cholesterol/2 types LDL?

[LionChild]

MY Cholesterol has recently been measure at 5.5, which I am told as a Type 1 diabetic needs to be nearer 4. The GP said Type 1s have stickier plaque on their vessels. Now, I have followed Suneel Dhand on YouTube who says that statins for this issue are not really effective because the problem is 'upstream'. I do not understand this. I do know that the so-called 'bad' cholesterol is the LDL, but I have also read that there are 2 different kinds of LDL and only one of these are harmful. I cannot remember more details at the moment, but I am working on it. Does anyone else have any more comprehensive knowledge of this cholesterol issue? I have so far said I do not want statins on the basis of what I have heard and read, and the harm they can cause, but I need to do more research.

 

[Westley]

I'd trust your doctor more than some youtuber. There's a lot of online fear mongering about statins, but they are the number one most prescribed drug for a good reason.
About LDL size, I believe the current consensus is that particle size does matter to some extent, but it's not that large ones are harmless - that's an unfortunately widespread misconception. Here's a good explainer on it

 

[KennyA]

For an alternative view to the "cholesterol is bad, everyone needs statins" line, you might try reading "The Great Cholesterol Con" by Dr Malcolm Kendrick.

 

[Westley]

Alternative being the operative word there.

Butter nonsense: the rise of the cholesterol deniers

A group of scientists has been challenging everything we know about cholesterol, saying we should eat fat and stop taking statins. This is not just bad science – it will cost lives, say experts

www.theguardian.com

 

[LittleGreyCat]

Alternative being the operative word there.

Butter nonsense: the rise of the cholesterol deniers

A group of scientists has been challenging everything we know about cholesterol, saying we should eat fat and stop taking statins. This is not just bad science – it will cost lives, say experts

www.theguardian.com

I would note that I have a strong prejudice against articles in the Guardian, but that is just me.

I also have a strong prejudice against statins due to previous bad experiences.

Suffice it to say that butter is one of my mainstays, and as I am approaching 75 with recent good blood pressure checks I am not convinced that butter is bad for me.

Edit: that article is from 2018 and science may well have moved on since then.

Edit #2: I really should have read the article before diving in.
"A high-fat diet is the secret to a healthy life, they say. Enjoy your butter and other animal fats. Cheese is great. Meat is back on the menu.".
Preach!!
Meat, cheese and butter are mainstays of my diet.

“The claims that blood LDL cholesterol levels are not causally related to cardiovascular disease (which is really in the same realm as claiming that smoking does not cause cancer) are factually false,”
However it is suggested that cholesterol levels in the blood are not directly related to cholesterol in the food that we eat.
It is suggested that much/most cholesterol is manufactured from carbohydrates.
Ancel Keys and "you are what you eat" caused at least a generation's worth of confusion.

I am finding this article somewhat biased, but note my views on the Guardian.
I note the use of the term "dissidents" is used very frequently.

Noting that statins do have their place, especially for those who have already had a heart attack.
I recall that when I was diagnosed in 2008 I was prescribed a statin because the risk of a heart attack for someone with T2 diabetes was the same as the risk for a non-diabetic who had already had a heart attack.
It seemed reasonable at the time, but later it was realised that the risk might be the same, but the causes were not, so that argument was dropped.

 

[Westley]

If you don't like the Guardian as a source that's fine, but note that it's not just the journalist giving their own opinion, but quoting top experts from major health bodies.
If you prefer some different and more recent sources for similar content:

How cholesterol denialism went from reasonable skepticism to pseudoscience - The Skeptic

There was a time when doubts over cholesterol and the utility of statins were valid - but the evidence now is unequivocal

www.skeptic.org.uk

Or

The Cholesterol Deniers

For decades, a tiny encampment of researchers has held that statin treatment is a hoax. In a time when contrarian views roar to life on social media, how can medicine keep minority opinions from doing irreparable harm?

protomag.com

 

[Westley]

Also to give context to that "Cheese is great. Meat is back on the menu." bit you quote for any that didn't open the link, it is included in the article only as an example of the sorts of views espoused by lipid denialists, and the following sentence is:

This is more than bad science, according to leading scientists and medical authorities. It will cost lives. “Encouraging people to eat more saturated fat is dangerous and irresponsible,” is a typical verdict, in this case from Prof Louis Levy, the head of nutrition science at Public Health England (PHE). “There is good evidence that a high intake of saturated fat increases your risk of heart disease. We need to think about where the sources of saturated fat are and how we can reduce them. The largest contributions are dairy products, including butter, and meat and meat products.”

 

[KennyA]

You'll recall that Malcolm Kendrick and Zoe Harcombe won their libel case against the Associated Newspaper Group, publishers of the Daily Mail and Mail On Sunday.

