Latest Dr's review....statins!

michita

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Well I knew it was coming! I'd had my latest blood test results, h1bac was 39 (perfectly happy with that) but after going low carb and moderate fat for 6 weeks, my cholesterol had risen. It's now a total of 8.9, (HDL 2.45, trigs 0.9, LDL 6.3). It had been around 7 previously with the same HDL & trigs. The Dr took one look and immediately wrote out a prescription for statins, not even the lowest dose but a mega dose of 40mg!

I spoke to him at length about it and pointed out my ratio which is still good and the trigs and HDL which are good. But no, he said 'We need to get that LDL down so that your total cholesterol is under 5'. WHAT?, under 5? It's never been under 5 and recent lipid tests show that my lipoprotein A (a lipo that is rarely checked) is higher than a 'normal' persons anyway meaning that no matter what I may eat or how perfect my lifestyle might be, it ain't never going to be under 5.

I know that it's my choice of course and even now I'm not going to take them but I will admit to a moment where I thought if I don't the Dr made me feel as though I was going to drop from a stroke or heart attack.

For context, I am slim, active, don't smoke or drink so to be fair he didn't bother giving me the old 'lifestyle' advice. Now I'm wondering whether to go back to a slightly higher carb diet (was on around 80 - 100) instead of sticking with the around 50 carbs. My priority is always going to be my glucose levels but although I know high cholesterol isn't the baddie they make it out to be, I do seem to be able to lower my LDL when eating a few more carbs.

I know most type 2s on here are different in that they have to low carb if they want to achieve good glucose levels but I do have the option of going a bit higher in carbs by utilising insulin. I dunno, you get one thing right and then your body decides to adjust by going into overdrive with another!

Thanks for listening!

I have similar numbers to yours. My highest was TC 9.7 (trig 0.8 HDL 3.15 LDL 6.2). Recently I had 2 separate tests done from same day bloods TC was 8.4 for one and the other 7.7. A bit higher than previous one maybe because I ate lots of chorizos night before...? Very low trig and high HDL.

Before low carbing (high carb) TC 4.5 trig 0.5 Hdl 2.1 ldl 2.2.

Not on statin and not worried.
 

michita

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479
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Type 1
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By the way, I was offered statin by my GP some time ago. I said I didn’t want to take it and since then statin has not been mentioned to me. Recently I had an appointment with Gp nurse and I was surprised to see on their computer screen my repeat prescription included statin which I didn’t even know.
 

Bluetit1802

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No difference to 75% of the population.
'However, in some people, high-cholesterol foods do cause a rise in blood cholesterol. These people make up about 25% of the population and are often referred to as "hyperresponders." This tendency is considered to be genetic'
https://www.ncbi.nlm.nih.gov/pubmed/9430080
https://www.ncbi.nlm.nih.gov/pubmed/16596800
https://www.healthline.com/nutrition/dietary-cholesterol-does-not-matter#section3

But I read those links as saying that hyperresponders also have higher HDL levels, which counteract the higher LDL, and dietary cholesterol makes an insignificant difference.
 

KK123

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I believe it can take about 6 mths lchf to bring down cholesterol levels, because the body needs to adjust. Statins will mess up your bs levels too.

Hi Dawn, thanks for replying. I was low carb but not high fat which is what made me wonder whether it was the lack of carbs per se that made my cholesterol go up.
 

ert

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But I read those links as saying that hyperresponders also have higher HDL levels, which counteract the higher LDL,

Unfortunately, the GP’s also look at total cholesterol. And I just didn’t want to ignore their advice. I have seen the research on HDL levels and mime were always excellent, but I wasn't comfortable running around with a total cholesterol of 10. It was easier to modify my diet.
 
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Cocosilk

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It sounds like you can approach your cholesterol in two ways. Since you know you have higher Lipoprotein a, you could "experiment" (under the supervision of an open-minded doctor) with something like Niacin. But do watch out for side effects.

"Niacin can lower Lp(a) in some patients by up to 30 percent. However, niacin can have serious side effects, so should only be taken with the supervision of a doctor." https://www.athero.org.au/fh/lipoproteina/

Otherwise, tackle your total cholesterol (and LDL) by experimenting with diet. It sounds like you don't eat much food containing cholesterol so maybe one of the other methods mentioned by the others in this thread would be more appropriate.

