The Cholesterol Thread: HDL v. LDL v. Lipitor - CAGEMATCH

[Core Shot]

Lipitor made me trippy. Racing thoughts. Increased anxiety. Pulsing pupils.
Quit after a few days.

I’m consistently around 220. Like you said, they want you wayyy lower.

It’s a personal decision. I’m going with Ernest Hemingway and eating meat even if I get fewer years. My wife has gone plant based. Not vegan. Lots of high performing athletes do it. Forks over knives etc.

PS. Ask your doctor how statins work. Answer? They don’t know. But they can lower cholesterol. But what side effects do you get?

[Buster Highmen]

They know how statins work to lower cholesterol production in the liver.

But the real issue is whether cholesterol correlation with heart disease is valid. Science marches on, polemics becoming paradigms and paradigms falling from fashion and consenseless.

[PB]

Seems negligent for doctors to claim statins are required without actually checking for arterial build-up. Is there some insurance back pressure on such scans? Don't have any hard numbers but am familiar with several people with high cholesterol numbers that have clean arteries, and also the reverse (low numbers but dangerously clogged arteries). Diagnosis on numbers alone sounds lazy.

[MagnificentUnicorn]

First of all, we “absorb” almost zero dietary cholesterol. There is no “bad” cholesterol, it’s essential for life


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[Core Shot]

They know how statins work to lower cholesterol production in the liver.

But the real issue is whether cholesterol correlation with heart disease is valid. Science marches on, polemics becoming paradigms and paradigms falling from fashion and consenseless.

Yes. Was being a bit snarky there. It’s systemic. Lots of other non liver effects.

Statins are a family of drugs that are used for treating hyperlipidaemia with a recognized capacity to prevent cardiovascular disease events. They inhibit β-hydroxy β-methylglutaryl-coenzyme A reductase, i.e. the rate-limiting enzyme in mevalonate pathway, reduce endogenous cholesterol synthesis, and increase low-density lipoprotein clearance by promoting low-density lipoprotein receptor expression mainly in the hepatocytes. Statins have pleiotropic effects including stabilization of atherosclerotic plaques, immunomodulation, anti-inflammatory properties, improvement of endothelial function, antioxidant, and anti-thrombotic action. Despite all beneficial effects, statins may elicit adverse reactions such as myopathy. Studies have shown that mitochondria play an important role in statin-induced myopathies. In this review, we aim to report the mechanisms of action of statins on mitochondrial function. Results have shown that statins have several effects on mitochondria including reduction of coenzyme Q10 level, inhibition of respiratory chain complexes, induction of mitochondrial apoptosis, dysregulation of Ca2+ metabolism, and carnitine palmitoyltransferase-2 expression. The use of statins has been associated with the onset of additional pathological conditions like diabetes and dementia as a result of interference with mitochondrial pathways by various mechanisms, such as reduction in mitochondrial oxidative phosphorylation, increase in oxidative stress, decrease in uncoupling protein 3 concentration, and interference in amyloid-β metabolism. Overall, data reported in this review suggest that statins may have major effects on mitochondrial function, and some of their adverse effects might be mediated through mitochondrial pathways.

[XXX-er]

I got higher blood suger so i cut sugar and food intake, the good cholesterol went up the bad cholesterol went down and my a1C went down a couple of points, i lost 15lbs and my BMI went normal

[Buster Highmen]

Seems negligent for doctors to claim statins are required without actually checking for arterial build-up. Is there some insurance back pressure on such scans? Don't have any hard numbers but am familiar with several people with high cholesterol numbers that have clean arteries, and also the reverse (low numbers but dangerously clogged arteries). Diagnosis on numbers alone sounds lazy.

I have a scan scheduled for tomorrow. If that shows non subtle arterial plaque, I'll for sure have to go on statins. Yech.

Summary:
lipitor has some bad side effects.
Simvastatin is one option
Rosuvastatin is another option.

