Aa
Do I need medication with this lipid profile?
I'm 38 years old male, 76 kg weight and 5ft 4inches height. I did lipid profile test and following are the numbers
Total Cholesterol 242
Triglyceride 254
HDL Cholesterol 38
LDL Cholesterol 153.2
VLDL Cholesterol 50.8
Total Cholesterol/HDL Cholesterol Ratio 6.3
LDL Cholesterol/HDL Cholesterol Ratio 4.0
My doctor suggested me to take medication Azur 10mg per day, I asked my doctor if it comes down to optimum level by lifestyle modification? Please suggest me, do I need to start the medications or wait for some months and check the profile again after lifestyle modification and healthy diet?
Total Cholesterol 242
Triglyceride 254
HDL Cholesterol 38
LDL Cholesterol 153.2
VLDL Cholesterol 50.8
Total Cholesterol/HDL Cholesterol Ratio 6.3
LDL Cholesterol/HDL Cholesterol Ratio 4.0
My doctor suggested me to take medication Azur 10mg per day, I asked my doctor if it comes down to optimum level by lifestyle modification? Please suggest me, do I need to start the medications or wait for some months and check the profile again after lifestyle modification and healthy diet?
COMMUNITY LEADER
You're taking my point concerning longevity too literal. My point was that life expectancy his increased because of meds and improvements in treatment. Why would one not take advantage? We have cars now, do you still walk across town? Yes, people died of conditions that no longer cause mass deaths, because we found ways to manage them. If we ignored the medical advances we have developed over the years life expectancy would again be in the 50s and of course there would be outliers that die earlier and later, that's why we look at expectancy.
As far as cycling goes it has been shown that pushing to your max heart rate or beyond has no benefit to health and in fact can be dangerous. I always make two runs to max METS on my ride where I'll get to my max rate or beyond, but I do it for short burst less than 5 mins so I can get a good measurement of my recovery rate. The balance of my ride is done with a goal of 85% to 90% of max which has the most benefit.
Well off for my morning ride..................
As far as cycling goes it has been shown that pushing to your max heart rate or beyond has no benefit to health and in fact can be dangerous. I always make two runs to max METS on my ride where I'll get to my max rate or beyond, but I do it for short burst less than 5 mins so I can get a good measurement of my recovery rate. The balance of my ride is done with a goal of 85% to 90% of max which has the most benefit.
Well off for my morning ride..................
COMMUNITY LEADER
Congrats on being proactive with your heath. I'm sure you'll do great!
I would like to thank both circa49 and erijon for their contribution. I get to know so many things from your suggestions. I met my doctor few days ago (actually she is my first cousin), she is very much aware of my family history therefore she suggested me with the medication. When I met her last time, she noticed that I have lose some weight.
I asked her if I can check my lipid profile after 3 months and then only, after analyzing results, I can start medication? She said okay. I will keep you posted about my next result.
I am continuing my morning walk with stair climbing (160 steps * 4 times back and forth) which takes me 12 minutes and additional 25 minutes of brisk walk. I have stopped taking rice, sugar.
Thank you once again
I asked her if I can check my lipid profile after 3 months and then only, after analyzing results, I can start medication? She said okay. I will keep you posted about my next result.
I am continuing my morning walk with stair climbing (160 steps * 4 times back and forth) which takes me 12 minutes and additional 25 minutes of brisk walk. I have stopped taking rice, sugar.
Thank you once again
Well I hope the original poster can read our exchange and draw some useful information from it. Then, together with his doctor, he can chart the course he believes is best.
On the point about humans not being engineered to live into their mid 70's.
You may find your concept is not only factually incorrect but especially with regard to cardio-vascular health, is off by a wide margin.
http://www.infoplease.com/ipa/A0005140.html
Going back to 1850 in the USA, a white male age 40 could expect to live 27.9 more years even when throwing in all causes of death.
A similar male age 50 could expect to live 21.6 years to age 71.6
Back then, if you got past birth and all the years of infection, flu, and bacteria, then your heart did quite well.
