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Tin Pot




Joined: 08 Jul 2013
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Location: Bromley

PostPosted: Mon Dec 29, 2014 9:36 pm    Post subject: Reply with quote

Tigger wrote:
Tin Pot wrote:
So the BHF are wrong saying this?

https://www.bhf.org.uk/heart-health/risk-factors/high-cholesterol


My answer is: I think you will find that it is a bit more complicated than that.

The BHF website is written for a wide range of people who may, for example, just be consuming chocolate, pizza, burgers and chips and who want to read a quick summary. It is not intended to be a complete. And it doesn't mention the different views that people have (i.e. it is not settled science).

So for example, it says

BHF wrote:
Low-density lipoproteins (LDL) is known as the bad type of cholesterol. LDL carry cholesterol from your liver to the cells that need it.


But a more detailed answer would be along the lines:

Cholesterol Clarity wrote:
There are two major classifications of LDL particles that can be measured: Pattern A is the large, fluffy, and generally harmless kind that is described as “good” LDL (yes, there is such a thing); Pattern B is the small, dense, potentially dangerous kind that is described as “bad.” Pattern B LDL can easily penetrate the arterial wall, compromising your heart health. This is what you are trying to avoid at all costs, so knowing the breakdown of your LDL particles is critical to determining overall heart health.


But when the tests that the doctor gives you just says "LDL" then what is the point of the BHF saying that?

The BHF also talk about the risks associated with saturated fat. My concern here is that this is a "common sense" answer rather than something that is evidence based (in the scientific sense). For example, eating more fat and less carbohydrates may have a bigger impact on overall heart health (e.g. because of a reduction in arterial inflammation).

My understanding is that high cholesterol by itself will not harm you. But if you have arterial inflammation it will. So I go back to my "it's a bit more complicated than that".


Okay, that's cool.

My GP showed me two level of cholesterol; good and bad. I have good in the right range and bad above the normal range.

The fact he was quite casual about it, and blamed my wifes cooking, means I'm not panicking. But it does seem like changing my diet is the right thing to do .
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Tigger




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PostPosted: Tue Dec 30, 2014 6:26 am    Post subject: Reply with quote

Tin Pot wrote:
My GP showed me two level of cholesterol; good and bad. I have good in the right range and bad above the normal range.

The fact he was quite casual about it, and blamed my wifes cooking, means I'm not panicking. But it does seem like changing my diet is the right thing to do .


My guess is that he gave you your HDL "good" and LDL "bad" levels rather than the different types of LDL.

As I said at the start, it is well worth reading "Cholesterol Clarity". It's well written and up to date.

I guess the reason he is quite casual about it is that lots of people have high cholesterol. Something like 71 million American adults have high LDL (34%). The UK measures "high" in a different way (and has changed the way it does) but something like 60% of adults have "raised cholesterol".
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Andy916




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PostPosted: Tue Dec 30, 2014 10:00 am    Post subject: Reply with quote

explorerJC wrote:
i ate walnuts, chia seeds and took garlic tablets daily to get mine down...


What magnitude of effect did you see on LDL, out of interest?
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Andy916




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PostPosted: Tue Dec 30, 2014 10:20 am    Post subject: Reply with quote

The particle size thing is an advance on simple LDL/HDL/TG (by the way it's the latter that correlates with CHD) but not readily available in the UK, on NHS at least. If you're in a position to read the original science on this you see that plaque formation really isn't well understood. What we have are population-level correlations and theories on how it happens, irrespective of how confident Jimmy Moore or any of the other commentators of the last decade may present themselves.

What I would say is read around the topic before your next appt and recognise there are vested interests in much of the advice. Oh, and don't worry too much because that in itself can end up being a source of stress that correlates with negative health outcomes...
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explorerJC




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PostPosted: Tue Dec 30, 2014 10:33 pm    Post subject: Reply with quote

Andy916 wrote:
explorerJC wrote:
i ate walnuts, chia seeds and took garlic tablets daily to get mine down...