And red rice yeast supposedly.

[Djongo Unchained]

I want in on this cagematch...

I finally made myself go get a primary care doctor this spring after some slight chest pains. She's a 30 something smokeshow with a storied family of HOF skiers.
I like going to see her.

My blood panel told her I was in exceptional shape.
I laffed.
She says 'whatever your secret is, keep doing it'. I said it's a lifetime of weed.
She laffed.

@57yrs, 5'9", around 215-220lbs...

Cholesterol total - 158
Triglycerides - 169
HDL - 50
non-HDL Chol. - 108
LDL - 74
Chol/HDL ratio - 3
VLDL - 34

Tri's and vldl are a tad high for me, everything else well inside the ref. range.

She says I could drink more water.
I wonder if living at 6300' ASL for 30+yrs. helps?

[Buster Highmen]

well sheeeit, you're just flaunting it whippersnapper

[Djongo Unchained]

^^^^

It just looked like some kinda cagematch I'd have half a chance in.
Those don't roll around much for me.

[BobMc]

I just looked at my lab results.

Cholesterol total: 226
Triglycerides: 84
HDL: 66
Non HDL cholesterol: 160
LDL: 143
Cho/HDL: 3.4
VLDL: 17

I don’t really know what any of that means, but apparently it’s bad as they diagnosed me with Hyperlipidemia and carotid artery disease. I’m now on atorvastatin, clopidogrel, and lisinopril. They may have some side effects but after last week I’ll take side effects over dying.

[Buzzworthy]

At one time I had a script for Lisinopril but it did not agree with me so that was short lived.

I’ve got my order to get my yearly blood work sitting on the table for a month so I probably ought to get in and get it done.

[fastfred]

Yeah, I've never taken any drugs and avoid Drs. Guess I can't avoid it anymore. Talk to them about the injectables. At your age, it might be an option.

I did that for almost 45 years (avoiding the dr and pharmaceuticals)
then they got me a nice room in the icu and cracked my chest open

don't be a puss everyone I'm on cholesterol meds and bp meds low doses could go off the bp meds tomorrow if I quit my job
I took myself off them this past year and realized that was stupid and I'm back on again
I think they have been lowering the numbers for everything the past decade to get more people on meds to make more money seriously
my cardiologists said don't worry about it they just lowered the number like three years ago so you are still good with the old numbers

some of you guys don't like beta blockers? I was on em for a year I liked them all weird though not getting your heart rate up like you think you would
my favorite is a couple beers an extra beta blocker or two and a tylenol pm talk about happy places

[Core Shot]

my favorite is a couple beers an extra beta blocker or two and a tylenol pm talk about happy places

Fast Fred
He’s fast
Asleep

[Hopeless Sinner]

Fast Fred
He’s fast
Asleep

And probably lucky to be alive!

[Dantheman]

Apparently there are injectable statins that are far more effective than the pills but are crazy expensive. Insurance usually won't cover them unless you have bad reactions to most pills.

I am guessing you're referring to PCSK9 inhibitors, which are very, very different from statins. None of them have gone off-patent yet so they are indeed very expensive, though also very effective. It will be interesting to see how much more often they get rx'ed when the cost comes down.

https://my.clevelandclinic.org/healt...sk9-inhibitors

First of all, we “absorb” almost zero dietary cholesterol. There is no “bad” cholesterol, it’s essential for life

The former is correct, the latter not so much, at least in the context of cholesterol that is bound to lipoproteins in the bloodstream. There are people with genetic mutations that cause them to not produce LDL at all, and they get virtually no atherosclerosis and don't seem to suffer any other ill effects. The discovery of these gene variants led directly to the development of PCSK9 inhibitors.

[Bunion 2020]

At one time I had a script for Lisinopril but it did not agree with me so that was short lived.

