What to do about Bad Cholesterol

Jings said:
Been there, done that. Diet and exercise did almost nothing to improve my cholesterol levels. My condition is hereditary.
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You have two main types of LDL cholesterol: small, dense LDL and large, fluffy LDL. The small, dense LDL particles are the ones that primarily cause damage to your artery walls. A poor diet is a major contributor to high levels of small, dense LDL.

It's not always helpful to look solely at total LDL levels. If your HDL ("good" cholesterol) is high and your triglycerides are low, it's a good indication that you have mostly large, fluffy LDL particles. This suggests a healthier metabolism.
 
ShloshMalosh said:
Noted,

So you are more exception that rule. Have you gone as far as elimination diets?

Are you experiencing symptoms that are affecting your quality of life or are you just addressing the "number" cos a doctor showed it to you and told you its a "concern" ?
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Bad cholesterol is like high blood pressure. It's a silent killer as most people don't experience warning signs.

My only symptom was shortness of breath, like there wasn't enough oxygen going into my lungs. Sort of like bad hay fever attacks but without the sneezing.

Been managing the condition for the last eight years so it's pretty much part of me now. Ironically I've always hated taking medication, even pain killers and would rather pursue natural alternatives. But unfortunately it's not always possible.
 
BBSA said:
You have two main types of LDL cholesterol: small, dense LDL and large, fluffy LDL. The small, dense LDL particles are the ones that primarily cause damage to your artery walls. A poor diet is a major contributor to high levels of small, dense LDL.

It's not always helpful to look solely at total LDL levels. If your HDL ("good" cholesterol) is high and your triglycerides are low, it's a good indication that you have mostly large, fluffy LDL particles. This suggests a healthier metabolism.
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Went off meds in 2020 due to side effects from the statin and both LDL and triglycerides climbed to dangerous levels. Back on a year later (different brand) and the condition improved again without obvious side effects.

What is so bad about statins?
 
BBSA said:
You have two main types of LDL cholesterol: small, dense LDL and large, fluffy LDL. The small, dense LDL particles are the ones that primarily cause damage to your artery walls. A poor diet is a major contributor to high levels of small, dense LDL.

It's not always helpful to look solely at total LDL levels. If your HDL ("good" cholesterol) is high and your triglycerides are low, it's a good indication that you have mostly large, fluffy LDL particles. This suggests a healthier metabolism.
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@warrenpfo look into this. HDL and Triglyceride levels can give an indirect indication of small dense LDL levels, but ideally you want to determine your LDL subfractions. Large buoyant is neutral from a CVS risk perspective. There is a company in Durban that does this (Lipidpro test - Molecular Diagnostic Services).

Also, statins have a surprisingly small (positive) effect on mortality when used for primary prevention of CVS disease, and may even increase mortality after age 55.
(edited to clarify - statins may increase mortality after age 55, not CVS)
 
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Jings said:
Went off meds in 2020 due to side effects from the statin and both LDL and triglycerides climbed to dangerous levels. Back on a year later (different brand) and the condition improved again without obvious side effects.

What is so bad about statins?
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From a health perspective, some individuals may choose not to take statins due to potential side effects. While statins effectively lower LDL cholesterol, they can also impact muscle health negatively, and the heart is essentially a large muscle.

I prioritise maintaining healthy HDL levels and lowering triglycerides. My main strategies are diet and exercise. I focus on reducing my intake of sugar, refined carbohydrates, and seed oils.
 
Have a look at this. Lustig is a paediatric endocrinologist who has been a voice in the wilderness for a few years, but his arguments are solid and very hard to fault. There is also an interview with him on the Levels website - another really worthwhile resource.
 
Jings said:
Went off meds in 2020 due to side effects from the statin and both LDL and triglycerides climbed to dangerous levels. Back on a year later (different brand) and the condition improved again without obvious side effects.

What is so bad about statins?
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Side effects (not all of them immediately obvious), limited benefit (it's complicated), possible inreased mortality after age 55.
I have been on them twice, and both times I developed well formed suicidal ideation - so yeah, I don't particularly like them.
 
BBSA said:
Maybe you should check your A1C level.
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The problem is that A1C can be entirely normal in the presence of insulin resistance. Ideally you want to do a proper metabolic evaluation and look at insulin levels / lipids / LDL fractions / homcysteine / urate levels, but that is expensive and not many people know what to do with the information. Check out Levels for more info - they have a really interesting thing going there. I wore a continuous glucose monitor about a year ago - life changing experience (and similarly for two other persons I helped with one as well). Hypertension, heartburn, joint pains gone, weight normalised, sleep improved, exercise tolerance way up.
 