What magnitude of effect did you see on LDL, out of interest?


good question - can't remember but it will be written on that year's calendar somewhere....

it was enough to take me below the at risk with other factors threshold....and it came down quite quickly...and stopped the doc wanting me to take statins...
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newarktricky




Joined: 11 May 2007
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PostPosted: Tue Dec 30, 2014 11:45 pm    Post subject: Reply with quote

jibberjim wrote:
Tin Pot wrote:
Yeah, three months is the next blood test. If it hasn't come down, he'll prescribe medication - I'd rather avoid that.


You're not obliged to take it, even if he prescribes it...


Absolutely but have a concordant discussion with the doctor before it goes that far to avoid contributing to the millions of pounds worth of medication wasted due to being prescribed but never taken...

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Tin Pot




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PostPosted: Wed Dec 31, 2014 8:39 am    Post subject: Reply with quote

newarktricky wrote:
jibberjim wrote:
Tin Pot wrote:
Yeah, three months is the next blood test. If it hasn't come down, he'll prescribe medication - I'd rather avoid that.


You're not obliged to take it, even if he prescribes it...


Absolutely but have a concordant discussion with the doctor before it goes that far to avoid contributing to the millions of pounds worth of medication wasted due to being prescribed but never taken...

NT Very Happy Very Happy


It's never wasted, it's sold on the SilkRoad Wink

I have a maternal family history of high cholesterol, so I'm unlikely to reject it if prescribed. Hence I'll try to resolve it through diet.

I've requested a thyroid function test, wasn't carried out previously though apparently it was in 2009. Don't remember that...
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Tin Pot




Joined: 08 Jul 2013
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PostPosted: Wed Dec 31, 2014 8:42 am    Post subject: Reply with quote

Tigger wrote:
Tin Pot wrote:
My GP showed me two level of cholesterol; good and bad. I have good in the right range and bad above the normal range.

The fact he was quite casual about it, and blamed my wifes cooking, means I'm not panicking. But it does seem like changing my diet is the right thing to do .


My guess is that he gave you your HDL "good" and LDL "bad" levels rather than the different types of LDL.

As I said at the start, it is well worth reading "Cholesterol Clarity". It's well written and up to date.

I guess the reason he is quite casual about it is that lots of people have high cholesterol. Something like 71 million American adults have high LDL (34%). The UK measures "high" in a different way (and has changed the way it does) but something like 60% of adults have "raised cholesterol".


Did some reading on cholesterol and statins. It is more complex isn't it? Smile
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dss123




Joined: 07 Apr 2010
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PostPosted: Fri Jan 02, 2015 10:25 am    Post subject: Reply with quote

The standard blood Cholesterol test is so inaccurate to be almost meaningless...

For starters "Total Cholesterol" will change on a daily basis. The time of day, fasted state, sun exposure, stress levels all affect levels.

As a point of interest - Dietary cholesterol intake has minimal (if any) affect on blood cholesterol. Your body MAKES cholesterol and decides how much you need. At best, dietary intake suppliments the body's own production.

But the real kicker is that, in the standard blood cholesterol test, they only measure total Cholesterol and HDL. Yet somehow tell you your total, HDL, LDL and TG levels.

So in other words, an equation with 4 variables, only 2 of which are measurable, yet they get values for all 4?? How does that work? (equations, estimations and guesswork - that's how)

The test also CRITICALLY takes no account of LDL particle size. (The large "fluffy" type are good, small dense are bad)

Still... a nice simple number is what the general public need...

"5" - that sounds good. Nice and snappy.

Let your total cholesterol go over this magic (made up) number and you'd better start buying fancy cholesterol lowering speads / drinks. Of maybe start taking a drug. You gotta take if for life though, because if you stop, your cholesterol level might go up again.

Bottom line.... If you have high cholesterol you may have some underlying issue causing it (chronic inflammation, stress, lifestyle etc) in which case you should address the cause NOT the effect.