Same, caused belly problems. Losarten is tolerable for me. Doc wanted me on Statins, so far I have resisted, hoping a lot more oatmeal for Bkfast did the trick along with reduction in beer and booze.

[old goat]

I have hereditary high cholesterol. My mom's LDL (without statins) was ~600. She's almost 80, overweight and going strong. Her mom was ~900 LDL without statins and lived to 93. I was 15 when I had mine measured the first time and it was 220. 15yrs ago I tried Lipitor and suffered muscle weakness and joint pain. My Dr told they wouldn't help much and took me off it.

Fast forward to August this year and I had a sudden heart attack while running. I'm 48 and in good shape. I exercise regularly and don't drink/smoke/drugs (Mormon). My cardiologist said my high cholesterol was not the cause but played a role (I have fairly minimal build up). I had a STEMI heart attack where the plaque ruptured in my artery and my body then created a clot causing 100% blockage. My plaque was not as stable due to my high cholesterol. It all happened within 10 minutes and no one would have been able to see anything prior to that day. I now have 2 stents, but also still have no issues with build up.

Since then, I'm now on Cestor due to my reaction to Lipitor. Apparently there are injectable statins that are far more effective than the pills but are crazy expensive. Insurance usually won't cover them unless you have bad reactions to most pills.

When I was younger, they said "high" cholesterol was ~200 LDL. My cardiologist said 150 is the new "high". He wants me down at 70 to firm up my plaque. I'm at ~160 now after a month of statins and he's not sure Crestor will get me there. I'm also cutting down red meat and getting back to my regular exercise. I'll see in a couple months how it goes.

This is important. Most heart attacks are caused by the sudden rupture of relatively small plaques. When you have bad plaques that mostly block the artery the heart develops collateral circulation that bypasses the blockage as the plaque grows, so that part of the heart is protected from a heart attack. That's why bypassing the heart arteries or stenting them open doesn't reduce the risk of heart attack--those procedures aren't targeting the plaques that cause heart attack.

Sorry to hear about the HA.

I'm 67.75, 195 lbs, OK but not great shape (bad right knee so no running, but lots of biking) 125/80 bp, relatively low (127) triglycerides.

As mentioned, I guess I'm going to have to follow the crowd now and start taking non recreational drugs.

I keep reading about how the Framingham Heart Study on which statin treatments is based is screwy and incorrect.

Thank you.

Anyone looking for a reason to avoid lipid lowering drugs, or vaccines, or anything else medical can always find support somewhere in this age of podcasts and blogs. Contrarian opinions get clicks; orthodox opinions don't.

Seems negligent for doctors to claim statins are required without actually checking for arterial build-up. Is there some insurance back pressure on such scans? Don't have any hard numbers but am familiar with several people with high cholesterol numbers that have clean arteries, and also the reverse (low numbers but dangerously clogged arteries). Diagnosis on numbers alone sounds lazy.

The benefit of statins was proven before coronary calcium scans were available. There is some evidence that people with higher ccs's may benefit more from statins but that doesn't mean people with low scores don't benefit. Whether or not someone gets statins should still be based on overall risk factors; a high ccs may be of benefit primarily to convince a patient or a patient's doctor to take a statin. Besides the fact that dangerous plaques may not have calcium, the benefits of statins in a person with moderate to high risk but low ccs plays out over time--especially for younger patients the statins will prevent the buildup of plaque in arteries that are clean today but won't be tomorrow.

[skaredshtles]

I want in on this cagematch...

I finally made myself go get a primary care doctor this spring after some slight chest pains. She's a 30 something smokeshow with a storied family of HOF skiers.
I like going to see her.

My blood panel told her I was in exceptional shape.
I laffed.
She says 'whatever your secret is, keep doing it'. I said it's a lifetime of weed.
She laffed.

@57yrs, 5'9", around 215-220lbs...

Cholesterol total - 158
Triglycerides - 169
HDL - 50
non-HDL Chol. - 108
LDL - 74
Chol/HDL ratio - 3
VLDL - 34

Tri's and vldl are a tad high for me, everything else well inside the ref. range.

