7

votes

Why is it cool to get bad lipid panels?

Answered on August 19, 2014
Created January 03, 2012 at 4:28 AM

Seems there are alot of "Lol I scared my doctor with my test results" posts around here.

Could it be possible that paleo dogma is supplanting common sense when it comes to interpreting these established measures of health?

03fa485bfd54734522755f47a5e6597e

(3944)

on January 05, 2012
at 01:10 PM

.... So the expanding use of statins is a pretty big controversy in medicine today. Even staid, mainstream Wikipedia gives both sides of the debate on its statins page. It would be hard to do even a 'quick google' about heart disease without running across the statin debate. If you don't even know what statins are, then I would respectfully suggest that you aren't in a very good position to know how much doctors -- or dedicated amateurs -- know about the latest research on health.

03fa485bfd54734522755f47a5e6597e

(3944)

on January 05, 2012
at 01:03 PM

Statins are, depending on whom you ask, either A) a great medical discovery which lowers cholesterol and (or doesn't, but in some unknown way) reduces heart disease and attacks, and should be given to everyone over the age of 40 or so who shows any CHD risk factors, and quite possibly put in the water; or B) an outrageously over-prescribed, dangerous drug that's making heaps of money for Big Pharma while causing health problems for people who had no real risk of CHD in the first place, and possibly killing more people than it saves....

03fa485bfd54734522755f47a5e6597e

(3944)

on January 05, 2012
at 12:46 PM

If you think the cholesterol hypothesis is actual science, then naturally you'll think it's whack. My whole point is that I don't. I see the same driving forces behind both: hope (we shouldn't use animals for food; events in our lives must have some larger purpose), bad logic (heart attack victims have high cholesterol, so B must have caused A; the stars are huge, so they must have some effect), and innumeracy (one study that cherry-picked from certain nations showed a correlation; my sister's neighbor's psychic totally predicted she'd get that job). No science needed.

9f54852ea376e8e416356f547611e052

(2957)

on January 05, 2012
at 10:00 AM

Thanks for the clarification. Still, putting astrology in the same bucket as actual science - no matter how bad - is whack.

03fa485bfd54734522755f47a5e6597e

(3944)

on January 04, 2012
at 04:41 PM

No, I compared the *belief* in the cholesterol hypothesis to astrology. A whole bunch of people believe something is true simply because a lot of other people believe it, and for no other reason. The closest thing the cholesterol hypothesis has to proof is some correlation in weak studies, and plenty of people will insist they observe correlation between their horoscopes and reality. Sure, I'm exaggerating to make a point, but it's still a decent analogy.

6120c989fd5b69f42a0834b69b87955b

(24553)

on January 04, 2012
at 11:22 AM

It sounds like continuing education for doctors in Europe is less corrupt than it is here in the states. Sadly, most of what doctors encounter in their post grad education comes from sources with a profit motive here, be it drug company funded "studies" or direct presentations from drug reps at conferences or even in their own offices. Very high cholesterol numbers do seem to indicate something unusual is likely happening, but it may be a sign of healing rather than a disease risk factor. From what I've discovered talking to my doctors is that they were not aware there could be a difference.

9f54852ea376e8e416356f547611e052

(2957)

on January 04, 2012
at 11:02 AM

Did you just compare medicine and/or medical practicioners to astrology? And people are voting this up? FFS this is getting ridiculous (maybe it was like this here all along, haven't been here for that long).

9f54852ea376e8e416356f547611e052

(2957)

on January 04, 2012
at 11:00 AM

Oh, and neither of my assumptions were incorrect. Well, at least here in Europe you DO need years and years of research to become a doctor, and I would bet a significant sum of money that the vast majority of people on this board have done less than "a few hours" of research on lipid panels.

9f54852ea376e8e416356f547611e052

(2957)

on January 04, 2012
at 11:00 AM

Oh, and neither of my assumptions were incorrect. Well, at least here in Europe you DO need years and years of research, and I would bet a significant sum of money that the vast majority of people on this board have done less than "a few hours" of research on lipid panels.