Often later dying of cancer or pneumonia.
Same was true for people in the 15th century. Remember so many died from water born illness and lack of sanitation.
For women in the USA in 1850, if you made it through disease and child birth, then at age 40 you would average 29.8 more years. At age 50, the average woman would live 23.5 more years to age 73.5.
Not all that different than todays expected age despite all the non-heart issues they could not treat back then.
Look at the best known founding fathers.
Jefferson 83
John Adams 90 (Adams and Jefferson died on the exact same day, July 4th, 1826
Benjamin Franklin 84
George Washington 67, (
Look at how presidents died in the past
http://python.net/crew/manus/Presidents/faq/causes.html
Of course I'm sure there was atherosclerosis way back.
And certainly even back then, some folks had good genes and others did not.
Regarding cycling, I do it as much for the great feeling afterwards as for the health aspects. Indeed, I push much harder than needed merely for health, because by doing so I get such a high when I stop.
In fact I have to tell myself to ease up sometimes.
At age 63 I really wonder if I might burst a brain artery if I push over a 160 heart rate. I'll have to look into that.
On the point about humans not being engineered to live into their mid 70's.
You may find your concept is not only factually incorrect but especially with regard to cardio-vascular health, is off by a wide margin.
http://www.infoplease.com/ipa/A0005140.html
Going back to 1850 in the USA, a white male age 40 could expect to live 27.9 more years even when throwing in all causes of death.
A similar male age 50 could expect to live 21.6 years to age 71.6
Back then, if you got past birth and all the years of infection, flu, and bacteria, then your heart did quite well.
Often later dying of cancer or pneumonia.
Same was true for people in the 15th century. Remember so many died from water born illness and lack of sanitation.
For women in the USA in 1850, if you made it through disease and child birth, then at age 40 you would average 29.8 more years. At age 50, the average woman would live 23.5 more years to age 73.5.
Not all that different than todays expected age despite all the non-heart issues they could not treat back then.
Look at the best known founding fathers.
Jefferson 83
John Adams 90 (Adams and Jefferson died on the exact same day, July 4th, 1826
Benjamin Franklin 84
George Washington 67, (
Look at how presidents died in the past
http://python.net/crew/manus/Presidents/faq/causes.html
Of course I'm sure there was atherosclerosis way back.
And certainly even back then, some folks had good genes and others did not.
Regarding cycling, I do it as much for the great feeling afterwards as for the health aspects. Indeed, I push much harder than needed merely for health, because by doing so I get such a high when I stop.
In fact I have to tell myself to ease up sometimes.
At age 63 I really wonder if I might burst a brain artery if I push over a 160 heart rate. I'll have to look into that.
COMMUNITY LEADER
I think we are both saying the same thing, my only point is there is no good reason to put off statins when there is this much risk.
Also, I agree that man was not engineered to take meds, however he also was not engineered to live into his mid 70s on average. 15th century men had a life expectancy of 35 years, 50 years in the 18th century and as recently as the 1900s around 55 years of age. The human body has been creating excessive amounts of cholesterol since the dawn of time. Recent imaging on mummies found atherosclerosis, man has had heart disease from the time of raw meats and nuts.
FYI, just got back from the evening bike ride. Good work out, feel great.
Also, I agree that man was not engineered to take meds, however he also was not engineered to live into his mid 70s on average. 15th century men had a life expectancy of 35 years, 50 years in the 18th century and as recently as the 1900s around 55 years of age. The human body has been creating excessive amounts of cholesterol since the dawn of time. Recent imaging on mummies found atherosclerosis, man has had heart disease from the time of raw meats and nuts.
FYI, just got back from the evening bike ride. Good work out, feel great.
Yes, we are clear, you made lots of changes. Diet, exercise, loss of a large amount of weight. Yet you still needed statins. I get that.
Others do the same and get substantial enough results that they don't need statins.