She says I could drink more water.
I wonder if living at 6300' ASL for 30+yrs. helps?

52yo, 6'1", 180lb

Total chol: 149
Triglyc: 90
HDL: 71
LDL: 61
VLDL: 17

PA says come back next year. Not sure I trust them quacks. Am I gonna die?

[MagnificentUnicorn]

LDL isn’t bad, it’s the concentration of LDL and particle size that can be bad. That’s a bit of a simplification but true


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[Djongo Unchained]

Well hell, I think skeered just stomped me in the cage match.

Damn.

[Dantheman]

LDL isn’t bad, it’s the concentration of LDL and particle size that can be bad. That’s a bit of a simplification but true

My understanding is that apolipoprotein B, which is a component of LDL, is the primary bad guy. LDL and ApoB are correlated, so LDL is a decent biomarker on average, but ApoB is what actually causes ASCVD.

https://pubmed.ncbi.nlm.nih.gov/31642874/
https://peterattiamd.com/measuring-c...f-apob-part-1/

[skaredshtles]

Well hell, I think skeered just stomped me in the cage match.

Damn.

A few years back I had a panel where my total was something like 125. It's my lame claim to fame.

I always like to attribute it to the butter, cheese, cream, and bacon I regularly eat.

ETA: found the results from 2020:

Total chol: 120
Triglyc: 47
HDL: 70
LDL: 37
CHOL/HDLC: 1.7
NON-HDL CHOL: 50

[Buster Highmen]

Anyone looking for a reason to avoid lipid lowering drugs, or vaccines, or anything else medical can always find support somewhere in this age of podcasts and blogs. Contrarian opinions get clicks; orthodox opinions don't.

I thought this was an impressive read, well founded in biochemistry .
https://www.amazon.com/Clot-Thickens.../dp/1907797769

The benefit of statins was proven before coronary calcium scans were available. There is some evidence that people with higher ccs's may benefit more from statins but that doesn't mean people with low scores don't benefit. Whether or not someone gets statins should still be based on overall risk factors; a high ccs may be of benefit primarily to convince a patient or a patient's doctor to take a statin. Besides the fact that dangerous plaques may not have calcium, the benefits of statins in a person with moderate to high risk but low ccs plays out over time--especially for younger patients the statins will prevent the buildup of plaque in arteries that are clean today but won't be tomorrow.

So, is this more clickbait?

One of the articles I read addresses the claim that statins have a 25% reduction in HAs .

The claim is that %age is with regard to the number of people that had heart attacks in the study group, not the total number of people in the study.

I think it was something like 3.6% in the control group (no statins) had a heart attack while 1.7% that took statins still had heart attacks. So if analyzed over the entire group, there was a 1.9% difference. The weird thing was that the latter analysis is applied to side effects to statins, so that's inconsistent.

Can anyone corroborate that? If that stat is valid, it makes me even more suspicious since the 25% is such a significant portion and a great sales pitch.

I do apologize OG if I offended you in my anti doctor rant years ago. At that time, I was fighting with my dad's negligent doctors who had him on warfrin and aspirin when he was passing out from internal stomach hemorrhaging and getting transfusions monthly. I think there were about 6 instances, he always hid them from me. After repeatedly failing to cauterize the ulcers, I forced his doctors to send him to the Mayo in Jacksonville where people with skillz fixed him. He eventually died of a stroke, possibly related to the thinners.

I've had other issues with health care when I needed doctors references (according to a neurosurgeon) and they refused. It's not the individual, it's the industry.

[Buster Highmen]

LDL isn’t bad, it’s the concentration of LDL and particle size that can be bad. That’s a bit of a simplification but true


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This is my understanding as well as the common LDL tests don't distinguish between big, more benign LDL and smaller, more hazardous, LDL.