Cholesterol Down - Target Lowered!

[mrburden]

Hi,
After many years of trying to lower my cholesterol level, I was really pleased to see that my recent blood test results showed my level is down to 4.1
Having had levels slowly reducing from over 11 over the past 10 years and hovering around 6.5ish for about 2 years, I was over the moon to finally be "within target range". Ha! not so, it seems. The new target is apparently 3.5 so the statins have been upped again. Better luck next time, eh?

 

[Fallenstar]

Well done you for getting it down...then they move the blooming goal posts :cry:

Can I ask what you are taking for your cholesterol?

Mine was over 13. I was told even if I lived on lettuce it would be near this. I have had mine brought down to 3 with medication but I'm on two types of tablet at the highest doses but still it was a relief to get it down.

 

[mrburden]

I've been on Ezetimibe (10mg/day) and Bezafibrate (400mg/day). I was on statins some years ago but was taken off them due (if my memory serves me correctly) to higher than normal liver enzymes. I asked about starting them again around 2 months ago and was put back onto Atorvastatin (10mg/day). Since that the cholesterol level has dropped but they have now increased the dose to 20mg/day to get it down to the "new" target.
Food wise, I have always eaten a low fat diet and I eat plenty of oily fish and rarely touch red meats etc, There is no obvious reason for the high cholesterol. Oddly, my father used to eat all the wrong things like chips, burgers, steak etc and never had a high cholesterol reading in his life, though he did die from heart disease.

 

[SugarPlums]

In the past drug companies made big profits with the compliance of the government/medical profession
, ie Statins. Now times are hard see how things will change, look at the Blood Pressure news today.

 

[noblehead]

Great result mrburden, didn't know there was a new target of 3.5 for people with diabetes and just assumed that the figure was still 4 or below.

Nigel

 

[viviennem]

With most people, dietary fat doesn't have a big impact on your blood cholesterol - or at least as far as I understand it. About 80% of it is made in your liver regardless of what you eat.

In my case, eating a lot of carbohydrates puts my cholesterol/blood lipid profile in a worse position that when I'm eating low carb/unrestricted fat.

And again speaking very very personally - my total cholesterol was 5.0 last time, and I'm happy with that. My total:HDL ratio was good too. I won't take statins any more (my choice) so I'm just hoping the Metformin protects me from CVD

Viv 8)

 

[angieG]

The 3.5 isn't the ratio of total to whatever is it?
My last test was 7.1 and the doc called me in to put me on statins but when I got there he said that now he had had time to study my figures he wasn't going to bother since my ratio was only 3 as I have lots of the good stuff, I'm not post menopausal, not over weight or anything so he was happy for me to carry on without medication.
Just a thought
Angie

 

[viviennem]

Hi angieG,

My lipid profiles usually show total cholesterol, HDL, triglycerides and calculated LDL. Then they have the total:HDL ratio which I think was just on 4 last time, for me. It's supposed to be under 4.5, I think, and 3 is very good.

I like the sound of your doctor! I know at least 3 HCPs who won't touch statins, one of whom is a doctor who will only prescribes them as a last act of desperation.

And yet some people seem to manage on them very well. Let's not argue again, folks - I know they suit some people!


Viv 8)

 

[Grazer]

I just saw my DSN., I asked if I needed a cholesterol test as I hadn't had one for about a year. She said no, my last test was 5.1 which was "perfect", so I didn't need another test 'till next March when they'll do my HbA1c as well - that's done once a year as well. So is 5.1 "perfect"? Not according to what you're writing

 

[viviennem]

I would be 'perfectly' happy with it, Grazer. Did she give you the breakdown as I detailed in my previous post? The triglycerides are the real baddies, and your total:HDL ratio is the one that shows your risk of CHD/stroke - or so I understand.

I am not a scientist or a medic, but I am quite concerned about what happens to (eg) the cholesterol under our skin (which makes Vitamin D using sunlight) and the cholesterol in our brains, which is vital for brain function, when we get our blood cholesterol down to these really low levels eg in the 3s). No one has given me any answers yet! but there is some evidence that Alzheimer's patients have low(er) levels of brain cholesterol. Google Stephanie Seneff.

All my GP diabetes specialist could say was "Blood cholesterol doesn't affect brain cholesterol", which may be right. But she wouldn't say more when I pressed her.

Viv 8)

 

[Fallenstar]

I agree Viv

I have Familial Hypercholesterolaemia (very high, 13, and runs in my family) . There is thought that this is what caused my Type 1 Diabetes, it probably is :roll: I wish I had been treated as a child but back then I don't think many adults were treated for high Cholesterol let alone children . I did suffer with chronic Pancreatitis throughout my childhood which was VERY painful, undiagnosed ,put down to anxiety :roll: :lol: . These were dibilitating attacks ,doubled up to the point of vomiting with the pain when it was a bad attack, Can't say I've seen that many 10 year old's THAT anxious, but maybe my GP had :lol: and now my Pancreas is just a big old lump of scar tissue after seeing it on a scan......explains a lot.

