Statin dilemma

BrianTheElder

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574
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I recently reported the shock news that my total cholesterol (TC) had shot up from 5.8 to 10.6 in the 4 months since I stopped taking statins. I retested and came up with the same score a week later.
My research showed that a small percentage of T2Ds on LCHF diets develop high cholesterol.
I therefore undertook a trial (n=1) by taking 10mg of atorvastatin daily and having a CT Scan on my heart.
The results of the 2-month trial are in - I have a coronary calcium score of 3, which is very low, but I also have non-stenotic (not narrowing) cholesterol plaques on my main heart arteries.
In the meantime, my TC has plummeted to 4.8! (non-HDL 3.3).
So, what to do? The heart guy wants me to increase my statins to 20mg daily to achieve a non-HDL of 2.5. However I have decided to continue with the 10mg dose to see if there are any further reductions in the pipeline before taking that step. I will have another blood test in a couple of months.
I am not looking for advice, I will continue with my n=1 trials, but I though some of you may be interested in the fact that cholesterol can get really high on a LCHF diet, and that statins are very effective in reducing cholesterol, for all their bad press.
As my heart guy says, there is no evidence of what happens when LCHFers have very high cholesterol in their arteries for an extended period, but he suspects it will not be good.
Meanwhile, my diabetes remains under control on diet only, with a HBA1c of 33.
 

Bluetit1802

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Good luck with your experiments. I hope it all works out for you.
 
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Ian_Laye

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I'm on a LCHF diet and my total Cholesterol levels are high but my unhealthy Triglycerides are low. Our bodies need Cholesterol. Not all Cholesterol is unhealthy. I was adamant that I would not take Statins when my Doctor offered them and I seem to be proven right.
 

BrianTheElder

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@BrianTheElder Good that they are investigating and not just fobbing you off. Well done on your continued excellent diabetes control :)
Thanks for your interest. Unfortunately, the NHS are not up to paying for this, despite the support of my GP. I have paid for the consultation, CT Scan and follow-up privately. I do get a lot of support from my wife, my GP, my heart specialist and this forum. I value the free support, but sometimes you have to pay to get what you feel is necessary in a realistic timescale.
 

bulkbiker

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19,576
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Great CAC scan results (mine was 40).. what did they say about the non-stenotic cholesterol plaques and how were they recognised? Was it noted by the radiologist or someone else?
 

Brunneria

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That is a great coronary calcium score!

And thanks for letting us know the results of your tests :)
 

ickihun

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My calcium scan was 19 and an invasive angiogram only showed mild heart disease. Phew! Cholestetol on lchf was 4.6 TC. Awaiting a new blood test for lclf diet.

Looks like chest pains were from insufficient vit d. Bone aches are far less now on 1000mg daily tablets.
 

douglas99

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I reversed my Type 2
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I'm on a LCHF diet and my total Cholesterol levels are high but my unhealthy Triglycerides are low. Our bodies need Cholesterol. Not all Cholesterol is unhealthy. I was adamant that I would not take Statins when my Doctor offered them and I seem to be proven right.
We all need food and water.
Too much of that will kill you as well as too little.
 

JoKalsbeek

Expert
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5,938
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I reversed my Type 2
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I quit the statines due to the side effects, and just stuck with the diet I devised with the help of a bunch of books (moderately low carb, low animal fat, dairy-free, and cholesterol-fighting, so with walnuts, blueberries and whatnot), and supplements like garlic and milkthistle. Without the statins my cholesterol (the bad kind) only went up a fraction from what it was on statins. Still have to sort out how to get the good cholesterol up a little though. But, one step at a time eh. Have to tackle my thyroid first. No idea if the walnut/berries/supplements might help, but I think they did pretty well for me.
 

JohnEGreen

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Where is the dilemma I in your position would listen to my heart specialist despite my reservations about statins.
 
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BrianTheElder

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574
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Great CAC scan results (mine was 40).. what did they say about the non-stenotic cholesterol plaques and how were they recognised? Was it noted by the radiologist or someone else?
The consultant commented that the modern scanners get lots of frames/minute and so they get multiple x-sections to view in moving 3D images. It is the consultant that reviews the images, but the technicians seem to do the calcium score. The cholesterol shows up a 'slicks' at main artery bifurcations, possibly caused by turbulent flow. His concern is that when the slicks move, this causes lesions. I have read alternative views that the cholesterol gathers where there is already inflammation and it is the scabs over the lesions moving that cause the heart problems. It is quite sobering to know that these things are there and a real incentive to reduce them. But I keep coming back to; what is so bad about high cholesterol? Early days on this and LCHF, I think.
 