It seems that many (who can tolerate a few extra carbs) do have some success at lowering their cholesterol by introducing a few extra carbs. You'd have to be selective not to upset your blood glucose levels. Maybe those eating low to moderate carb on this forum can recommend some foods that they have tested their blood glucose reactions to.

I've seen some say they have had success lowering LDL (and total cholesterol) by eating a cup of steel cut oats each day. I thought I would try but it does seem to raise my blood glucose a little higher than I like.

Then there are so many other things from carob powder to psyllium husks that supposedly lower cholesterol. And of course fish oil and monounsaturated fats (which you would be already getting from olive oil, but macadamia nuts are another good source). This article talks about lipids (including saturated fat) and their affects on cholesterol. https://openheart.bmj.com/content/5/2/e000871

And then you might simply join Dave Feldman's followers on his FB page called "LMHR" and be excited to have such high cholesterol levels with good ratios. Although the Lipoprotein a is still the problem, isn't it?

And it seems that statins do nothing to reduce Lipoprotein a. It also doesn't sound like they increase anyone's life expectancy by much either. And they seem to be dished out as frequently as lollies are to children...

If you did have a CAC or a CIMT (Carotid artery scan) and found significant blockages, then I guess a statin might be more tempting if it acts faster than dietary changes, but if Dave Feldman's research shows anything, it's that you can change your cholesterol levels within days with extreme dietary measures so I think statins are for those who don't have any other information about how they might alter their cholesterol levels and just do what their doctors tell them.

Luckily you won't be going Low Fat High Carb because that doesn't seem to help one bit http://www.jlr.org/content/early/2010/08/16/jlr.M005769.full.pdf

Here's yet another article:
"...other investigators have reported an increase in Lp(a) levels in individuals after they reduced their saturated fat intake. Monounsaturated fats also seem to reduce Lp(a) levels, as shown by a study that reported a significant decrease in Lp(a) levels in individuals whose diets were supplemented with almonds."
https://www.docsopinion.com/health-and-nutrition/lipids/lipoprotein-a/
 
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KK123

Well-Known Member
Messages
3,967
Type of diabetes
Type 1
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It sounds like you can approach your cholesterol in two ways. Since you know you have higher Lipoprotein a, you could "experiment" (under the supervision of an open-minded doctor) with something like Niacin. But do watch out for side effects.

"Niacin can lower Lp(a) in some patients by up to 30 percent. However, niacin can have serious side effects, so should only be taken with the supervision of a doctor." https://www.athero.org.au/fh/lipoproteina/

Otherwise, tackle your total cholesterol (and LDL) by experimenting with diet. It sounds like you don't eat much food containing cholesterol so maybe one of the other methods mentioned by the others in this thread would be more appropriate.

It seems that many (who can tolerate a few extra carbs) do have some success at lowering their cholesterol by introducing a few extra carbs. You'd have to be selective not to upset your blood glucose levels. Maybe those eating low to moderate carb on this forum can recommend some foods that they have tested their blood glucose reactions to.

I've seen some say they have had success lowering LDL (and total cholesterol) by eating a cup of steel cut oats each day. I thought I would try but it does seem to raise my blood glucose a little higher than I like.

Then there are so many other things from carob powder to psyllium husks that supposedly lower cholesterol. And of course fish oil and monounsaturated fats (which you would be already getting from olive oil, but macadamia nuts are another good source). This article talks about lipids (including saturated fat) and their affects on cholesterol.

https://openheart.bmj.com/content/5/2/e000871




And then you might simply join Dave Feldman's followers on his FB page called "LMHR" and be excited to have such high cholesterol levels with good ratios. Although the Lipoprotein a is still the problem, isn't it?

And it seems that statins do nothing to reduce Lipoprotein a. It also doesn't sound like they increase anyone's life expectancy by much either. And they seem to be dished out as frequently as lollies are to children...

If you did have a CAC or a CIMT (Carotid artery scan) and found significant blockages, then I guess a statin might be more tempting if it acts faster than dietary changes, but if Dave Feldman's research shows anything, it's that you can change your cholesterol levels within days with extreme dietary measures so I think statins are for those who don't have any other information about how they might alter their cholesterol levels and just do what their doctors tell them.