BBSA said:
From a health perspective, some individuals may choose not to take statins due to potential side effects. While statins effectively lower LDL cholesterol, they can also impact muscle health negatively, and the heart is essentially a large muscle.

I prioritise maintaining healthy HDL levels and lowering triglycerides. My main strategies are diet and exercise. I focus on reducing my intake of sugar, refined carbohydrates, and seed oils.
Click to expand...

I use coenzyme Q10 in conjunction with the statins.

Our bodies naturally produce less of the enzyme as we age. Studies have found that coenzyme Q10 is beneficial for heart health.

www.ncbi.nlm.nih.gov

Coenzyme Q10 in Cardiovascular and Metabolic Diseases: Current State of the Problem

The burden of cardiovascular and metabolic diseases is increasing with every year. Although the management of these conditions has improved greatly over the years, it is still far from perfect. With all of this in mind, there is a need for new methods ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov

HvRooyen said:
Side effects (not all of them immediately obvious), limited benefit (it's complicated), possible inreased mortality after age 55.
I have been on them twice, and both times I developed well formed suicidal ideation - so yeah, I don't particularly like them.
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Suicidal tendencies are obviously good reason to abstain from certain brands.

I suppose each individual needs to work out the best treatment with their healthcare professionals. But logically it is better to continuously check and treat the condition, even if only with diet, exercise and supplements. My SO had high LDL cholesterol but he was able to correct it with diet and exercise after six months on statins.
 
warrenpfo said:
Would be good to know, I received my chronic script for statins yesterday but am hesitant.

I'm healthy in my eyes having cut out physical sugar in coffee, cereal etc. Exercises 5 to 6 days a week either a 5km run or an hour of squash but cholesterol was still 7.4.

Family has a history but I'm going to give a change in diet further and some supplements a go. How long must one make changes before you start seeing results, 6-8weeks?
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Confirm your HbA1C is 14%?
Weight, height, waist circumference?
 
HvRooyen said:
The problem is that A1C can be entirely normal in the presence of insulin resistance. Ideally you want to do a proper metabolic evaluation and look at insulin levels / lipids / LDL fractions / homcysteine / urate levels, but that is expensive and not many people know what to do with the information. Check out Levels for more info - they have a really interesting thing going there. I wore a continuous glucose monitor about a year ago - life changing experience (and similarly for two other persons I helped with one as well). Hypertension, heartburn, joint pains gone, weight normalised, sleep improved, exercise tolerance way up.
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I think you mean that fasting glucose levels can be normal if your insulin is still doing its job. A1C is a good indication of whether you get regular blood glucose spikes, which you want to avoid. So, it's a really good test. But yes, a continuous glucose monitor would be even better.
 
BBSA said:
I think you mean that fasting glucose levels can be normal if your insulin is still doing its job. A1C is a good indication of whether you get regular blood glucose spikes, which you want to avoid. So, it's a really good test. But yes, a continuous glucose monitor would be even better.
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No. HbA1C is more a measure of average glucose than peak glucose. So high glucose spikes may increase HbA1C, but not in all cases. Also, HbA1C can undoubtedly still be normal in the presence of insulin resistance - especially during the early stages, when glucose levels are still normal (even though end organ damage is already occurring - which explains the earlier onset of organ damage with type 2 diabetes as opposed to type 1).
 
warrenpfo said:
As mentioned above I googled HbA1c and it read hemoglobin and so my reading is 14g/dl

1.9m 82kg
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Hemoglobin is the oxygen carrying molecule in your blood. 14 g/dl is normal. HbA1C is a measure of glycation damage to Hemoglobin - 14% is distinctly abnormal. Apologies if I misunderstand you.
 
HvRooyen said:
No. HbA1C is more a measure of average glucose than peak glucose. So high glucose spikes may increase HbA1C, but not in all cases. Also, HbA1C can undoubtedly still be normal in the presence of insulin resistance - especially during the early stages, when glucose levels are still normal (even though end organ damage is already occurring - which explains the earlier onset of organ damage with type 2 diabetes as opposed to type 1).
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Sure, but your average glucose will be higher if you constant spike your blood glucose levels.
 
All good you had me worried.

Results are in from ampath
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Cholesterol is better than expected but still higher than ideal
 
BBSA said:
Sure, but your average glucose will be higher if you constant spike your blood glucose levels.
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Not necessarily. Some people hyper / hypo. Or just don't spike that much. I appreciate you may think I am splitting hairs here (fair, I will move on). The important thing to realise is that insulin resistance / metabolic syndrome can be present with absolutely normal (average) glucose and HbA1C levels.
 
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