprofile test at $69

http://www.mdlabtests.com/md087428-nmr-lipoprofile.html

8f2d9842fdfec224a425c0f77c4ee34d

(1241)

on January 09, 2013
at 03:29 PM

Thanks for giving a place where I can get the tests. I purchased the VAP from Directlabs for $98.

2
A45af235ed4dd0b4f548c59e91b75763

(1936)

on January 08, 2013
at 10:41 PM

Just a shot in the dark, but what about having it checked again? Could it be a bogus test result? I think I would make sure I was properly fasted, rested, and try the test again. Can't hurt.

2
E753cf7753e7be889ca68b1a4203483f

on January 08, 2013
at 09:22 PM

If you don't suffer from hypothyroidism or any other condition that can explain the elevated LDL count, my best guess would be that you have FH. Personally I would be avoiding statins. Hypothyroidism can be the result of a low carb diet, but not every low carber suffers from it.

1
6714718e2245e5190017d643a7614157

on January 09, 2013
at 04:13 AM

Normally, Dr Oz is not a good source of info but he had a couple of good guests on his show in December who set Dr Oz straight on the subject of cholesterol.

Research indicates that people with high cholesterol tend to live longer than people with low cholesterol.

http://www.youtube.com/watch?v=swrKkwlnSnI

1
29a7bdf79a6f87f63b92e6e061ac7db9

on January 08, 2013
at 09:47 PM

can you give some more info? like your weight and height? what is a typical day of eating like for you? When was your blood test in relation to your last meal. I would ask you doctor to consider another test before putting you on medication.

0
D60a36346ff1078f083edcdfbf199ab9

on January 16, 2013
at 10:41 PM

"My doctor was VERY concerned....."

I think that's a great starting point. Work with your doctor and make the best informed decision that you can, bearing in mind all of the good information available.

0
D067765bedd689f6373739334ec473df

on January 14, 2013
at 07:58 PM

I would get re-tested and get a new doctor.

0
24a0a0d5073f0a77c3737ef9d0e4c426

on January 10, 2013
at 07:41 AM

I would be careful taking medical advice from diet books and people that read diet books. It's all good information but your situation is different then any one else's. like a lot of posters here have said there are lots of causes and different interpretations of tests.

Also, I do believe in self testing but be warned that many docs will not even consider your testing and this can leave you in a very stressful place.

If you're not happy with the diagnosis or suggested treatment, get a doc that works better for you.

Cheers.

0
96440612cf0fcf366bf5ad8f776fca84

(19463)

on January 09, 2013
at 11:06 AM

Well, you know, it is an economic recession/depression right now, and as the printing presses are running at full speed, busy inflating the US$ to catch up to Zimbabwean dollar, because, after all it is a race.

So can you really blame your doctor for trying to make a few extra dollars courtesy of big pharma? After all, they have medical school bills to pay, and all sorts of malpractice insurance, rent, etc. While doctors may have a huge income on the surface, they have huge bills as well.

Of course, you should fire your doctor immediately, on principle, but beyond that, your LDL does seem a bit high in relation to your HDL, so you'll want to raise your HDL by consuming good fats such as grassfed butter, ghee, egg yolks, avocado, bacon, real EVOO, etc.

Get checked for hypothyroid (or Hashimotos) and familial hypercholesterolemia, of course, but even then, look for non-statin treatment. Certainly B6, folate, betaine HCL, iodine, will be useful here. (If it's Hashimotos, avoid the iodine.)

0
4961307265e904dfe7154572821d8894

on January 08, 2013
at 09:28 PM

Are you taking a high quality fish oil? Made from sardines and anchovies? That's the first thing you should do if you're not. I don't think anyone should ever use statin drugs. If you are eating a primal diet maybe the next step would be to make sure you're only eating grass fed meats. Cholesterol isn't a good indicator of overall health, I think sugar is usually the culprit in most cardiovascular disease.

7fc82eebafd44badc73c520f44660150

(3275)

on January 09, 2013
at 09:44 PM

I thought fish oil lowered triglycerides, not LDL. Please confirm.

0
3846a3b61bc9051e4baebdef62e58c52

(18635)

on January 08, 2013
at 09:06 PM

Your doctor might be right. Those numbers are very high. I'd check for familial hypercholesterolemia for one thing.

0
744342f7ec832d8be55df79dbc067ebd

(76)

on January 08, 2013
at 08:58 PM

Did you have a VAP done that tells you what the partical size is? Are you eating paleo, primal, etc.? Do you exercise?

4a3611b0503cbc5ee14d8d1d566c7f44

(124)

on January 08, 2013
at 09:53 PM

Ken, Dan just asked for recommendations for where he can order a VAP test, so that would suggest that he has not had one done yet. Also, he stated that he was following the Perfect Health Diet and getting sufficient exercise. Please don't be in such a hurry to help, that you forget to read the entire question.

-1
D8eb01c4eed9c2fe05b915d1d798d50e

on January 17, 2013
at 12:41 AM

This is a seriously bad lipid panel. Why not make an n=1 experiment and try a low-fat vegetarian diet for three months? Get yourself tested and see what happens.

I am NOT a vegetarian mole. I do think that you are being misled by bad information and that your situation is serious enough to warrant a re-think. Why not give it a try? If it doesn't result in a better lipid panel, go back to Paleo.

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