As Ornish said in his article in the journal
http://www.ornishspectrum.com/wp-content/uploads/Statins-and-the-Soul-of-Medicine.pdf
"Many patients, perhaps most, can achieve the therapeutic
goal of LDL 100 mg/dl without lipid-lowering
drugs if they make changes in diet and lifestyle
that are more intensive than the NCEP panel recommends.
These intensive changes in diet and lifestyle
reduced LDL cholesterol by 40% (from an average
LDL of 143.8 to 86.56 mg/dl) after 1 year in ambulatory
patients who were not taking cholesterol-lowering
drugs.8 In Asia, where a very low fat diet is the
norm, the average LDL in the entire population of 4
billion people is 95 mg/dl.9"
Now, to be fair, I realize that most patients, probably 8 out of 10, won't make enough lifestyle changes to get those results.
But they need to know the path is available and effective for many who follow it.
I'm afraid your idea of doing drugs first only makes the path to "minimal lifestyle changes" all that much more inviting.
I would imagine that those who take statins make far fewer lifestyle changes than those who make a greater effort at changing their diet, exercise and other habits before they do statins.
Now that you are taking statins, do you still do the full compliment of dietary changes as recommended by Ornish and others of a similar mind?
Very very few people would do so because they get such a result from the statins. Much easier to take the statins and then do a good but not great diet. After all its easier and you still get good numbers.
A easy path.
One has to wonder, were large numbers of humans really designed to need drugs?
How is it that in some areas of the world, that humans can eat their traditional diets and not have the same problems?
Only 50 years ago, no one had statins, yet heart disease in many of those areas was only a fraction of what it is in America.
BTW, I also am a cyclist. And at age 63 go above 13 mets, and over 100% of my max* on almost every ride. (* yes I know one really can't go over one's max heart rate, but using the 220 -age I get about 157 and on my final climb I almost always surpass that. So my real max is probably about 164 to 165. I'll have to put on my HRM and test it again.
Simply put, ever since being a runner in high school, I like to push on all rides.
Though I do admit that lower level heart rates gain one all the heart healthy benefits one needs. Indeed I don't advise others to push so hard.
I've just grown up enjoying it.
The full benefits of exercise are gotten at far lower levels of heart rate and exertion. Brisk walking is probably optimal and sufficient for most.
AS you indicated, in some capacity you work with people.
I fully admit when looking at a large group of people, your advice may be fine for them as a group.
Having said that, there is a sub-group of motivated people, many of whom can achieve their needed results without resorting to drugs from the very beginning.
They should be allowed and encouraged to do so in the short term.
I their changes fail to achieved the needed results, then they should add in drugs.
We should not under estimate the drug side effects that many dislike
http://www.mayoclinic.com/health/statin-side-effects/MY00205
Certainly the benefits outweigh the problems in most patients.
But the patient should initially be given the chance to change and see what he or she can do without the drugs.
If that fails to work fully, then perhaps a combination of the lowest dose of statin along with significant dietary change will accomplish the goal.
I keep thinking this OP also said BOTH is parents are now on high blood pressure medicine and that his THREE uncles have Type 2 diabetes.
Taking statins is not going to prevent those other two problems from being in his future. Statins have only a small effect on blood pressure and do not prevent Type 2 diabetes.
He has both these potential problems in his future.
Significant dietary change can possibly prevent both of those from coming to pass.
Hence, a very strong attempt by him to change his diet and lifestyle can have a triple effect on his future health to include all three problems he may face.
I'm afraid if he just takes the easy route of drugs only, that he may find himself still ending up like his parents and uncles, on yet more drugs.
Others do the same and get substantial enough results that they don't need statins.
As Ornish said in his article in the journal
http://www.ornishspectrum.com/wp-content/uploads/Statins-and-the-Soul-of-Medicine.pdf
"Many patients, perhaps most, can achieve the therapeutic
goal of LDL 100 mg/dl without lipid-lowering
drugs if they make changes in diet and lifestyle
that are more intensive than the NCEP panel recommends.