Or - you might actually be perfectly healthy.

My advice - ditch the "diet" sheet you've been given. Eat natural, nutrient dense, whole foods including natural saturated fats (and other fats). Cut out all refined / processed crap. Consume carbs around training

Keep exercising, don't smoke, drink in moderation, avoid stress.

And let your own body look after it's own cholesterol levels.


Dunc
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Compo




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PostPosted: Sun Jan 04, 2015 10:05 pm    Post subject: Reply with quote

Adding a slightly different side to this thread I was diagnosed with Familial hypercholesterolaemia 18 years ago after the death of a brother. This result came after many months of blood tests in a specialist unitand I have been on statins now for all this time. Diet has had little or no impact but the tablets do. One thing that has always been commented on though by the medics is that my tri lifestyle and no smoking has been equally significant in impacting on my health, and apart from an annual blood test and check-up the Doctors are happy.
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dss123




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PostPosted: Mon Jan 05, 2015 9:04 am    Post subject: Reply with quote

Compo wrote:
Adding a slightly different side to this thread I was diagnosed with Familial hypercholesterolaemia 18 years ago after the death of a brother. This result came after many months of blood tests in a specialist unitand I have been on statins now for all this time. Diet has had little or no impact but the tablets do. One thing that has always been commented on though by the medics is that my tri lifestyle and no smoking has been equally significant in impacting on my health, and apart from an annual blood test and check-up the Doctors are happy.
#


Yes this is indeed a special case and diet will have no impact on this since it is due to a malfunctioning gene. So diet can't "make it better" but it could exacerbate it

So drugs are the only way to reduce the exccess levels of LDL.

As you say - keeping fit / healthy is also very important.

So this is one situation where a statin may be required. In this instance, I'd also recommend taking a CoQ10 supplement to offset the reduction in the bodies own production when statins are taken. This will help minimise the negantive affects (muscle pain, muscle cell breakdown) of statins.

Dunc
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MTriton




Joined: 16 Feb 2005
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Location: N Surrey

PostPosted: Tue Jan 06, 2015 1:10 pm    Post subject: Reply with quote

dss123 wrote:
The standard blood Cholesterol test is so inaccurate to be almost meaningless...

For starters "Total Cholesterol" will change on a daily basis. The time of day, fasted state, sun exposure, stress levels all affect levels.

As a point of interest - Dietary cholesterol intake has minimal (if any) affect on blood cholesterol. Your body MAKES cholesterol and decides how much you need. At best, dietary intake suppliments the body's own production.

But the real kicker is that, in the standard blood cholesterol test, they only measure total Cholesterol and HDL. Yet somehow tell you your total, HDL, LDL and TG levels.

So in other words, an equation with 4 variables, only 2 of which are measurable, yet they get values for all 4?? How does that work? (equations, estimations and guesswork - that's how)

The test also CRITICALLY takes no account of LDL particle size. (The large "fluffy" type are good, small dense are bad)

Still... a nice simple number is what the general public need...

"5" - that sounds good. Nice and snappy.

Let your total cholesterol go over this magic (made up) number and you'd better start buying fancy cholesterol lowering speads / drinks. Of maybe start taking a drug. You gotta take if for life though, because if you stop, your cholesterol level might go up again.

Bottom line.... If you have high cholesterol you may have some underlying issue causing it (chronic inflammation, stress, lifestyle etc) in which case you should address the cause NOT the effect.

Or - you might actually be perfectly healthy.

My advice - ditch the "diet" sheet you've been given. Eat natural, nutrient dense, whole foods including natural saturated fats (and other fats). Cut out all refined / processed crap. Consume carbs around training

Keep exercising, don't smoke, drink in moderation, avoid stress.

And let your own body look after it's own cholesterol levels.


