Statin dilemma

lindisfel

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Thanks for your reply lindesfel , I certainly don't want to take anything that makes type 2 any worse as I have worked hard at being med free and keeping my bloods under control.
I have agreed to go just to see what they can offer other than Statins which should be interesting. I don't think my LDL is that bad either at 4.2 but seems my doctor does not agree !
Difficult one there Connie, doctor education! I have the same problem my eldest is a GP. and a prophet is not accepted in his home country! :)
 
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librarising

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Agree. Here is a test I have had which is really useful in the medicate with statins (traditional or pharmaceutical), not medicate decisionmaking process. It comes with a nurse expert in the test explaining your results

https://heartmdinstitute.com/heart-...-test-cholesterol-particle-size-alternatives/
This first link you list says the following
"While we’re talking cholesterol, I want to remind you that the old rules for determining cardiovascular risk by looking at ratios of LDL to HDL, or HDL to total cholesterol, are also outdated.

The new benchmark ratio is triglycerides to HDL cholesterol ... The ideal triglyceride-to-HDL ratio, in my opinion, is 2:1 or less."
2:1 is a US ratio which converts to a UK (and any country measuring in mmol/L) ratio of 0.87.
Geoff
 

BrianTheElder

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If you don't mind, could you give a ball park cost figure for what you had done, and what it included?

One big problem with high cholesterol is establishing if it is having an adverse effect before major symptoms manifest themselves.
Hi @LittleGreyCat I will let you know, no problem. The consultant cost 2 lots of £120, one before and a follow-up after the CT Scan. I haven't had the bill for the CT Scan, but it's about £2k. I will let you know when they send it, but I'm not chasing it!
 

LittleGreyCat

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Have you thought of asking your GP to refer you to the Lipid Clinic ? I have been referred and am awaiting an appointments I cannot take Statins ( tried 3 different ones and all caused terrible side effects ) and although my bloods are in non diabetic range my cholesterol is 6.4 and as i have already had 2 strokes she was not happy to let me continue with cholesterol like this . My doctor seems to think I am a candidate for a new cholesterol medication Repatha which can only be prescribed by a consultant so let's see what they say . I will let you know how it goes .

Sensible suggestion.

Probably worth a chat at my next review.

I will dig my last two tests out in the morning; the surgery has recently changed software and I am still learning the new system.
 

connie104

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Thanks for above information. I spent 6 years with permanent cold like symptoms on vildagliptin and certainly would not like to repeat that again .
Like all new drugs only time will tell how beneficial they really are.
 
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ickihun

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I've stopped statin and it looks like I could be having an inflammatory reaction. Discs and lungs are inflammed more. If it doesn't settle down I will see gp's advice. Side affects of atorvastatin for me was pins and needles from lower forearms to finger ends on both hands and severe foot cramps. Side affects stopped on stopping statin but at same time I started multivitamins and vit d.
Co-incidence?
 

BrianTheElder

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If you don't mind, could you give a ball park cost figure for what you had done, and what it included?

One big problem with high cholesterol is establishing if it is having an adverse effect before major symptoms manifest themselves.
Hi @LittleGreyCat , I have now finally receive my bill from the hospital - they apologised for the delay, although I am more than happy to have delayed payment!
The Calcium Scoring Cardiac CT Scan cost £400 and the CT Coronary Angiogram cost £1284. This was lower than I expected, but you usually get something off when you are self-funding.
Although the results were good, it still leaves up in the air what the long-term effects of such high cholesterol are on a LCHF diet. However, since I went back onto 10mg Atorvastatin, my TC has dropped from 10.6 to 4.8 mmol/l, so I won't be part of the experiment. I am still on a ketogenic diet and all my indicators are A1.
I find it all very puzzling.
 

bulkbiker

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Hi @LittleGreyCat , I have now finally receive my bill from the hospital - they apologised for the delay, although I am more than happy to have delayed payment!
The Calcium Scoring Cardiac CT Scan cost £400 and the CT Coronary Angiogram cost £1284. This was lower than I expected, but you usually get something off when you are self-funding.
Although the results were good, it still leaves up in the air what the long-term effects of such high cholesterol are on a LCHF diet. However, since I went back onto 10mg Atorvastatin, my TC has dropped from 10.6 to 4.8 mmol/l, so I won't be part of the experiment. I am still on a ketogenic diet and all my indicators are A1.
I find it all very puzzling.
Do you think you may be someone who has quite large variations in their cholesterol figures during the day?
Thus finding big differences over a short time period might not be so surprising?
Could I also ask where you had your CAC score done?
 

bulkbiker

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Hi @LittleGreyCat , I have now finally receive my bill from the hospital - they apologised for the delay, although I am more than happy to have delayed payment!
The Calcium Scoring Cardiac CT Scan cost £400 and the CT Coronary Angiogram cost £1284. This was lower than I expected, but you usually get something off when you are self-funding.
Although the results were good, it still leaves up in the air what the long-term effects of such high cholesterol are on a LCHF diet. However, since I went back onto 10mg Atorvastatin, my TC has dropped from 10.6 to 4.8 mmol/l, so I won't be part of the experiment. I am still on a ketogenic diet and all my indicators are A1.
I find it all very puzzling.
This is an old paper that I found on the subject
http://circ.ahajournals.org/content/circulationaha/22/2/247.full.pdf
 

BrianTheElder

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Hi @bulkbiker . Thanks for the paper, which goes to show there is a great deal of variation possible, although I think I have always had my cholesterol tests first thing in the morning. But my body does seem to be very sensitive to certain influences. I also had my high scoring test repeated and got the same result. I am now down to my long-term normal level.
My scans were at the Guildford Nuffield on this occasion.
 