BrianTheElder

Well-Known Member
Messages
574
Type of diabetes
Type 2
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I'm on a LCHF diet and my total Cholesterol levels are high but my unhealthy Triglycerides are low. Our bodies need Cholesterol. Not all Cholesterol is unhealthy. I was adamant that I would not take Statins when my Doctor offered them and I seem to be proven right.
I am just like you, completely opposed to statins. The problem is that a small percentage of people on LCHF react and get very high cholesterol. It is then a decision between the lesser of two evils. By continuing with LCHF I am protecting my heart in the best possible way; the statins are an unfortunate result. I could just ignore the cholesterol, but at these levels, there is no data, only a general concern.
 

BrianTheElder

Well-Known Member
Messages
574
Type of diabetes
Type 2
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Diet only
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Snide people
Where is the dilemma I in your position would listen to my heart specialist despite my reservations about statins.
Thanks. It is a dilemma because I am so opposed to statins. However, I have resolved my dilemma as explained. I have done exactly what you advise, but it took some thought.
 

bulkbiker

BANNED
Messages
19,576
Type of diabetes
Type 2
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But I keep coming back to; what is so bad about high cholesterol?
Me too.. I think there is still a huge amount to be discovered here.. we are still mainly in the dark about how it all fits together. I was at a recent talk by Dr Kendrick where he was suggesting a similar mechanism for the covering of existing inflammation lesions causing the narrowing of the arteries. Something like (i'm paraphrasing badly) when you cut yourself you get a scab on the outside of your skin which falls off. When you have a tear on the inside of an artery the last thing you want is the scab to come off and get into the blood stream so the body covers over the scab stopping it from becoming detached and causing problems further down the system. Inflammation causes the problems cholesterol is the repair mechanism which is trying to cure them. That's way to simplistic an explanation and even he said it was very theoretical but seems to make sense.
 

lindisfel

Expert
Messages
5,659
I recently reported the shock news that my total cholesterol (TC) had shot up from 5.8 to 10.6 in the 4 months since I stopped taking statins. I retested and came up with the same score a week later.
My research showed that a small percentage of T2Ds on LCHF diets develop high cholesterol.
I therefore undertook a trial (n=1) by taking 10mg of atorvastatin daily and having a CT Scan on my heart.
The results of the 2-month trial are in - I have a coronary calcium score of 3, which is very low, but I also have non-stenotic (not narrowing) cholesterol plaques on my main heart arteries.
In the meantime, my TC has plummeted to 4.8! (non-HDL 3.3).
So, what to do? The heart guy wants me to increase my statins to 20mg daily to achieve a non-HDL of 2.5. However I have decided to continue with the 10mg dose to see if there are any further reductions in the pipeline before taking that step. I will have another blood test in a couple of months.
I am not looking for advice, I will continue with my n=1 trials, but I though some of you may be interested in the fact that cholesterol can get really high on a LCHF diet, and that statins are very effective in reducing cholesterol, for all their bad press.
As my heart guy says, there is no evidence of what happens when LCHFers have very high cholesterol in their arteries for an extended period, but he suspects it will not be good.
Meanwhile, my diabetes remains under control on diet only, with a HBA1c of 33.
Even Prof Sakaris , often
referred to in a scientific discussion on lipids said patients with your condition, Brian, should be on statins. D.
 

douglas99

Well-Known Member
Messages
4,572
Type of diabetes
I reversed my Type 2
Treatment type
Other
Me too.. I think there is still a huge amount to be discovered here.. we are still mainly in the dark about how it all fits together. I was at a recent talk by Dr Kendrick where he was suggesting a similar mechanism for the covering of existing inflammation lesions causing the narrowing of the arteries. Something like (i'm paraphrasing badly) when you cut yourself you get a scab on the outside of your skin which falls off. When you have a tear on the inside of an artery the last thing you want is the scab to come off and get into the blood stream so the body covers over the scab stopping it from becoming detached and causing problems further down the system. Inflammation causes the problems cholesterol is the repair mechanism which is trying to cure them. That's way to simplistic an explanation and even he said it was very theoretical but seems to make sense.

He didn't realise a scab is mainly dried blood?
You don't got scabs that can detach in a blood vessel, because the blood can't dry out, and all the reasons the rest of the scab is made, (to keep germs out, to keep white blood cells in etc), don't exist

I would be more worried the high cholesterol would become detached, or close the blood vessel entirely, and the even biggest lump of cholesterol causes an ischemic stroke.