Talking to doctor about cholesterol

edited December 2016 in The Bulletproof Diet

Quick backround, I'm a 5'5" 150lb 29-year-old female. My doc recently ordered some blood work, mainly to recheck my cholesterol levels (which were already high last time she checked 2 years ago, pre-bulletproof diet likely due to poor eating habits). I got them back and she called wanting to discuss them - I've got my appointment with her on Dec. 5 to discuss. I know what she's going to say, that my levels are high and she'll likely want to do something about it. A little background about this doc... she's older, in her late 60s, and that's pretty much where her mindset has stayed medicine-wise. She has suggested to me on several occasions that I should be a vegetarian, eat soy, consume low-fat dairy. I know what you're thinking... why am I still going to her? Military insurance, so its complicated. Luckily we're moving soon and I'll have a chance to go to someone new! Anyways, I'm wondering how to counter what she suggests... Here are my levels:

Total cholesterol: 290 (Reference range 125-200mg/dL)
HDL cholesterol: 69 ((Reference range > or = 46mg/dL)
Triglycerides: 73 (Reference range <150mg/dL)
LDL cholesterol: 206 (Reference range <130mg/dL) calc
(Here it talks about levels > or = 190mg/dL may indicate familial hypercholesterolemia. I don't think this runs in my family, but still need to ask.)
Chol/HDLC ratio: 4.2 (Reference range < or = 5.0 calc)
non HDL cholesterol: 221 mg/dL (target for non-HDL is 30mg/dL higher than LDL target)

Listening to some of Dave's podcasts on cholesterol, it seems as though even as my LDL is high, my triglycerides are fine and I should only worry about the LDL if I've got inflammation. Does that sound about right? If my doc suggests going on some meds to lower my cholesterol or removing most fat from my diet, what do I say? What evidence and research can I point her to? I know the decision is mine, but I also want to make sure I'm understanding things to the best of my ability.

So, how do these levels look? Do I have anything to worry about? Should I request further tests to see if these levels are indeed dangerous? I only know what's "high" according to Quest Diagnostics, and am looking for further research to indicate what further action to take if any.

Thanks in advance!

-Danielle

Comments

  • dazdaz today is a good day ✭✭✭
    edited December 2016

    hsCRP is the blood test of choice for inflammation iirc.
    (High-sensitivity C-reactive Protein)

    fake it till you make it

  • dazdaz today is a good day ✭✭✭
    edited December 2016

    The good range for tg/hdl ratio is 0.5 - < 2.0
    Your tg/hdl ratio is 1.06 (ie. good)

    Study ref PMC2664115
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664115/
    (I think there are other study refs for this ratio range as well, but this is the one I remember)

    fake it till you make it

  • DManDMan Master of Arts ✭✭✭

    @dlambert87

    It is being said that you have to look into LDL types of particles. LDL c and LDL P if I remember correctly. LDL as such is not accurate enough to be scared about. It has been discussed in several podcast episodes. I have not tested but I am high in LDL cholesterol as well since bulletproof and I assume that I am sensitive to saturated fat.... due to the DNA Fit diet analysis. I am a little lower than you are but not I am also only somewhat sensitive. My doctor does not put me on cholesterol lowering drugs since this is something you would only go for if you have several types of biomarkers pointing at heard disease. Cholesterol will always be looked at in context with other biomarkers.

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  • Thanks for the study reference!

    @daz said:
    hsCRP is the blood test of choice for inflammation iirc.
    (High-sensitivity C-reactive Protein)

    I believe that was the test I was looking for. I've been wanting to check it, since I've been trying to get rid of some stubborn belly fat and have wondered if inflammation is the culprit, along with possibly playing a part in my migraines and sinus issues.

    @Jason Miller said:
    If you are looking to at least lower it a bit (I don't think there is a slice of evidence that being above range has a health benefit), possibly look into adding oatmeal to your diet, you can get gluten free if it pleases you, and it pretty reliably lowers cholesterol.

    I am hesitant to incorporate oats back into my diet since I've found I'm definitely sensitive to gluten. Do you know if the gluten-free varieties offer the same benefits?

    @DMan said:
    @dlambert87

    My doctor does not put me on cholesterol lowering drugs since this is something you would only go for if you have several types of biomarkers pointing at heard disease. Cholesterol will always be looked at in context with other biomarkers.

    I do have what my doc calls "labile" high blood pressure, meaning sometimes it's high, sometimes it's normal. I also have some anxiety problems which I know can cause strain on the heart over time. I think I'd at least like to give my heart a look just in case, as high BP runs in my family.

