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Cholesterol -statins- high ldl

Discussion in 'Diabetes Discussions' started by gemma_T1, Mar 11, 2019.

  1. gemma_T1

    gemma_T1 Type 1 · Well-Known Member

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    Hi all,

    I wrote on someone else’s thread yesterday about my new cholesterol levels and my imminent diabetes hospital appointment today.

    Today’s appointment was the first time this specialist had ever seen me ... and what does he do?

    Ignores Hba1c of 50 (6.7%)

    Goes straight to
    LDL - 147mg/dL (<115)
    Total cholesterol - 222mg/dL (<190)
    Ignoring
    HDL - 83mg/dL. (45-90)
    Trigs - 52 (<150)
    And tells me that I have to take statins because my risks of cardiovascular disease, heart attacks, strokes etc. etc. are very high.
    I politely refused saying that I didn’t want to take them... result an extremely cross doctor and a twenty minute monologue on the wonders of statins.
    It was impossible to have a conversation. It was put that statins are the only solution, he went on to spend my hospital visit talking about statins and explaining why it was necessary to take them and that I was risking my life by not taking them. Not to mention putting into doubt his expertise and intellect by refusing.
    I had only said, “I don’t want to take statins”, I got no further than that. I never mentioned other schools of thought or even the side effects or having watched the video Statin Nation that someone from the forum had helpfully posted. I had to listen, what else could I do? After 20 minutes of this, I politely asked him to let me have the bloods tested again in 2 months and see if I got a different result ... after all this is the first time my LDL levels and total cholesterol have been so high....
    He grudgingly gave me two months to change my diet back to the high carb diet, stop eating saturated animal fats and proteins and then do the tests. I was thus sent home with the hospital’s diabetic carbs & low fat diet book.

    What do you guys think?
    I know my measurements are in Italian units, but you can see the guideline levels in brackets. I think the total cholesterol is 5.75.
    It’s the highest I’ve ever had it was 202, 2 months ago and 192 a few months before that... so it is going up gradually...
    I add that I have been ill this last 6 months so I’ve had a rather sedentary life during this time. I also told the doctor this.

    I have to be honest, I am rather shocked that the first time you meet a diabetic patient you focus on their cholesterol and handing out statins without taking a medical history.
    He never said a word about my diabetic control. or diabetic complications .... we ran out of time.

    But I suppose I should be positive at least I have been given a chance to lower it before the dreaded pills are prescribed.

    I’d appreciate your thoughts
     
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  2. ziggy_w

    ziggy_w Type 2 · Well-Known Member

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    Hi @gemma_T1,

    Based on my readings, most of your ratios sound ideal -- high HDL, low trigs, this is what I personally would want to see. My numbers are actually quite similar and my GP doesn't seem to be too concerned -- however it seems that many HCPS still focus on lower overall TC and LDL for diabetics. Did you have a look at the cholesterol calculator at http://www.hughcalc.org/chol.php?

    This being said, if you want to impact your overall TC and LDL, it seems that some people do well by switching from animal fats to olive oil. Might make your specialist happy.
     
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    #2 ziggy_w, Mar 11, 2019 at 6:23 PM
    Last edited: Mar 11, 2019
  3. DavidGrahamJones

    DavidGrahamJones Type 2 · Well-Known Member

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    My total cholesterol dropped when I cut the carbs. Is there a suggestion that yours will drop if you go back on the carbs?

    Today, I've had an appointment with the diabetes specialist at my local hospital and I'm totally confused at how the NHS, albeit England, Scotland, Wales and Northern Ireland can have different attitudes in different parts of the country (UK).

    Not only have I been recommended to read about low carb diets (I'm ahead of the game there) but when I grinned at the lovely poster showing the Eatwell guide, I was very quickly assured that the guide was changing to have a much lower portion of carbs, and that was before I said anything, just a knowing grin.

    How about asking him to explain the different between relative risk and absolute risk, he seems to be confused. Hardly surprising, I don't think medics spend much time studying statistics. Perhaps you can ask him why so many people seem to have problems with statins, enough to report them to the Yellow Card Scheme.

    https://info.mhra.gov.uk/drug-analy...NCOMBINED/UK_NON_000293263216.zip&agency=MHRA
     
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  4. mariavontrapp

    mariavontrapp Type 2 · Well-Known Member

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    Why why why would he tell a diabetic choose to eat a load of carbs. Where is the logic in this? A four year old could do better
     
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  5. KK123

    KK123 Type 1 · Well-Known Member

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    I'm guessing it's to do with Gemma being type 1. I am not saying there is not great benefit in type 1s having fewer carbs but you do have to balance it all with the insulin etc, and it is 'easier' for a Consultant to go down the easy route of 'more carbs equals fewer hypos' rather than maybe 'less insulin means fewer hypos' When I mention I am on around 60 carbs a day they look at me as if to say 'idiot', their 'go to' is always eat more carbs.
     