Luckily you won't be going Low Fat High Carb because that doesn't seem to help one bit http://www.jlr.org/content/early/2010/08/16/jlr.M005769.full.pdf

Here's yet another article:
"...other investigators have reported an increase in Lp(a) levels in individuals after they reduced their saturated fat intake. Monounsaturated fats also seem to reduce Lp(a) levels, as shown by a study that reported a significant decrease in Lp(a) levels in individuals whose diets were supplemented with almonds."
https://www.docsopinion.com/health-and-nutrition/lipids/lipoprotein-a/


Hi Cocosilk, thank you for such an informative reply. My diet pretty much follows the same each day; nothing until around 3pm when I might eat low fat greek yogurt and a few berries (I know! but I just can't bring myself to eat high fat), then around 6/7pm my main meal is mainly veg (sometimes root veg and sometimes above ground) and fresh salmon or very occasionally a steak or Bolognese sauce). For 'snacks' and mainly to keep from dropping weight I have nuts (probably too many), and 30g of cheese a day. That is pretty much it, probably once a fortnight I will have something like tinned salmon and chickpeas or beans. I rarely take novarapid since goingvery low carb and take 10 lantus each evening so I know that if I up my carbs to around 100, I can cope with keeping my levels steady with an extra unit or two of insulin. I really would not mind if I was still around 7 total cholesterol but I don't like it sitting at 9 even though it seems like my HDL compensates for it. It's the genetic factor that concerns me more, I know for other people higher cholesterol is 'healthy' for them but I have the added 'risk' of that pesky lipoprotein A which they say is high risk in and of itself for strokes etc. Everything else about me is pretty much spot on. I will look at those links, thank you.
 
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Cocosilk

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Hi Cocosilk, thank you for such an informative reply. My diet pretty much follows the same each day; nothing until around 3pm when I might eat low fat greek yogurt and a few berries (I know! but I just can't bring myself to eat high fat), then around 6/7pm my main meal is mainly veg (sometimes root veg and sometimes above ground) and fresh salmon or very occasionally a steak or Bolognese sauce). For 'snacks' and mainly to keep from dropping weight I have nuts (probably too many), and 30g of cheese a day. That is pretty much it, probably once a fortnight I will have something like tinned salmon and chickpeas or beans. I rarely take novarapid since goingvery low carb and take 10 lantus each evening so I know that if I up my carbs to around 100, I can cope with keeping my levels steady with an extra unit or two of insulin. I really would not mind if I was still around 7 total cholesterol but I don't like it sitting at 9 even though it seems like my HDL compensates for it. It's the genetic factor that concerns me more, I know for other people higher cholesterol is 'healthy' for them but I have the added 'risk' of that pesky lipoprotein A which they say is high risk in and of itself for strokes etc. Everything else about me is pretty much spot on. I will look at those links, thank you.

If you are Type 1, does that mean your insulin sensitivity is not necessarily compromised as it always is with Type 2? If so, then provided you dose your insulin appropriately, you should be fine to add a few extra carbs if you wanted to try that, shouldn't you? But you are not eating grains, are you?

Your diet sounds more like what I should do so I can lose weight. I'm breastfeeding and struggled along with keto, now more low carb and even testing moderate carb. My cholesterol levels were measured at 8 weeks postpartum and I have since read that it was a bit early after a c-section, but also elevated cholesterol is normal while breastfeeding as well. My numbers were very similar to yours (TC 8.7 / LDL 5.5 / HDL 2.89 / Trigs 0.7) and my silly doctor would have had me quit breastfeeding my 8 week old baby so I could take a statin... But I'm also wondering which part of my diet to tweak to maybe see if I can bring it down a bit myself. I haven't checked what levels of Lipoprotein a I might have yet. Nor levels of small dense LDL.

I'm eating a little differently from you. Can't fast for as long but I eat breakfast late, 10:30 or 11:30am. Usually 2 eggs (was 3 while pregnant!), cheese, sauerkraut, avocado. Today I added a chicken liver and a few slices of a European semi-dried sausage. Sometimes I have bacon. On certain days I'll have a slice of my husband's sourdough rye or spelt bread too. I wanted to quit grains but I keep going back and forth with his bread. It doesn't spike my blood sugar as high as other breads so I still lean towards that as a carb if I want to have a few extra carbs in my diet.