These intensive changes in diet and lifestyle
reduced LDL cholesterol by 40% (from an average
LDL of 143.8 to 86.56 mg/dl) after 1 year in ambulatory
patients who were not taking cholesterol-lowering
drugs.8 In Asia, where a very low fat diet is the
norm, the average LDL in the entire population of 4
billion people is 95 mg/dl.9"
Now, to be fair, I realize that most patients, probably 8 out of 10, won't make enough lifestyle changes to get those results.
But they need to know the path is available and effective for many who follow it.
I'm afraid your idea of doing drugs first only makes the path to "minimal lifestyle changes" all that much more inviting.
I would imagine that those who take statins make far fewer lifestyle changes than those who make a greater effort at changing their diet, exercise and other habits before they do statins.
Now that you are taking statins, do you still do the full compliment of dietary changes as recommended by Ornish and others of a similar mind?
Very very few people would do so because they get such a result from the statins. Much easier to take the statins and then do a good but not great diet. After all its easier and you still get good numbers.
A easy path.
One has to wonder, were large numbers of humans really designed to need drugs?
How is it that in some areas of the world, that humans can eat their traditional diets and not have the same problems?
Only 50 years ago, no one had statins, yet heart disease in many of those areas was only a fraction of what it is in America.
BTW, I also am a cyclist. And at age 63 go above 13 mets, and over 100% of my max* on almost every ride. (* yes I know one really can't go over one's max heart rate, but using the 220 -age I get about 157 and on my final climb I almost always surpass that. So my real max is probably about 164 to 165. I'll have to put on my HRM and test it again.
Simply put, ever since being a runner in high school, I like to push on all rides.
Though I do admit that lower level heart rates gain one all the heart healthy benefits one needs. Indeed I don't advise others to push so hard.
I've just grown up enjoying it.
The full benefits of exercise are gotten at far lower levels of heart rate and exertion. Brisk walking is probably optimal and sufficient for most.
AS you indicated, in some capacity you work with people.
I fully admit when looking at a large group of people, your advice may be fine for them as a group.
Having said that, there is a sub-group of motivated people, many of whom can achieve their needed results without resorting to drugs from the very beginning.
They should be allowed and encouraged to do so in the short term.
I their changes fail to achieved the needed results, then they should add in drugs.
We should not under estimate the drug side effects that many dislike
http://www.mayoclinic.com/health/statin-side-effects/MY00205
Certainly the benefits outweigh the problems in most patients.
But the patient should initially be given the chance to change and see what he or she can do without the drugs.
If that fails to work fully, then perhaps a combination of the lowest dose of statin along with significant dietary change will accomplish the goal.
I keep thinking this OP also said BOTH is parents are now on high blood pressure medicine and that his THREE uncles have Type 2 diabetes.
Taking statins is not going to prevent those other two problems from being in his future. Statins have only a small effect on blood pressure and do not prevent Type 2 diabetes.
He has both these potential problems in his future.
Significant dietary change can possibly prevent both of those from coming to pass.
Hence, a very strong attempt by him to change his diet and lifestyle can have a triple effect on his future health to include all three problems he may face.
I'm afraid if he just takes the easy route of drugs only, that he may find himself still ending up like his parents and uncles, on yet more drugs.
COMMUNITY LEADER
I too made radical changes when first diagnosed with high cholesterol. I currently cycle daily at a rate that takes my heart rate up to 85% of max and 10 - 12 METs. I dropped 70 pounds and change my diet completely. Guess what, I still need statins.
Make the changes and start the statins. An LDL of 153 and a ratio of 6.3 are too dangerous to postpone treatment. I have read Dr. Ornish's book and I am very familiar with his works. I can assure you that in a clinical setting he would do the same thing as the OP's doctor, start statins and make lifestyle changes then recheck in 6 months and again in a year. It is the protocol laid out by the AMA. The OP can't change his family history or genetics and all the exercise and diets in the world won't change that. He is young enough to make some serious changes and change what can be done but old enough to have already seen some arterial disease forming at these levels and that will not go away.