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  6. NoCrbs4Me

    NoCrbs4Me I reversed my Type 2 · Well-Known Member

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    My thoughts are you should not worry about your cholesterol levels. They are fine. Just keep eating a healthy low-carb diet.
     
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  7. AloeSvea

    AloeSvea Type 2 · Well-Known Member

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    I was lucky that the doctor who had the statin conversation with me, as a newly T2 diabetes patient, as in wanting me, strongly to take them, was a doll. It did not feel like I was being attacked like in your experience @gemma_T1 - and my LDL cholesterol is way high. Bad form by this doctor of yours and I am very sorry you had that experience. I accepted the prescription, back in the day, read up on them, and put them in my bottom drawer where they stayed until I moved house and I disposed of them altogether. A team of endocrinologists later on was harder to deal with! And yes, the same thing where they ignore the results around HBA1c, and focus on dyslipidemia.

    That still happens to me today, even with new nurses. I say, as a woman who has not had a CVD event, I choose not to treat my dyslipidemia with statins. They get measured on prescribing statins to folks with certain readings, so as long as you take full responsibility in the event of a CVD/event, they tend to leave you alone on the medications front, is my experience. (For me - in two countries.)

    I say to medical professionals - I particularly take note of the trig/HDL ratio, and focus on having a fasting triglycerides test. This is accepted, as the fasting trig part is measuring how your body is dealing with dietary fats overnight. Also - being clearly physically fit with OK blood pressure goes a very long way in these medical conversations. (I bought my own BP meter.)

    A particular shocking facet of the statin and cholesterol focus, even for those of us presenting with diabetes - both types, is the lack of focus on physical fitness - you know - heart health! - for preventing CVDs and strokes, for those of us with a much increased risk. I never cease to be shocked, when I ask friends and family what was said in the doc's office, how few times - "move more" is said in this regard, and the prescription pad got out instead. But as Herr Svea says, the pharmaceutical companies can't make money off prescribing a low carb diet, and plain old exercise. Too sad and very bad that this is the current situation.
     
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  8. gemma_T1

    gemma_T1 Type 1 · Well-Known Member

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    Hi
    Thankyou I tried the link for the fabulous cholesterol calculator, if you can tell me how to upload it I’ll post it here ... especially because I am now very happy apart front the two borderline results, the rest were all optimum and ideal ... so I feel much better although I will see about lowering the LDL.

    The doctor didn’t ask about my diet, he made an assumption looking at the LDL, nor did he look at my blood pressure, I’m not sure if this is relevant to his case for statins but my blood pressure taken by his nurse was 111/59.
    The only thing he was concerned about was the cholesterol. I wanted to talk about my diabetes
    Ps living in Italy we have the best Extra Virgin Olive Oil my family is especially lucky as we use one that my best friend’s dad produces organically in the south - it’s amazing! You could drink it! My son calls it the nectar of the Gods! The only thing I have changed is eating more meat which I hardly did before as I prefer fish. This has worked wonders for my iron levels ... the highest in my life!
    I love the link you sent I’m going to try it for my father-in- law’s next test results. Thanks again!
     
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  9. gemma_T1

    gemma_T1 Type 1 · Well-Known Member

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    Hi, it seems so... ( my cousin in London was told a few weeks ago to increase his carbs to help his heart and lower cholesterol he’s under 40 and already being prescribed statins)
    I really don’t know what to think of what happened today ... I wasn’t exactly allowed to speak as he was very offended that I had said I didn’t want to take statins... to be honest I had thought that would be the end of it. He decided I didn’t eat correctly based on his assumptions from the LDL only. He was convinced I was in grave danger if I didn’t take them.
    It wasn’t possible to have conversation with him, let alone ask questions or for clarification. I’m just glad I have all you nice people on this forum to support and inform my choices.
    Thanks for the link t the yellow card scheme I’ll photograph it and send it to my cousin.
    I’ll prepare myself better next time... he caught me by surprise with his outburst...
     