  • dazdaz today is a good day ✭✭✭
    edited December 2016

    "I am hesitant to incorporate oats back into my diet since I've found I'm definitely sensitive to gluten. Do you know if the gluten-free varieties offer the same benefits?"

    the gluten-free labeling thing (in the US) just relates to cross contamination with gluten containing grains, ie. wheat, barley, rye.
    most people think of gluten as the prolamins (storage proteins) gliadin and glutenin found in wheat, barley, rye.
    Oats contain the prolamin avenin, which some people are also sensitive to.
    In Australia, all oats (labeled in Australia) have to carry the 'contains gluten' label, irrelevant of how they have been processed. The reasoning being (i think), is that some people on a gluten free diet react to avenin as well, so they are being precautionary with the labeling.

    If you do give oats a go, personally i would go with oat bran.

    fake it till you make it

  • RekaReka ✭✭✭

    I second the lowering with fiber idea. But why do you have to say anything and get into arguments with her? Just listen to what she says and do what you believe is best. No need to argue or point evidences, it is pretty much pointless. I would avoid arguments, statins and soy but increase fiber intake until you reach the "normal" range.

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  • I just this week received tests back that I dropped 70 points in total cholesterol and wanted to share how. I run about 200 total cholesterol normally (ie pre BP diet). In July I was 192. Initially on BP diet I spiked to 240, then back down to 200. I'm on the BP diet for about 15 months at this point. In November (last month) I spiked to 240 again. HDL was 52, LDL was 167, TG 112. I sort of freaked out and was at a crossroads about BP diet because of it. I tried a 30 day experiment. Regular BP diet, BPC etc, except no pork, limited red meat, no alcohol, TONs of fiber (PGX, FiberRich+ crackers (wheat, not BP, I know), Psyllium Husk, etc, black/blue berries every night) and as much Vital Choice fish as possible (Mackerel, Sockeye, Sardines). I probably had fish 3 times a day for 28 of the days of the month. As a side note, I dropped 5 pounds. The only other thing I did that was different was taking Berberine (500mgs), which I read could help Cholesterol and I ate a garlic clove twice a day. I admit that this isn't a controlled experiment with one variable at a time, but I again, I kind of freaked out.

    My Total Cholesterol is now 171, HDL dropped to 47 (which I'm not happy about of course), LDL to 106, and TG to 86. As another side note, my Testosterone went up about 50 points, Liver and Iron stats are normal, and inflammation was 0.5 (slightly up from 0.3 in Nov). My only point of writing this is that I adjusted my BP diet and at least statistically there was a massive change. True that I didn't test LDL particle size (just had that checked yesterday, no results yet) and I know total cholesterol isn't the main issue anymore, but in case you wanted to try something....Hope this is somewhat helpful. This is my first posting ever and I felt compelled to write this down.

  • Thanks @JKelley! Interesting experiment. I've nixed my BPC for now to see if that will have any affect, so we'll see. We're about to move, so that'll give me a little fresh start once we get settled in to make some more adjustments. I know I definitely need more fiber intake (going through a lot now and it's caused me to fall of the wagon a bit and eat more "comfort foods" than normal) so I haven't been eating as much veggies as I was. New Year coming up, it's time for me to get back in the game! I've got 1 size to get back to my goal, so I can see the light at the end of the tunnel :)

  • DManDMan Master of Arts ✭✭✭

    I wonder who of you has gut/autoimmune/inflammation problems?

    I know I have.

    If you all have some problems like that we might be on to something here.

    However @dlambert87 has good HDL so that is why I am not so worried about her. @JKelley has also low hdl like i had in the past which is what I worry about... At this point.

    We might also want to find people who have high ldl low hdl and be in good condition without inflammation/gut issues in order to disprove this hypothesis.

    May you be well, may you be happy, may you be healthy, may you be loved.

    How much to eat:
    advanced | How to train: bulletproof training | HRV: HRV FOR TRAINING HRV BASICS What Affects HRV | Brain  & Memory dual n back training advanced training

     

     

  • You read my mind. I am working hard on the gut aspect. I have been trying to read up on different takes on which probiotics to take, starting taking microdoses of kefir, and tuning into what Dave Asprey's guests have said. Toyed with potato starch briefly but after Grace Liu and others' comments on it, I backed off. I have a cardiologist doing full on thyroid, autoimmune and cholesterol panels (beyond the typical) that I should get back soon.

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