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Just had a text from my GP........Cholesterol Gurus please advise!

CondorX

Well-Known Member
Messages
241
Location
Midlands, UK
Type of diabetes
Type 2
Treatment type
Diet only
Not posted for a while although still popping in regularly........have stuck to LCHF consistently since diagnosis in April 2019 and have now lost approx 20kg........

Used to test blood glucose very frequently and also used Freestyle Libres for some time, although not recently. My finger prick tests are all in the 4-5.9 bracket these days.

I had a repeat HbA1c and Fasting Lipids this Monday.......no idea what the HbA1c is, will phone practice tomorrow, but got a desperate text from my GP this evening saying my "total cholesterol remains very high at 8.8 with LDL of 6. I think we need to consider a statin urgently, please let me know what you think. Happy to issue a script and recheck in 2 months".

I will of course attempt to get the proper details tomorrow as we all know that quoting total cholesterol is not particularly helpful and I need the ratios, really..........just looking for some thoughts and opinions? I really don't want Statins............
 
You could maybe ask for a CAC scan before moving forward. Then watch the virtual tumbleweed breeze by...
 
LOL Jim.........knowing my GP, and indeed anyone who quotes total cholesterol levels as if they are all important and doesn't give all the others, he is unlikely to even know what a CAC scan is, let alone refer me for one

I should add, I am entirely asymptomatic as far as cardiac symptoms go and now that I have lost around 20kg am quite active and energetic again........
 
CondorX said:
I am entirely asymptomatic as far as cardiac symptoms go and now that I have lost around 20kg am quite active and energetic again........
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I don't want to alarm anybody, but I didn't think I had any Cardio symptoms. I'd been ignoring occasional numbness in my arms .when off piste skiing at high altitude, for several years. Only when I got the same symptoms when walking did I go yo my GP - it was Angina and I needed a 3x CAB later that year.

I'm not a fan of Statins, especially the fat soluble ones which can cross the blood/brain barrier (includes Simvastatin and Atorvastatin). Some studies say these reduce chance of Alzheimers and Parkinsons , but other studies suggest that Statin make these worse/more likely.
 
You are in a better place to argue with your GP. I just tell them "no". Yes my LDL has gone up but I am on prednisolone which raises LDL. I also have myasthenia gravis so my cardiologist (don't have one) would have to talk to my neuro before I considered them.
 
I am not on any medication other than when I remember my asthma preventer (which I seem not to have really needed since losing a lot of weight). It is a steroid based inhaler - Serevent - but I honestly don't think my sporadic use of it has any effect on my cholesterol. I think I might fall into Dave Feldman's Hyper Responder Cohort. Not sure what I should do though, it is a bit of a puzzle. Maybe I should reduce my daily double cream and berries and replace with a lot more avocado!!
I should add.....I want to lose a little more weight - about 4kg or so - and then maintain it there. Most of my excess weight was abdominal and there is still a bit there to lose despite getting down to 64kg at present.
 
I read this with interest. I have blood tests coming up. I eat a lot of “good” fats. It will be interesting to see my latest cholesterol readings and the interpretation of the results.
 
Listlad said:
I read this with interest. I have blood tests coming up. I eat a lot of “good” fats. It will be interesting to see my latest cholesterol readings and the interpretation of the results.
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Minimum 12 hr fasting remember. Make sure they break down all elements and ratios.
 
HSSS said:
Minimum 12 hr fasting remember. Make sure they break down all elements and ratios.
Click to expand...
Annoyingly, the GP only sent the total cholesterol and LDL levels as the reason to want me to instantly take statins.....Grrr. Will have to try to get through in the time they allow results to be given!! I can understand him being mildly hysterical about TC 8.8 and LDL 6 if he doesn't know much about ratios and keto diets or suchlike, but I would rather not take statins, nonetheless!
 
Can you get your breakdown online?
 
There is a thought that lipids can be raised during weight loss. It was never one of my problems so I didn't look into it, but some on this forum may be able to provide the links for it. It may be worth looking into. Once the weight loss stops and the weight is stabilised, the lipids drop back to where they should be.