  10. AloeSvea

    AloeSvea Type 2 · Well-Known Member

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    My understanding of the stats around statins and CVD and too early mortality is, for men who have had a CVD event can have an increased lifespan of about three weeks (if memory serves) (sources Dr Malcolm Kendrick, and also incorporating Ivor Cummins' work, Krafft's work...). For women, there isn't an increase in lifespan. And for the elderly - their too early mortality is increased, not decreased, as cholesterol seems to have a lifespan increasing role for them. (Something I quote to my super-ager parents rather often!). Do correct me if I got any of these figures wrong! I'm eating breakfast and reading this practically on the run...
     
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  11. gemma_T1

    gemma_T1 Type 1 · Well-Known Member

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    Hi
    You’re right Type 1 is a difficult balancing act ...
    like you say lowering carbs is a good move to sort out the high and low swings ... since lowering my carb intake to 50g max but mostly less, my control has gotten much better and is much easier to control and predict... seeing that I’m allergic to the Libre now.
    And today I would have liked that we focused on the diabetes and not in getting the LDL to less than 100mg/dL
    I had the same experience as you when trying to talk to the doctors and especially the dietitians, who almost killed me with their diets.
     
  12. gemma_T1

    gemma_T1 Type 1 · Well-Known Member

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    You’re right my son understood it aged three
     
  13. ziggy_w

    ziggy_w Type 2 · Well-Known Member

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    Hi @gemma_T1 -- I don't think you can download the calculator, so the best I can do is to give a link.

    I agree really good olive oil is the nectar of the gods. You are really lucky to live in Italy. It might have been the meat that increased your LDL -- mind you, personally I don't think this is a problem.

    Did you know that most of the time LDL isn't measured, but calculated based on your TC, HDL and trigs? For this, generally the Friedewald equation is used -- unfortunately, for very low levels of trigs (like yours), the Friedewald equation doesn't work, but the Iranian formula should be used instead. For me, this made a difference of 20 points in LDL.
     
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  14. gemma_T1

    gemma_T1 Type 1 · Well-Known Member

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    This equation info is very interesting, I’ll definitely look into that before the next appointment, even though it’s ridiculous that I should have to study to say no to a medication.
    Thankyou for letting me know about that. That’s another piece of information I shall be sending along to my cousin.
     
  15. ziggy_w

    ziggy_w Type 2 · Well-Known Member

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    Hi @gemma_T1,

    Glad I could help -- though I agree with you, we really shouldn't have to do all the research ourselves.
     
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  16. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    @gemma_T1 - After many discussions, me sharing various papers, YouTube videos and calculations, my GP and I have reached an amicable agreement on my lipids.

    At first, she was very agitated by them, and offered a referral to a lipidologist to investigate what was going on. I would have been quite happy to have the referral, but was about to go overseas for a couple of months, so we agreed to wait until I got home, retest and go from there.

    Having left her in the safe hands of Professor Ron Sikaris, and his excellent YouTube presentations, by the time I got back, she agreed I "must be delighted with those lipids". Result!

    I user ther hughscalc thing every time, and take my view from there, but I certainly concentrate my first glance on the Trigs. I'd love to have the LDL particle size testing done, but its not routinely available in UK, it seems.

    (Professor Sikaris is definitely worth a watch if you want to do a bit of learning. His explanations are very straightforward and clear, to me anyway.)
     
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  17. gemma_T1

    gemma_T1 Type 1 · Well-Known Member

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    Thanks very much, I will check that video out today
     
  18. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    The position my GP and I have arrived at to describe my position is excellent lipids, with an inconveniently large total. Inconvenient only in that it isn't under 5 or whatever arbitrary figure we go by these days!
     
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  19. Ponchu

    Ponchu · Well-Known Member

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    I finally assented to the pressure from administrators and filled the prescription. I did not want to be labeled “against medical advice” or be possibly shown the door.

    I’ve never taken a single pill and will not ever.
     
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  20. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    For those in the UK who have had their records put online, you may have noticed that LDL no longer has a limit (it was there around 3 years ago). LDL is one of the weakest links to heart disease, especially when HDL is high and Triglycerides are low. If LDL is high and the other 2 markers are not great then, further investigation is warranted. High circulating insulin, high blood pressure, obesity, low HDL and high triglycerides trump LDL in terms of risk profile.
     
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