I appreciate your point of view, this is just mine having worked with many, many people in his position.
Make the changes and start the statins. An LDL of 153 and a ratio of 6.3 are too dangerous to postpone treatment. I have read Dr. Ornish's book and I am very familiar with his works. I can assure you that in a clinical setting he would do the same thing as the OP's doctor, start statins and make lifestyle changes then recheck in 6 months and again in a year. It is the protocol laid out by the AMA. The OP can't change his family history or genetics and all the exercise and diets in the world won't change that. He is young enough to make some serious changes and change what can be done but old enough to have already seen some arterial disease forming at these levels and that will not go away.
I appreciate your point of view, this is just mine having worked with many, many people in his position.
Yes I've seen that study. Have you read the original full study?
Half the participants dropped out. For those that remained, even though many of them did not fully comply with the prescribed diet as indicated, the Ornish group still came out best.
When only those who completed the study were included in the analysis, those on the Ornish diet lost on average 14.5 pounds (6.6 Kg) and reduced their cholesterol by 21.5 mg/dl – by far the best results of all the diets tested.
With in that group are some people who did far better than average.
You often don't know who those significant responders are until you try it.
Look, I'm not a Ornish devotee. He is one of many doctors who advise a similar diet.
I mentioned him for several reasons.
1. Medicare has approved his program for patients with cardio vascular concerns as a alternative to surgery.
Meaning they are willing to pay for it because it has been proven to be effective in studies. None of those other programs or diets you mentioned have been given similar credibility by the government.
2. The particular book I mentioned is a general book with a "spectrum" that does not force the follower to make dive in overnight, yet shows them a roadmap to better diet and lifestyle.
3. Ornish is the only one of that group who has conducted actual studies.
4. Intelligent and well advised individuals such as former President Bill Clinton attribute their current healthy lifestyle to Dr. Ornish, along with one other doctor.
You seem focused on the LDL reading.
You might want to read the following discussion of that from Dr. Ornish in the American Journal of Cardiology, where he discusses a 40% drop in LDL.
Discusses statins and diet in a way far better than I can
http://www.ornishspectrum.com/wp-content/uploads/Statins-and-the-Soul-of-Medicine.pdf
I'm just saying, that this poster, who is 38, has expressed a willingness to make a real effort to correct his numbers without beginning a lifetime of medicine.
If he attempts a significant change and is dedicated, then within a few months he will be able to see if he is getting a worthwhile response without having to take drugs for the rest of his life.
Obviously there are many other benefits, including weight loss, that come along with the diet for those who make lifelong changes.
We don't even know if his doctor thinks his situation is so "dire" that the can't take a few months to experiment with lifestyle changes before throwing in the drugs for life.
Understandably, most doctors have little faith in the outcome because 90 or 95 out of 100 patients who say they will make lifestyle changes stick with it in a dramatic fashion.
Very possibly this patient will have to add in drugs later on.
But he seems willing to try it for now.
Just because dietary changes don't work for everyone is no reason for a dedicate person to not try them before drugs.
How crazy are we to assume that it won't work?
As though humans weren't designed to be able to live without drugs if they eat a proper diet.
Small wonder that the majority of Americans over age 50 are on drugs for high blood pressure.
If you only take your meds then you don't have to make all the changes?
Some people can actually regain their health without drugs.
Put a time limit on it. Ask the doctor if he can make a full-on change for 3 months and retest his blood. Go from there.
I think your experience is influencing your insistence that he go on drugs right away.
As I said previously, I'd do amazing changes in diet, exercise, and weight loss before I'd submit to a lifetime of statins... and then probably high blood pressure meds like both of his parents.
I assume he wants to avoid that route and also the potential for Type 2 diabetes such as his uncles have (along with more meds for that)
He can see his future in his own family. That should give him strong motivation to alter that outcome.
