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Latest Dr's review....statins!

K

KK123

Well-Known Member
Messages
3,966
Location
Solihull
Type of diabetes
Type 1
Treatment type
Insulin
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!
 
The current advice regarding cholesterol has changed. It used to be that diabetics were advised to restrict their cholesterol from food to 200 mg/day and normal people 300 mg/day. Current advice appears to suggest that you can't control it through diet, you can have as much cholesterol as you like.
Like you, I changed to an LC(HF) on diagnosis two years ago. After 3 months my total cholesterol had risen from normal to 10 and the GP and specialist insisted that I took statins. I asked for 3 months of trying to control it with diet and managed to get it to 4.9 by only eating 200 mg/day of cholesterol a day.
Personally, I think it's more complicated than simply 'you can't control cholesterol through diet.' I think it's to do with how good you are at burning body fat. If you go into fat-burning through IF or just with the LCHF diet, then you burn up the cholesterol you eat in your meal, so how much cholesterol you have in your diet won't make any difference. If you're not good at burning body fat, then you're all out of luck and need to count the cholesterol in your diet.
 
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I would aim for good BG levels and to heck with the cholesterol.

As you note, you ratios are good and you aren't showing any of the high risk pointers.
 
KK123 said:
I know high cholesterol isn't the baddie they make it out to be,
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So are you worried?
Your trig/HDL ratio is stupendously good (0.367)
Any chance the doc will get you a CAC scan to look at the possibility of calcification before medication?
 
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As I understand current thinking only 20% of cholesterol comes directly from dietary sources and the other 80% is generated by the body, usually from carbohydrates.

Which is why we can eat eggs, eggs, eggs.......

Of course, that may change again any day.
 
If you increase your carbs, all you will do is see higher blood sugar levels AND lower HDL. Carbs deplete the HDL. Your HDL is excellent and keeping those ratios down. In my opinion it would be a backward step for you, and injecting extra insulin to cover the extra carbs might even lead to weight gain.
 
bulkbiker said:
So are you worried?
Your trig/HDL ratio is stupendously good (0.367)
Any chance the doc will get you a CAC scan to look at the possibility of calcification before medication?
Click to expand...

Hi Bulkbiker, I will certainly ask that question. I'm not worried enough to start taking 40mg of statin every day, that's for sure. I may try and get a CAC done privately. I actually did say something like that to my Consultant who said it was more of a preventative thing anyway but I would feel better knowing whether my ateries were clogged! I also know there is nothing more I can do re 'lifestyle' so that check is probably the next step. Many thanks.
 

Hi ert, I don't know whether my body fat burns or not, my ketones were at 0.6 when I was doing very low carb? I'm right in the middle of BMI and run 5 miles every day. How can you tell? Also, I eat maybe 1 egg a week, no prawns etc so not sure I eat many things with cholesterol?, meat about once a week if that. x
 
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Personally I wouldn't have accepted the prescription. I'd have just debated the doctor until they ran out of energy/time, then gone home and eaten a whole packet of bacon.
 
Jim Lahey said:
Personally I wouldn't have accepted the prescription. I'd have just debated the doctor until they ran out of energy/time, then gone home and eaten a whole packet of bacon.
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Hi Jim, that made me smile! I don't actually eat bacon or sausages etc (even though I know they are fine as such), but if you'd mentioned cheese.....30g a day is my vice!!!! My Dr is actually a type 1 diabetic also, I asked him if he took statins but he declined to answer.
 
KK123 said:
I eat maybe 1 egg a week, no prawns etc so not sure I eat many things with cholesterol?, meat about once a week if that. x
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As mentioned above, dietary cholesterol makes no difference whatsever. Our livers make our cholesterol as and when it is needed. Any obtained from food, then the liver will just make a bit less. I practically live off eggs and my lipids are perfect. I think part of the problem is the consumption of processed oils, which tend to contain too much inflammatory omega 6 among other nasties. It is omega 3 (anti inflammatory) that we need to keep things ticking over, so best to cook with animal fats and eat plenty of omega 3 foods, in my opinion.
 