9f54852ea376e8e416356f547611e052

(2957)

on January 04, 2012
at 10:58 AM

Aaron, my comment was not directed at anyone in particular, but I've seen definite signs of hubris in some of the omglol commentary going on here. I don't even know what statins are, but I'm just concerned that some people might be putting their health in jeopardy by doing a quick google on LDL and deciding there's nothing to be worried about based on a blog post from someone with no actual credentials, or more than a cursory understanding of the matter.

100fd85230060e754fc13394eee6d6f1

(18706)

on January 03, 2012
at 07:48 PM

This is exactly it. Your total is perfectly normal. Your HDL/Trig is about the best I've ever heard of (mine was close at 94/38) For a doctor to be freaked out is the ultimate irony.

Cf32992bfa1907147c7cdc451bba9c63

(2890)

on January 03, 2012
at 05:24 PM

I haven't got mine tested in a couple years, but it was ~50HDL, ~50LDL, ~30Tri. This means I won't ever die right?

9d43f6873107e17ca4d1a5055aa7a2ad

on January 03, 2012
at 04:46 PM

http://paleohacks.com/questions/25606/who-here-has-normal-cholesterol#axzz1iM4vYv6z

03fa485bfd54734522755f47a5e6597e

(3944)

on January 03, 2012
at 04:01 PM

Wisper, you've made two incorrect assumptions: first, that most doctors "spend years and years studying and researching health"; and second, that people here have only spent a few hours. I can't speak for anyone else, but I've spent well over a thousand hours researching and discussing this stuff over the past decade or so, which is far more time than most doctors. And that's not even really a criticism -- they're busy trying to alleviate symptoms all day, so they don't have the time to invest in re-educating themselves about subjects that their professors told them they were good on.

8949bf87b0e0aefcad10f29975e4fa2b

(8989)

on January 03, 2012
at 03:19 PM

Whisper, what I don't like is when some docs spend a lifetime reading all the same things.

8949bf87b0e0aefcad10f29975e4fa2b

(8989)

on January 03, 2012
at 03:17 PM

+1 for the trigs

E34fbfa1bca9ae970c9c7313bf9de9f8

(1436)

on January 03, 2012
at 02:25 PM

+1 - context matters.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on January 03, 2012
at 01:46 PM

Paleo folks like to be contrarian.

8c64b1560bc8cb67f8276b70de8537c7

(170)

on January 03, 2012
at 01:17 PM

I'm reminded of Twain's saying: "if you are a cynic before the age of 48, you know too much. If are not a cynic by the age of 48, you know too little." I think many of us have done more than a mere google search on the lipid hypothesis. My doctor is befuddled when I talk about vldl and hdl:triglyceride ratio. I am healthier NOT deferring to authority. I can point to a number of examples of people I've known who had bad medical outcomes by not understanding their medical conditions and deferring to their doctors. Doctors are a resource, not an authority.

1d0497f8781845ab371b479455bfee8e

(11157)

on January 03, 2012
at 11:56 AM

My friend is a doctor. He even told me that docs hand out statin prescriptions at the drop of a hat, even if the patient doesn't really need them. He doesn't agree with the practice, but admits that it's widespread because it's so easy. Getting people to change their diet and lifestyle is hard. Writing an Rx is easy.

9f54852ea376e8e416356f547611e052

(2957)

on January 03, 2012
at 10:59 AM

I'm glad someone asked this, been wondering about it myself.

9f54852ea376e8e416356f547611e052

(2957)

on January 03, 2012
at 10:58 AM

So let me get this straight: lipid panel interpretation is "well over the top of the heads" of people who spend years and years studying and researching health, and then spend their entire careers keeping up-to-date and their patients healthy. And then someone who has spent a few hours googling lipid panels comes here going "haa haa my cholesterol made my physician pass out tee hee" (not necessarily talking about you). Now THAT'S what I call hubris. I'm just utterly flabbergasted and disgusted.

A64ed062eb5e2c3407122fcf16c5de6b

(715)

on January 03, 2012
at 08:56 AM

Too bad these "established measures" are being perverted so everyone need more statins. Babies that are breastfed for 6 months end up with about 200 total cholesterol. Should we give them statins? The applied medical practice around cholesterol values is pretty poor. I do agree that hubris should only be engaged in when you are very sure of yourself.

Cf32992bfa1907147c7cdc451bba9c63

(2890)

on January 03, 2012
at 04:32 AM

I mean: You're being illogical. I suspect a leaky gut + gluten hypocretins have affected your interleukin mesoneurons. The only cure is a bacon fast.