Half the participants dropped out. For those that remained, even though many of them did not fully comply with the prescribed diet as indicated, the Ornish group still came out best.
When only those who completed the study were included in the analysis, those on the Ornish diet lost on average 14.5 pounds (6.6 Kg) and reduced their cholesterol by 21.5 mg/dl – by far the best results of all the diets tested.
With in that group are some people who did far better than average.
You often don't know who those significant responders are until you try it.
Look, I'm not a Ornish devotee. He is one of many doctors who advise a similar diet.
I mentioned him for several reasons.
1. Medicare has approved his program for patients with cardio vascular concerns as a alternative to surgery.
Meaning they are willing to pay for it because it has been proven to be effective in studies. None of those other programs or diets you mentioned have been given similar credibility by the government.
2. The particular book I mentioned is a general book with a "spectrum" that does not force the follower to make dive in overnight, yet shows them a roadmap to better diet and lifestyle.
3. Ornish is the only one of that group who has conducted actual studies.
4. Intelligent and well advised individuals such as former President Bill Clinton attribute their current healthy lifestyle to Dr. Ornish, along with one other doctor.
You seem focused on the LDL reading.
You might want to read the following discussion of that from Dr. Ornish in the American Journal of Cardiology, where he discusses a 40% drop in LDL.
Discusses statins and diet in a way far better than I can
http://www.ornishspectrum.com/wp-content/uploads/Statins-and-the-Soul-of-Medicine.pdf
I'm just saying, that this poster, who is 38, has expressed a willingness to make a real effort to correct his numbers without beginning a lifetime of medicine.
If he attempts a significant change and is dedicated, then within a few months he will be able to see if he is getting a worthwhile response without having to take drugs for the rest of his life.
Obviously there are many other benefits, including weight loss, that come along with the diet for those who make lifelong changes.
We don't even know if his doctor thinks his situation is so "dire" that the can't take a few months to experiment with lifestyle changes before throwing in the drugs for life.
Understandably, most doctors have little faith in the outcome because 90 or 95 out of 100 patients who say they will make lifestyle changes stick with it in a dramatic fashion.
Very possibly this patient will have to add in drugs later on.
But he seems willing to try it for now.
Just because dietary changes don't work for everyone is no reason for a dedicate person to not try them before drugs.
How crazy are we to assume that it won't work?
As though humans weren't designed to be able to live without drugs if they eat a proper diet.
Small wonder that the majority of Americans over age 50 are on drugs for high blood pressure.
If you only take your meds then you don't have to make all the changes?
Some people can actually regain their health without drugs.
Put a time limit on it. Ask the doctor if he can make a full-on change for 3 months and retest his blood. Go from there.
I think your experience is influencing your insistence that he go on drugs right away.
As I said previously, I'd do amazing changes in diet, exercise, and weight loss before I'd submit to a lifetime of statins... and then probably high blood pressure meds like both of his parents.
I assume he wants to avoid that route and also the potential for Type 2 diabetes such as his uncles have (along with more meds for that)
He can see his future in his own family. That should give him strong motivation to alter that outcome.
COMMUNITY LEADER
Understood, but a couple of points. First read this;
http://www.ncbi.nlm.nih.gov/pubmed/15632335
The NIH found no significant difference between the Ornish, Zone, Weight Watchers or Atkins diet. In fact any diet that promotes weight loss will lower cholesterol and much depends on how fanatical the participant is. It is more likely than not that the participant will NOT get the maximum results.
Secondly consider the fact that Dr. Ornish's "trial" was a small controlled clinical trial that included a mere 48 participants which is not statistically large enough to prove any results. It is large enough to see a trend, but not to prove the connection.
I am all for dietary changes and exercise under a doctor's supervision to lower cholesterol, but when numbers are this far out of line in a individual with additional risk factors the current medical protocol is to treat the high LDL first.
http://www.ncbi.nlm.nih.gov/pubmed/15632335
The NIH found no significant difference between the Ornish, Zone, Weight Watchers or Atkins diet. In fact any diet that promotes weight loss will lower cholesterol and much depends on how fanatical the participant is. It is more likely than not that the participant will NOT get the maximum results.