If you have the results of your previous fasting lipid tests you can compare to see how much they have increased. It sounds like you don't have access to blood test results on-line. If you are in England these should be available to you, but you have to register with your surgery for this service.
 
Have a look at these with your numbers
https://cholesterolcode.com/new-report-tool-launched/
https://www.hughcalc.org/chol-si.php
Eating keto skews ldl as it’s calculated not measured and doesn’t take account of diet apparently.
 
Cholesterol is the way fat is moved around in the bloodstream, when losing weight or changing shape cholesterol levels are almost bound to rise.
There doesn't seem to be evidence that lowering cholesterol is a good thing - after all the white tissue of our brains is cholesterol, and the protective covering of the nervous system is a lipid.
 
Listlad said:
Can you get your breakdown online?
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No, our surgery simply does not offer it despite being very much in England!! even making appointments online is such a clunky, dreadful process that I doubt many bother - so the surgery can say "see our patients don't want this service!"
 
Please ask for your lipids in more detail e.g. what are your triglycerides and HDL. High LDL can contain lots of small low density lipo proteins which are linked to arterial disease. This could be for genetic reasons or because you eat a typical Western diet.
I found this YouTube clip explaining it all quite useful and you should discuss with the GP when you are amed with some further knowledge:
Hope that helps you make an informed choice about your risk and whether it is worth taking medication.
 
Nicole that video of Prof Sikaris is excellent - many thanks for posting it as it is reassuring.

Getting my detailed results from the GP practice is proving a nightmare as receptionists are now no longer able to give them out and there is no online facility at this practice for patients to access results. I am persisting however and hopefully will get the HDL and Trig levels and my HbA1c!! they are even refusing to post them, saying the GP has to authorise disclosing any results at all. Sigh. Might just pay for private tests I think.
 
CondorX said:
they are even refusing to post them, saying the GP has to authorise disclosing any results at all.
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So why can’t they get it authorised? There should be a system in place. My surgery will not release results until a dr has approved it either! They even withhold them from online results so et8mes til this is done
 
HSSS said:
So why can’t they get it authorised? There should be a system in place. My surgery will not release results until a dr has approved it either! They even withhold them from online results so et8mes til this is done
Click to expand...
Makes little sense, really - all a bit of an obstructive tactic!!

Anyhow, to update this thread with more info........my GP phoned me back, fortunately after my own outpatient clinic and his morning surgery!

He gave me the full blood results which I am very pleased to note place me reasonably firmly in a LOW RISK category and am most likely, as I thought, one of the Hyper Responders. I had a useful discussion with him about how Total Cholesterol is not a helpful number on its own, particularly in the context of considerable weight loss and keto diets.........and also discussed some of Prof Sikaris' presentations and how hyper responders can have TC levels of 15 or more sometimes...... I did manage to spark a hint of interest in him, I think.

The numbers are as follows for those interested:

Total Cholesterol 8.8
LDL 6.02
HDL 2.4
Trigiserides 0.84 (YIPPEEE!!!)
Non-HDL 6.4

The ratios are all pretty ideal - he agreed - and the Trigs had come down from my initial levels when I was firmly in diabetic territory, of over 2.

My HbA1c is now no longer pre-diabetic even - 5.4 % (39.9!)

GP initially thought I was on metformin - he should know really!!!! I said I was on NOTHING but dietary control.......he was puzzled and surprised i had managed to lose approx 25% of my body weight in the past 9 months and said "it must have been very difficult, but that is great!" I pointed out that it was not difficult at all...............and i would look to losing another approx 4kg before stabilising at just under 60kg.

He said he guessed I would pass on the statin and I said indeed I would - We agreed further HbA1C and lipids etc in 6 months.

I was going to try to source privately, electrophoresis of the LDL and even possibly a CAC scan, but I don't think it is necessary - I think I am one of the Dave Feldman cohort of Hyper Responders and that my Lipids reflect my very low carb diet and weight loss. And, for now anyway, my diabetes is IN REMISSION !!
 
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Hero status unlocked. Well done, and congratulations. Taking back control of your health from the clutches of metabolic meltdown is a liberating and exhilarating experience.
 
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