Cf32992bfa1907147c7cdc451bba9c63

(2890)

on January 03, 2012
at 04:31 AM

Yes. It's hubris.

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7 Answers

13
0d2dec01a5ed9363a9915e111ae13f7e

on January 03, 2012
at 04:45 AM

But some of the Doctors are so "under-informed"! My doc saw a total cholesterol of 220 and was writing a 'scrip for statins. This is with an HDL over 100, trigs under 35, and c-reactive protein that was "not measurable"..... so yes, it is fun to have such a doctor shocked and in horror that my TC went from 180 to 220.....

100fd85230060e754fc13394eee6d6f1

(18706)

on January 03, 2012
at 07:48 PM

This is exactly it. Your total is perfectly normal. Your HDL/Trig is about the best I've ever heard of (mine was close at 94/38) For a doctor to be freaked out is the ultimate irony.

8949bf87b0e0aefcad10f29975e4fa2b

(8989)

on January 03, 2012
at 03:17 PM

+1 for the trigs

9
Medium avatar

(19479)

on January 03, 2012
at 01:11 PM

A physician friend and I were discussing cholesterol a few weeks ago and we shared similar viewpoints regarding the importance of discerning between different lipoprotein fractions rather than taking the position that "TC below 200 is good" and "TC above 200 is bad".

We also agreed that a cholesterol reading higher than the currently accepted "healthy" level absent elevated blood sugar, blood pressure, and other markers of metabolic disease is likely not a reason for concern.

This is not to say that cholesterol results should be disregarded. I am of the opinion that extremely elevated levels are like the "canary in the coal mine" and indicate some underlying issue whether it be nutrient deficiency, inflammation, etc.

There is, however, a clear economic incentive for pharmaceutical companies to "educate" doctors about the benefits of widespread statin prescriptions and this is evidenced by the fact that they are one of the most widely used, and profitable, products in recent history. It would be naive to think otherwise.

E34fbfa1bca9ae970c9c7313bf9de9f8

(1436)

on January 03, 2012
at 02:25 PM

+1 - context matters.

5
6120c989fd5b69f42a0834b69b87955b

(24553)

on January 03, 2012
at 04:44 AM

I believe it to be an equal part gallows humor for those who fear high cholesterol numbers, and mocking the entire concept for those who don't believe in the lipid hypothesis at all.

In my opinion it may established, but what to make of the numbers and what they really mean is well over the heads of the average physician who has been educated about cholesterol primarily by statin sales reps.

1d0497f8781845ab371b479455bfee8e

(11157)

on January 03, 2012
at 11:56 AM

My friend is a doctor. He even told me that docs hand out statin prescriptions at the drop of a hat, even if the patient doesn't really need them. He doesn't agree with the practice, but admits that it's widespread because it's so easy. Getting people to change their diet and lifestyle is hard. Writing an Rx is easy.

8c64b1560bc8cb67f8276b70de8537c7

(170)

on January 03, 2012
at 01:17 PM

I'm reminded of Twain's saying: "if you are a cynic before the age of 48, you know too much. If are not a cynic by the age of 48, you know too little." I think many of us have done more than a mere google search on the lipid hypothesis. My doctor is befuddled when I talk about vldl and hdl:triglyceride ratio. I am healthier NOT deferring to authority. I can point to a number of examples of people I've known who had bad medical outcomes by not understanding their medical conditions and deferring to their doctors. Doctors are a resource, not an authority.

9f54852ea376e8e416356f547611e052

(2957)

on January 03, 2012
at 10:58 AM

So let me get this straight: lipid panel interpretation is "well over the top of the heads" of people who spend years and years studying and researching health, and then spend their entire careers keeping up-to-date and their patients healthy. And then someone who has spent a few hours googling lipid panels comes here going "haa haa my cholesterol made my physician pass out tee hee" (not necessarily talking about you). Now THAT'S what I call hubris. I'm just utterly flabbergasted and disgusted.

8949bf87b0e0aefcad10f29975e4fa2b

(8989)

on January 03, 2012
at 03:19 PM

Whisper, what I don't like is when some docs spend a lifetime reading all the same things.