BrianTheElder

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Indy51

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Thank you I have read this before and I'm not sure what the value of artificially lowering your cholesterol for a short period is. Although, truth be told, I'm not sure what importance to put on any level of cholesterol or what effects that would have on my body.
I guess for all of us, it comes back to which experts we trust.

Not sure if you follow Twitter, but there's a very interesting conversation going on between Ivor Cummins and others about what a BS marker LDL is for CAD.

https://twitter.com/tednaiman/status/890203548704686081

A link worth reading:
http://www.thefatemperor.com/blog/2...-the-bad-cholesterol-thats-simplistic-foolery

Another graphic illustrating the lipids of the 136,905 patients hospitalised with CAD (unfortunately it uses US measurements):

DFqjZ6WUwAAn8tb.jpg
 

Indy51

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I guess the other question to ask - how useful is a marker that is so changeable and easily modifiable?

Next time I'm due for a lipid test (for some reason my GP insists on them even though he knows I won't take statins), I plan on eating a lot of additional fat in the 3 days prior to the test to see if it makes any difference. I think mine is even higher as the result of the intermittent fasting regime I adopted about 18 months ago.
 

GrantGam

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I guess the other question to ask - how useful is a marker that is so changeable and easily modifiable?

Next time I'm due for a lipid test (for some reason my GP insists on them even though he knows I won't take statins), I plan on eating a lot of additional fat in the 3 days prior to the test to see if it makes any difference. I think mine is even higher as the result of the intermittent fasting regime I adopted about 18 months ago.
My lipids are all in range and I intermittently fast for roughly half the year (when away working).

Do you think intermittent fasting drives up all the results of your lipid profile? Interested to find out:)

Personally, the only one of mine that changes are trigs if I eat before the bloods are drawn. My last trigs were less than half because it was fasting vs getting the bloods drawn after lunch.
 

Indy51

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My lipids are all in range and I intermittently fast for roughly half the year (when away working).

Do you think intermittent fasting drives up all the results of your lipid profile? Interested to find out:)

Personally, the only one of mine that changes are trigs if I eat before the bloods are drawn. My last trigs were less than half because it was fasting vs getting the bloods drawn after lunch.
Yes, IF seems to have made a difference to mine - but I do seem to be a hyper-responder to LCHF and IF as outlined in Dr Eades blog and the results @DaveKeto has logged: "There are some old studies out there kicking around showing that people who fast actually drive their cholesterol levels up, which goes along with Dave’s theory as to mechanism. During a fast, the liver is sensing no fat coming in, so really needs to package some and send it to the tissues."

Then again, I've always had high cholesterol, especially HDL, since I started tracking it back in 2003. I've also had a 23andme DNA test that comes back with multiple SNPs for high HDL and high cholesterol, so my results seem to line up with what the DNA would predict.

Example results:
Overall highest individual readings on various tests since 2003:
TC = 9.0 / Trigs = 4.3 / HDL = 2.3 / LDL = 6.1 / Trigs:HDL Ratio = 3.09

About the time I was diagnosed with Type 2 - on calorie controlled "standard" diet but not losing weight (also diagnosed with hypertension, hypothyroidism and Vitamin D3 deficiency):
29/2/2012 TC = 7.4 / Trigs = 3.1 / HDL = 1.4 / LDL = 4.6 / Trigs:HDL Ratio = 2.21

On LCHF but not IF:
25/1/2016 TC = 6.5 / Trigs 1.0 / HDL = 1.9 / LDL = 4.1 / Trigs:HDL Ratio = 0.53

After daily IF/time restricted feeding window:
27/6/2016 TC = 8.9 / Trigs 1.1 / HDL = 2.3 / LDL = 6.3 / Trigs:HDL Ratio = 0.48
 

librarising

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I guess for all of us, it comes back to which experts we trust.

Not sure if you follow Twitter, but there's a very interesting conversation going on between Ivor Cummins and others about what a BS marker LDL is for CAD.

https://twitter.com/tednaiman/status/890203548704686081

A link worth reading:
http://www.thefatemperor.com/blog/2...-the-bad-cholesterol-thats-simplistic-foolery

Another graphic illustrating the lipids of the 136,905 patients hospitalised with CAD (unfortunately it uses US measurements):

DFqjZ6WUwAAn8tb.jpg
Conversion to UK numbers (rounded to one decimal point) for these two graphs gives the following :
TC 4.5 / 4.7
LDL 2.7 / 2.9
Trigs 1.8 / 1.9
HDL 1.0 / 0.9

Trigs/HDL ratios of 1.8 / 2.1
Geoff
 
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lindisfel

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There are probably some less debatable studies on the net regarding the benefits of statins, excluding lowering cholesterol! If you have left ventricular hypertrophy, they have been shown to thin the heart muscle and improve heart ejection fraction. Having the above problem due to Conn's syndrome I have to weigh up their plusses and minuses more accurately. Fact is I can't take Atorvastatin. Derek