Dunc

Bingo. What a great post.
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leahnp




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PostPosted: Tue Jan 06, 2015 1:56 pm    Post subject: Reply with quote

Thanks of this dss
I too was diagnosed last year with high cholesterol when I had my 'health tests' for my Pru Health cover at a local pharmacy. After 6 months I saw my GP to discuss the next steps/retest and I was told the same- the tests are not accurate so make dietary changes to a more natural diet and keep up the exercise. I am now 2kg lighter in my hibernation state compared to last year with the changes made.
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dss123




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PostPosted: Tue Jan 06, 2015 4:28 pm    Post subject: Reply with quote

It makes my blood boil to hear the scare mongering going on around around cholesterol levels - by people who probably don't even understand what cholesterol is and how critical it is to life.

I mean... they are even doing cholesterol tests in supermarkets for goodness sake! Supported by Flora or some other giant food producer who can then sucker the unexpected into buying their cholesterol lowering product. Or the drug company who wants more customers for life.

The biggest con job in medical history.
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Andy916




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PostPosted: Thu Jan 08, 2015 9:05 pm    Post subject: Reply with quote

dss123 wrote:

For starters "Total Cholesterol" will change on a daily basis. The time of day, fasted state, sun exposure, stress levels all affect levels.

As a point of interest - Dietary cholesterol intake has minimal (if any) affect on blood cholesterol. Your body MAKES cholesterol and decides how much you need. At best, dietary intake suppliments the body's own production.

But the real kicker is that, in the standard blood cholesterol test, they only measure total Cholesterol and HDL. Yet somehow tell you your total, HDL, LDL and TG levels.

So in other words, an equation with 4 variables, only 2 of which are measurable, yet they get values for all 4?? How does that work? (equations, estimations and guesswork - that's how)

The test also CRITICALLY takes no account of LDL particle size. (The large "fluffy" type are good, small dense are bad)

Still... a nice simple number is what the general public need...

"5" - that sounds good. Nice and snappy.

Let your total cholesterol go over this magic (made up) number and you'd better start buying fancy cholesterol lowering speads / drinks. Of maybe start taking a drug. You gotta take if for life though, because if you stop, your cholesterol level might go up again.

Bottom line.... If you have high cholesterol you may have some underlying issue causing it (chronic inflammation, stress, lifestyle etc) in which case you should address the cause NOT the effect.

Or - you might actually be perfectly healthy.

My advice - ditch the "diet" sheet you've been given. Eat natural, nutrient dense, whole foods including natural saturated fats (and other fats). Cut out all refined / processed crap. Consume carbs around training

Keep exercising, don't smoke, drink in moderation, avoid stress.

And let your own body look after it's own cholesterol levels.


Yup, agree with most of that.

Do you have a reference or personal example for the measurements being so dynamic? My understanding, and indeed the rationale for taking them only every few months/years, is that they're generally slow to change.

Detail point, the standard measurements include TG, from which VLDL is guesstimated and plugged into the Friedenwald equation.

Yes, LDL particle size appears to be important, but it's still just a theory with a bunch of population level data in support rather than mechanistic understanding. The theory is that the endothelium is susceptible to intrusion
by the small dense particles and not to the large 'fluffy' ones. But do you know the difference in diameter between the two? It's 20% absolute maximum, 19-20.5nm as opposed to 20.6-23.0nm. Not exactly consistent with the popular view of them being massively distinct, is it? It's a continuum divided by a pair of fairly arbitrary categories. Also, there's no recognised standard yet for the various particle size estimation methods.

Diet, yes, most people's blood levels aren't sensitive to it. About 25% are though (according the last number I saw, admittedly a few years ago), and in those individuals diet interventions may well be important - lower cholesterol intake, monounsaturates instead of too much saturated fat, chia, walnuts, almonds, various herbs etc etc.

Full agree on nutrient-dense natural diet with carbs targetted to training.

I'm fairly convinced the tests can be useful, so long as you take care with (and responsibility for) interpretation, avoiding the standard advice to take statins....
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