9f54852ea376e8e416356f547611e052

(2957)

on January 04, 2012
at 11:00 AM

Oh, and neither of my assumptions were incorrect. Well, at least here in Europe you DO need years and years of research to become a doctor, and I would bet a significant sum of money that the vast majority of people on this board have done less than "a few hours" of research on lipid panels.

03fa485bfd54734522755f47a5e6597e

(3944)

on January 03, 2012
at 04:01 PM

Wisper, you've made two incorrect assumptions: first, that most doctors "spend years and years studying and researching health"; and second, that people here have only spent a few hours. I can't speak for anyone else, but I've spent well over a thousand hours researching and discussing this stuff over the past decade or so, which is far more time than most doctors. And that's not even really a criticism -- they're busy trying to alleviate symptoms all day, so they don't have the time to invest in re-educating themselves about subjects that their professors told them they were good on.

03fa485bfd54734522755f47a5e6597e

(3944)

on January 05, 2012
at 01:10 PM

.... So the expanding use of statins is a pretty big controversy in medicine today. Even staid, mainstream Wikipedia gives both sides of the debate on its statins page. It would be hard to do even a 'quick google' about heart disease without running across the statin debate. If you don't even know what statins are, then I would respectfully suggest that you aren't in a very good position to know how much doctors -- or dedicated amateurs -- know about the latest research on health.

9f54852ea376e8e416356f547611e052

(2957)

on January 04, 2012
at 11:00 AM

Oh, and neither of my assumptions were incorrect. Well, at least here in Europe you DO need years and years of research, and I would bet a significant sum of money that the vast majority of people on this board have done less than "a few hours" of research on lipid panels.

6120c989fd5b69f42a0834b69b87955b

(24553)

on January 04, 2012
at 11:22 AM

It sounds like continuing education for doctors in Europe is less corrupt than it is here in the states. Sadly, most of what doctors encounter in their post grad education comes from sources with a profit motive here, be it drug company funded "studies" or direct presentations from drug reps at conferences or even in their own offices. Very high cholesterol numbers do seem to indicate something unusual is likely happening, but it may be a sign of healing rather than a disease risk factor. From what I've discovered talking to my doctors is that they were not aware there could be a difference.

9f54852ea376e8e416356f547611e052

(2957)

on January 04, 2012
at 10:58 AM

Aaron, my comment was not directed at anyone in particular, but I've seen definite signs of hubris in some of the omglol commentary going on here. I don't even know what statins are, but I'm just concerned that some people might be putting their health in jeopardy by doing a quick google on LDL and deciding there's nothing to be worried about based on a blog post from someone with no actual credentials, or more than a cursory understanding of the matter.

03fa485bfd54734522755f47a5e6597e

(3944)

on January 05, 2012
at 01:03 PM

Statins are, depending on whom you ask, either A) a great medical discovery which lowers cholesterol and (or doesn't, but in some unknown way) reduces heart disease and attacks, and should be given to everyone over the age of 40 or so who shows any CHD risk factors, and quite possibly put in the water; or B) an outrageously over-prescribed, dangerous drug that's making heaps of money for Big Pharma while causing health problems for people who had no real risk of CHD in the first place, and possibly killing more people than it saves....

3
9d43f6873107e17ca4d1a5055aa7a2ad

on January 03, 2012
at 05:01 PM

I asked if there were people out there with "normal" panels last year http://paleohacks.com/questions/25606/who-here-has-normal-cholesterol#axzz1iM4vYv6z

Turns out there are a lot of us. It seems like a lot of the people with numbers that would make your average doc's head explode are kind of new to the diet. I'd be curious if their numbers are a little more normal after a few years for the reasons outlined by Masterjohn here. The panel I posted in that thread was after doing ancestral-type diets for three years when systems have healed and malnutrition has been abated.

3
03fa485bfd54734522755f47a5e6597e

(3944)

on January 03, 2012
at 04:09 PM

You're loading the question by saying these are "established measures of health." The whole point is that they haven't been established by science, but by poor logic and peer pressure, and some of us don't consider them to be measures of health at all.

Many people, maybe a majority, believe in astrology, carry something around for luck, forward chain letters, or put real credence in other kinds of magical thinking. If I go outside on a day my horoscope said to stay home, and intentionally walk under a ladder and step on a crack in the sidewalk, is that hubris?