Let's compromise and go with a Wall's Viennetta made with cheese and streaky bacon. You can pick out the bacon from yours and put it on my plate
 
KK123 said:
Hi ert, I don't know whether my body fat burns or not, my ketones were at 0.6 when I was doing very low carb? I'm right in the middle of BMI and run 5 miles every day. How can you tell? x
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Firstly, you need to discuss this your GP's as we can't give advice on this forum. I can only talk about my own personal experience where I worked with a sports nutritionist and GP.

I used to get waking blood ketone values from trace to 0.6 which meant I exercised predominately on carbs (I run a similar distance every day) and my nutritionist suggested I would respond to counting cholesterol (though most people won't which follows current recommendations that you can eat without restricting cholesterol.) I asked my GP and specialist for a 3-month delay in taking their medication to lower my total cholesterol of 10.

The ketones, for normal people, the sweet spot for weight loss is 1.5 to 3.0 mmol/l. This level of nutritional ketosisis recommended by researchers Stephen Phinney and Jeff Volek. So my sports nutritionist said this was evidence I wasn't burning fat efficiently, being below this range. Three months later my total cholesterol was below 5. Every time I stop counting, it creeps up and I have to be stricter again, but they haven't thrown the statins word my way again.

Anyhow, having lower ketones was not a bad thing because as a type 1 diabetic, high ketones and extended high sugars (greater than 13 mmol/l) are something to be avoided at all costs.
(Fast forward two years: I had to go onto insulin when my ketones started to come in over 6 as I could no longer clear them away. This wasn't anything to do with my diet.)

This is what I use. I only bother counting the big numbers. https://www.ucsfhealth.org/education/cholesterol_content_of_foods/
 
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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.
 

Thanks Bluetit, I most certainly do not eat ANYTHING processed, especially those oils. Only olive oil for me which I think is ok?, that's it, nothing else.
 

Hi Ert, yes I realise people can only discuss their experiences and thanks for that. You do sound very similar to me though and that table you linked to is VERY interesting. Most of the stuff I eat on that table comes in at under 30mg each which is good apart from salmon and eggs! Wow, eggs are 'high' in cholesterol. I really do understand people like bluetit saying that generally speaking it's not what you eat so much (my own Consultant said that, and he also said because of the lipoprotein A which is inherited and a stack of DNA markers that they tested for were higher than 'normal', what I ate would not make much difference). BUT, something has whizzed it up to 8.9 from 7 which I was happy with so anything is worth a try. Maybe some individuals are just different and their bodies process things in a different way. I will try a little experiment for 3 months, no eggs, very little meat (which I do now), will prob have 30g of cheese every other day (pleeeeeeeassseeee), and keep to under the 200mg. It could simply be that I am sensitive to ANY dietary cholesterol which wouldn't bother other people. Many thanks.
 

It's supposed to be as high as 25% of the population who are sensitive to dietary cholesterol.
'However, in some people, high-cholesterol foods do cause a rise in blood cholesterol. These people makeup about 25% of the population and are often referred to as "hyperresponders." This tendency is considered to be genetic.
https://www.healthline.com/nutrition/dietary-cholesterol-does-not-matter#section3
https://www.ncbi.nlm.nih.gov/pubmed/16596800
https://www.ncbi.nlm.nih.gov/pubmed/9430080

That's the problem with generalisations, they don't fit everyone. From what I read, I would try to keep your cholesterol at around 200 mg as too low dietary cholesterol can have the effect of raising your total cholesterol as well as your body compensates by making more.
 

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
 
I am a type 1 and eat whatever carbs I want. (I am a vegan so as long as it's vegan) I just dose properly for it. I do not have any other issues other than a bad back from a bad fall last year and type 1 diabetes. My cholesterol levels are great and I have a high HDL level. My A1C is 6% (42). I use an average of about 50 total units of insulin a day.

Higher carbs do not have to mean a higher BG level, It's about dosing properly, for me that means prebolusing so that insulin is ready to be used when I eat.
 
dawnmc said:
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.
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Agree with @dawnmc there - my hba1c increased from 48 to 54 when I started taking statins “because all diabetics should take them” and soon dropped after I stopped taking them due to other side effects. Hence why my GP has put ‘statin intolerant’ on my notes.
 
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