I was put on Rusuvastatin 40MG , my Cholesterol came down to 6...blooming good for me I thought, I was well happy with that, also the Pancreatitis pain ceased. This had abated over the years anyway probably due to my Pancreas not being much more than scar tissue by now.
My Endo was not happy with this figure so he put me on Ezetrol 10mg about a year ago alongside the 40mg of Rusvastatin....MY Labs were fantastic after a few months my Cholesterol came down to under 2, he was very happy.....I felt like death, not from muscle pain or anything. I just felt like someone had pulled the plug out and I was showing all the symptoms of Addisons disease. I was very poorly actually.

During this time I read a lot about the Endocrine system to do with my problems. And this is what I found , Pregnenolone ( the Daddy of the steroid Hormones) is made from Cholesterol. I was having severe adrenal fatigue and my Thyroid was very under active. I wondered could it be that I just had too little cholesterol for me now to convert to the metabolic Hormones which give me energy .

Well I started to alternate my Cholesterol meds have done ever since and have had a few Cholesterol bloods done and my level is now just over 3....I feel a whole lot better, my Adrenals have picked up...enough for now anyway I also take DHEA which helps my Adrenals with Cortisol production , which in turn helps to steady my Diabetic control and I feel great on it. I still do get drop's in my Cortisol though which effects my Diabetes.

Sorry for ramble but like you Viv I worry that the Dr's might want to keep us too low and this is to the detriment of how we feel on a daily basis, which is the important factor in life at the end of the day. No good if you have fantastic lab's on a piece of paper if you feel like crud.

I need the Stats, they will save/prolong my life in the long run but too aggressive a treatment with them can be at the detriment to the patient sometimes,or it was with me. You must go on how you feel at the end of the day not just lab figures....or some GP back in the day telling you it's Anxiety :wink: If you could have seen me at 10, I was the most lazy laid back kid you could wish to meet :lol:

 

[viviennem]

You have had a tough time, Fallenstar! I feel very sorry for your 10 year old self - a miserable life for a child, and I'm glad you're so much better now.

The body is such a complicated system. I believe we need to think very carefully about the consequences of messing about with just one bit of it. As you say, no good being the healthiest person in the district on paper, if you can't function in daily life!

Viv 8)

 

[noblehead]

I just saw my DSN., I asked if I needed a cholesterol test as I hadn't had one for about a year. She said no, my last test was 5.1 which was "perfect", so I didn't need another test 'till next March when they'll do my HbA1c as well - that's done once a year as well. So is 5.1 "perfect"? Not according to what you're writing

This was the most recent advice I have seen:

HDL: 1mmol/l or above for men; 1.2mmol/l or above for women

LDL: below 2mmol/l

Triglycerides: equal to or below 1.7mmol/l

Total cholesterol: below 4mmol/l

(taken from Diabetes UK)

As ever it's always best to discuss cholesterol control individualy with a gp or cardiologist as they are privy to your past and present family history etc.

Nigel

 

[pianoman]

I posted this article elsewhere but it seems appropriate to this thread as well...

Beyond Routine Cholesterol Testing: The Role of LDL Particle Size Assessment...
http://www.centerforpreventivemedicine.com/04114med_messenger.pdf

The LDL value reported to clinicians is the summed contribution in mg of LDL particles in a deciliter of plasma. LDL particles are, however, hetero-geneous in size, density, and composition. A growing body of evidence suggests that LDL particles that are small and dense are more atherogenic than those which are large and “fluffy.” Thus, two patients with the same LDL measurement in mg/dl may have differing levels of cardio-vascular risk depending on the relative proportions of small, dense and large, fluffy particles.
...
Observational and epidemiological studies suggest those having a predominance of small, dense particles may have an increase in risk up to 300 percent greater than those having a predominance of large and fluffy LDL particles.
...
Small, dense LDL particles are found in association with high triglycerides and low HDL

---

It puzzles me why we still put so much focus on the LDL "volume" and Total Cholesterol -- as in the above article: the LDL (LDL-C) volume does not take into account the different sized LDL particles.. it's like comparing the number of tennis balls vs beach balls it takes to fill a rubbish bin. Same volume but very different number of particles... and the size of the particles is important if we recognise that small-dense is seen as indicating a 300% higher risk than large-fluffy.

And we are told that an higher HDL (HDL-C) is preferable but this counts toward the Total Cholesterol... so higher HDL = good = higher Total C = bad ??? This is the kind of logical paradox Captain Kirk might use to convince a computer to self-destruct.

Also worth reminding that "LDL" is not even "cholesterol" but a Lipoprotein carrier for cholesterol AND that the atherosclerotic plaques do not build up on the walls of arteries (like clogged pipes as we are told) but inside the layers of the artery walls.

That these plaques contain cholesterol is about as indicative of cause and effect as examining a scab over a graze and seeing platelets, fibrin and other clotting factors -- should we then seek to prevent grazes and cuts by artificially lowering the body's levels of clotting factors?

I agree that this ought to be something between yourself and our HCPs but please read around the topic as it is clear that there is no a clear scientific/medical consensus on how and why these blanket guidelines are set.