9f54852ea376e8e416356f547611e052

(2957)

on January 04, 2012
at 11:02 AM

Did you just compare medicine and/or medical practicioners to astrology? And people are voting this up? FFS this is getting ridiculous (maybe it was like this here all along, haven't been here for that long).

9f54852ea376e8e416356f547611e052

(2957)

on January 05, 2012
at 10:00 AM

Thanks for the clarification. Still, putting astrology in the same bucket as actual science - no matter how bad - is whack.

03fa485bfd54734522755f47a5e6597e

(3944)

on January 04, 2012
at 04:41 PM

No, I compared the *belief* in the cholesterol hypothesis to astrology. A whole bunch of people believe something is true simply because a lot of other people believe it, and for no other reason. The closest thing the cholesterol hypothesis has to proof is some correlation in weak studies, and plenty of people will insist they observe correlation between their horoscopes and reality. Sure, I'm exaggerating to make a point, but it's still a decent analogy.

03fa485bfd54734522755f47a5e6597e

(3944)

on January 05, 2012
at 12:46 PM

If you think the cholesterol hypothesis is actual science, then naturally you'll think it's whack. My whole point is that I don't. I see the same driving forces behind both: hope (we shouldn't use animals for food; events in our lives must have some larger purpose), bad logic (heart attack victims have high cholesterol, so B must have caused A; the stars are huge, so they must have some effect), and innumeracy (one study that cherry-picked from certain nations showed a correlation; my sister's neighbor's psychic totally predicted she'd get that job). No science needed.

3
Cd61bdabc3cc5fad501cefa0d19c663e

on January 03, 2012
at 03:45 PM

You use the term "common sense" in an ironic manner in your question.

I think the whole idea with the Paleo diet is that it's a response to this type of "common sense" thinking that has led our country down a steep path of chronic disease and malnutrition.

As far as medical practice goes, it's slowly becoming apparent to many physicians that total cholesterol is a useless number when determining someone's health status. So if your doctor tries to prescribe statins based on your total cholesterol being higher than 200, because that's what they were taught in medical school 15+ years ago, then I'd say the doctor's advice should be disregarded.

Laughing about disregarding your doctor's advice may be haughty and unnecessary. Being educated about blood lipid results and following the most current scientific recommendations rather than blindly following one doctor's prescription is simply proactive.

As a final thought, most doctors are not adequately educated in nutrition:

"Researchers from the University of North Carolina at Chapel Hill asked nutrition educators from more than 100 medical schools to describe the nutrition instruction offered to their students. While the researchers learned that almost all schools require exposure to nutrition, only about a quarter offered the recommended 25 hours of instruction, a decrease from six years earlier, when almost 40 percent of schools met the minimum recommendations. In addition, four schools offered nutrition optionally, and one school offered nothing at all. And while a majority of medical schools tended to intersperse lectures on nutrition in standard, required courses, like biochemistry or physiology, only a quarter of the schools managed to have a single course dedicated to the topic."

http://www.nytimes.com/2010/09/16/health/16chen.html?_r=2&ref=health

0
778b36f4f699f202de135ef176fe9ab7

on January 03, 2012
at 03:13 PM

I have heard through various sources within the medical community that doctors also get bonuses or kickbacks from drug companies if they reach a certain quota on prescriptions. For example, one such kickback I was told about when I was pregnant and contemplating the flu shot was that doctors receive large bonusus from the drug companies if they reach a certain number of doses. I'm not saying that every doctor is like this, but I definately believe that the doctors work more for the big drug companies than they do for us. My nephew had drainage, so they gave me an antibiotic. Really? Doesn't make sense to me... My family never gets the flu shot. Maybe someday we will suffer for it, but as of now, I believe that feeding my family a balanced diet, getting enough sleep, and generally taking good care of our selves will reep better benefits than taking vaccinations and prescription drugs. My children are 2 1/2 and 4 1/2. Neither have ever had a serious illness and I can count on one hand how many times the two of them combined have been given any kind of prescription drug. I do regular vaccinations, like MMR and TB, but no additionals, like flu shots. It's just my personal opinion, but I think that a lot of doctors make it their business to scare the shi*t out of people so they will sign up for a long list of prescription drugs...

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