I do eat fatty red meats, chicken with skin on, lard (my husband makes ours), or I just eat the drippings from our roasted pork bellies, liver when I can get it, salmon most weeks, tinned tuna and sardines in between, and vegetables, including lentils and chickpeas, and salads as sides or a late evening meal. My husband (a Serb by the way) brings home ox tongues and lamb hearts and makes soups, which I also have. Chicken hearts are a new favourite actually. And chicken liver pate. Tofu and tempeh sometimes. Miso soup with seaweed. Tiny amounts of Basmati rice here and there. My husband has just started making sauerkraut and I love it! And I drink tea, coffee with cream, carob and cocoa on full cream milk or warmed milk with a square of dark chocolate melted through it... Mmm

Snacks are nuts (too many as well), cheese, full fat yoghurt (husband also makes yoghurt), goat's milk I drink, and I have the odd bite of a banana. Just experimented with making jelly using a wild berry tea (no sweeteners) and serving it with raspberries and cream. I clearly eat too much! ha ha I also end up nibbling on and off through the day and into the late evening, which is bad, but happens because I get interrupted by baby or one of my other 2 small kids. I just hope the breastfeeding uses up some of it but I still have weight to lose after this last pregnancy.

Let us know what you end up trying and if it does have any affect on your cholesterol levels!
 

KK123

Well-Known Member
Messages
3,967
Type of diabetes
Type 1
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If you are Type 1, does that mean your insulin sensitivity is not necessarily compromised as it always is with Type 2? If so, then provided you dose your insulin appropriately, you should be fine to add a few extra carbs if you wanted to try that, shouldn't you? But you are not eating grains, are you?

Your diet sounds more like what I should do so I can lose weight. I'm breastfeeding and struggled along with keto, now more low carb and even testing moderate carb. My cholesterol levels were measured at 8 weeks postpartum and I have since read that it was a bit early after a c-section, but also elevated cholesterol is normal while breastfeeding as well. My numbers were very similar to yours (TC 8.7 / LDL 5.5 / HDL 2.89 / Trigs 0.7) and my silly doctor would have had me quit breastfeeding my 8 week old baby so I could take a statin... But I'm also wondering which part of my diet to tweak to maybe see if I can bring it down a bit myself. I haven't checked what levels of Lipoprotein a I might have yet. Nor levels of small dense LDL.

I'm eating a little differently from you. Can't fast for as long but I eat breakfast late, 10:30 or 11:30am. Usually 2 eggs (was 3 while pregnant!), cheese, sauerkraut, avocado. Today I added a chicken liver and a few slices of a European semi-dried sausage. Sometimes I have bacon. On certain days I'll have a slice of my husband's sourdough rye or spelt bread too. I wanted to quit grains but I keep going back and forth with his bread. It doesn't spike my blood sugar as high as other breads so I still lean towards that as a carb if I want to have a few extra carbs in my diet.

I do eat fatty red meats, chicken with skin on, lard (my husband makes ours), or I just eat the drippings from our roasted pork bellies, liver when I can get it, salmon most weeks, tinned tuna and sardines in between, and vegetables, including lentils and chickpeas, and salads as sides or a late evening meal. My husband (a Serb by the way) brings home ox tongues and lamb hearts and makes soups, which I also have. Chicken hearts are a new favourite actually. And chicken liver pate. Tofu and tempeh sometimes. Miso soup with seaweed. Tiny amounts of Basmati rice here and there. My husband has just started making sauerkraut and I love it! And I drink tea, coffee with cream, carob and cocoa on full cream milk or warmed milk with a square of dark chocolate melted through it... Mmm

Snacks are nuts (too many as well), cheese, full fat yoghurt (husband also makes yoghurt), goat's milk I drink, and I have the odd bite of a banana. Just experimented with making jelly using a wild berry tea (no sweeteners) and serving it with raspberries and cream. I clearly eat too much! ha ha I also end up nibbling on and off through the day and into the late evening, which is bad, but happens because I get interrupted by baby or one of my other 2 small kids. I just hope the breastfeeding uses up some of it but I still have weight to lose after this last pregnancy.

Let us know what you end up trying and if it does have any affect on your cholesterol levels!