The Mail's health editor (who claimed not to believe the accusations he had written) relied heavily on the opinions of Professors Rory Collins and Prof Colin Baigent.

Dismissing the newspaper’s public interest defence, the Judge observed (at paragraph 457 of his judgment) that:

“There is perhaps a palpable irony in the fact the Defendants, in Articles that so roundly denounced those [ie Kendrick and Harcombe] alleged to be the purveyors of misinformation, so seriously misinformed their own readers.”

High Court dismisses Mail on Sunday’s public interest defence in “statin deniers” libel case - Carter-Ruck

In a major Judgment delivered on 25 June 2024, Mr Justice Nicklin has dismissed a public interest defence advanced by The Mail on Sunday in a libel claim brought by Dr Zoë Harcombe and Dr Malcolm Kendrick. The decision follows a preliminary trial last year in what the Judge described as “the...

www.carter-ruck.com

 

[Westley]

I'm not clear on the relevance of that lawsuit to this discussion. It looks like the Daily Mail failed to meet good journalistic standards, which doesn't massively surprise me from what I know of that paper, and were rightly ruled against. However that judgment is in no way a confirmation or support of Kendrick/Harecombe's writings.

 

[Jaylee]

MY Cholesterol has recently been measure at 5.5, which I am told as a Type 1 diabetic needs to be nearer 4. The GP said Type 1s have stickier plaque on their vessels. Now, I have followed Suneel Dhand on YouTube who says that statins for this issue are not really effective because the problem is 'upstream'. I do not understand this. I do know that the so-called 'bad' cholesterol is the LDL, but I have also read that there are 2 different kinds of LDL and only one of these are harmful. I cannot remember more details at the moment, but I am working on it. Does anyone else have any more comprehensive knowledge of this cholesterol issue? I have so far said I do not want statins on the basis of what I have heard and read, and the harm they can cause, but I need to do more research.

Hi,

Just to address the “upstream” query.
Could they mean the liver? https://www.heartuk.org.uk/cholesterol/what-is-cholesterol

Hey, I’m no expert. But I was told 16 or 17 years back I would be dead in 10 years Despite consistent normal markers. That even the HCPs were pleased with.. the “scare mongering” is not just online.
The “other one” I know of could be HDL?

 

[LionChild]

I have j

Hi,

Just to address the “upstream” query.
Could they mean the liver? https://www.heartuk.org.uk/cholesterol/what-is-cholesterol

Hey, I’m no expert. But I was told 16 or 17 years back I would be dead in 10 years Despite consistent normal markers. That even the HCPs were pleased with.. the “scare mongering” is not just online.
The “other one” I know of could be HDL?

I have just found this on line from Dr. Berg:

"LDL (low-density lipoprotein) cholesterol is primarily categorized into two main types: Type A and Type B, each with distinct characteristics and health implications.

Type A LDL​

• Characteristics: Type A LDL particles are larger and more buoyant. They are considered less harmful and are not typically associated with the development of arterial plaque or clots.
• Health Implications: Individuals with a higher proportion of Type A LDL generally have a lower risk of cardiovascular diseases. These particles tend to circulate in the bloodstream for about two days before being cleared by the liver.
  
  
  

Type B LDL​

• Characteristics: Type B LDL particles are smaller and denser. They are more likely to penetrate the arterial walls and contribute to plaque formation, which can lead to atherosclerosis and cardiovascular issues.
• Health Implications: A higher concentration of Type B LDL is associated with an increased risk of heart attacks and strokes. These particles linger in the bloodstream for about five days, giving them more time to cause potential damage.
  
  

Small Dense LDL​

• Subclassification: Within the Type B category, there is a specific type known as small dense LDL. This subtype is particularly atherogenic, meaning it has a higher propensity to cause arterial plaque buildup compared to larger LDL particles.
  
  
  

Summary​

Understanding the types of LDL cholesterol is crucial for assessing cardiovascular health. While both Type A and Type B LDL are essential for transporting cholesterol in the body, managing the levels of Type B LDL is particularly important due to its association with heart disease. Regular check-ups and lifestyle modifications can help maintain healthy cholesterol levels and reduce the risk of cardiovascular complications.

MY comment: but unfortunately I do not think the doctors generally test for this type B LDL. If the above is the case,that would seem like a good idea??

 

[Westley]

That would be 'Dr' Berg, who is in fact not a medical doctor despite the impression his social media might give. In his bio he says
"Since graduating from chiropractic school, most people call me Dr. Berg"

Dr. Gil Carvalho (who is an actual accredited medical doctor and has a PhD in biology https://www.truehealthinitiative.org/council_member/4125/) has this video fact checking some of these claims by Berg:

Key point - large LDL is still associated with increased cardiovascular risk