Hi Cocosilk, I haven't eaten any grains for the last 6 weeks but I did before that. Every person is different of course no matter what type and anyone can have insulin resistance but it is (apparently) more common to type 2. I have high insulin sensitivity according to my Consultant meaning any injected insulin goes a long way, as he put it. I had been eating around 80 to 100 carbs and this was still keeping my glucose levels steady with a very small amount of insulin so for me, it is not about having to go low carb to keep my levels 'low', it was about preventing myself from sometimes dropping lower at work, my theory was if I ate a carby ish meal at work it meant taking around 2 units of insulin and wham, 2 hours later I would be hypoing. It seemed easier to just not have any (or many carbs) so I was trying the low carb, MEDIUM to LOW fat approach. All this has done is send my LDL up so now I think I will go back to around 100 carb. Obviously as a type 1 I could eat many more carbs but I would never eat 'rubbish', the only carbs I contemplate are a slice of wholegrain toast or sourdough, (I take 1 unit for that), root vegetables (1 unit) and the carbs that might come from gravies or sauces or a piece of fruit, etc. I don't like the fat from fatty meats, I don't eat bacon or sausages or anything processed which is why the only thing I upped in the last 6 weeks was cheese (still only 30g a day) and nuts! I will try going back to what I was doing and see what my cholesterol is like in another few months. Interestingly, when I had the lipids tests done (full ones), as well as the lipoprotein A being elevated and at least 9 out of the 12 DNA tests showing a propensity towards higher inherited cholesterol, it showed my vit D was low (I am half Jamaican). That has never been mentioned again by anyone and I kept forgetting to mention it so I may start taking vit D tablets. x
 
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Listlad

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Hi Cocosilk, thank you for such an informative reply. My diet pretty much follows the same each day; nothing until around 3pm when I might eat low fat greek yogurt and a few berries (I know! but I just can't bring myself to eat high fat), then around 6/7pm my main meal is mainly veg (sometimes root veg and sometimes above ground) and fresh salmon or very occasionally a steak or Bolognese sauce). For 'snacks' and mainly to keep from dropping weight I have nuts (probably too many), and 30g of cheese a day. That is pretty much it, probably once a fortnight I will have something like tinned salmon and chickpeas or beans. I rarely take novarapid since goingvery low carb and take 10 lantus each evening so I know that if I up my carbs to around 100, I can cope with keeping my levels steady with an extra unit or two of insulin. I really would not mind if I was still around 7 total cholesterol but I don't like it sitting at 9 even though it seems like my HDL compensates for it. It's the genetic factor that concerns me more, I know for other people higher cholesterol is 'healthy' for them but I have the added 'risk' of that pesky lipoprotein A which they say is high risk in and of itself for strokes etc. Everything else about me is pretty much spot on. I will look at those links, thank you.
How do you feel, generally? If you feel great that is a positive indicator.
 

KK123

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How do you feel, generally? If you feel great that is a positive indicator.

Absolutely great, at 58 not an ache or a pain anywhere. I really feel that I am in the best of health although I do know that some things are 'invisible' so I never take anything for granted. x
 

Scott-C

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If you increase your carbs, all you will do is see higher blood sugar levels AND lower HDL.

As the OP is T1 and as recently dx'd T1s may be reading this thread, it is fair to point out that, in a T1 context, increasing carbs does not necessarily lead to higher bg.

There's a variety of T1 techniques, such as getting basal correct, assessing ratios, pre-bolusing, splitting and corrections, which allow us to eat moderate amounts of healthy carbs in the order of 50 to 100g per meal without any noticeable bounce.
 
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becca59

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We live in a free society. We can go through life denying ourselves everything under the sun and still get cancer, or run over by a bus. We sit in the GPs surgery he/she frowns and says you need statins. Err are they going to come around every day to ensure you are taking them. I fail to understand why every one gets so uptight about this. We make own decisions and live and die by them. I made my decision many years ago, I am a big girl and the answer is No! I may have a heart attack next week, but on the other hand I may live for another 20 years. I nearly died trying to have children, something most women do without any problems whatsoever.
Make your decision, stick by it and get on and live life. In my opinion the less drugs you take the better. Apart from insulin!!
 

Listlad

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I know this is a T1 thread but the focus seems to be on statins and cholesterol.

Like you I am not so confident with my diet when it comes to cholesterol. However I am putting my faith in forum consensus and taking higher quantities of fats than I have done for years. While this is going on, my weight is down and blood pressure is down.

I keep meaning to have another cholesterol check but haven’t managed to get around to it. If I was really worried I would find the time to get it done soon enough. But perhaps I am being too casual.

On statins. My GP was offering me statins last year. It went in one ear and out the other. He never suggested it again.
 
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