Secondly consider the fact that Dr. Ornish's "trial" was a small controlled clinical trial that included a mere 48 participants which is not statistically large enough to prove any results. It is large enough to see a trend, but not to prove the connection.
I am all for dietary changes and exercise under a doctor's supervision to lower cholesterol, but when numbers are this far out of line in a individual with additional risk factors the current medical protocol is to treat the high LDL first.
Erijon, you said,
"My point is simple, cutting certain fats and cholesterol laden foods will have a minimal effect on serum cholesterol."
I'm uncertain what you mean by "minimal effect on serum cholesterol"
There are averages and there are many people who respond in a large way when "significant" changes are made in diet and lifestyle, to include exercise and weight reduction.
Though I doubt this individual will alter his diet to the degree subjects in Dean Ornish's original study did, he still could get meaningful results.
We don't know and he doesn't know until he tries.
Look to his original post. He indicates he is discussing this with his doctor and that at the end of that discussion the issue is still open.
In the Ornish study, the average total cholesterol drop was 63 points. From 225 to 162. That is dramatic and on average that is unusual, not the norm, but within any averages there are a subset of high responders for whom dietary changes can produce significant outcomes.
Much depends on how significant the changes in diet are.
Even then, many people have stubborn cholesterol and make little progress without meds.
This poster seems willing to change in a attempt to not go on a lifetime of drugs.
He may be successful or he may not. I think he will have to eventually change his diet more than he anticipates to get into safe levels.
However as I said, some people respond well to changes and are willing.
Perhaps you and I come from two different perspectives.
I lowered my cholesterol without drugs even though I began at a fairly safe level. You used drugs as you saw fit.
I am certainly not against the use of drugs but I would, in my own life, be willing to become quite radical in dietary change to lower my cholesterol naturally.
I don't think my posts are unduly influencing this poster.
Clearly there are lots of people who cannot get results from only diet.
Often others are unwilling to make large changes and stick with them.
Humans were not designed to need statins, stents and bypasses, but given our modern lifestyle, the need for these has arisen.
We weren't in on the discussion he had with his doctor. Only he knows how adamant and immediate his doctor's suggestions were.
It is unclear if his doctor was OK with him giving lifestyle changes a try over a few months.
He might find the following study of interest regarding the people of Nepal who share his genetics.
http://www.nmcth.edu/images/gallery/Editorial/VoZ2Iyrlimbu.pdf
Under any circumstances, he should learn all he can about the subject of cholesterol, diet and living in healthy manner.
As he noted, there is diabetes and high blood pressure in his family.
He stands a good chance to avoid or minimize these problems with significant changes in lifestyle, if he so chooses.
Obviously he should discuss all changes he makes with his doctor.
Hopefully in any case, which ever path he chooses, or if he uses diet, exercise, and drugs, his future cholesterol tests will much better than his most recent one.
"My point is simple, cutting certain fats and cholesterol laden foods will have a minimal effect on serum cholesterol."
I'm uncertain what you mean by "minimal effect on serum cholesterol"
There are averages and there are many people who respond in a large way when "significant" changes are made in diet and lifestyle, to include exercise and weight reduction.
Though I doubt this individual will alter his diet to the degree subjects in Dean Ornish's original study did, he still could get meaningful results.
We don't know and he doesn't know until he tries.
Look to his original post. He indicates he is discussing this with his doctor and that at the end of that discussion the issue is still open.
In the Ornish study, the average total cholesterol drop was 63 points. From 225 to 162. That is dramatic and on average that is unusual, not the norm, but within any averages there are a subset of high responders for whom dietary changes can produce significant outcomes.
Much depends on how significant the changes in diet are.
Even then, many people have stubborn cholesterol and make little progress without meds.
This poster seems willing to change in a attempt to not go on a lifetime of drugs.
He may be successful or he may not. I think he will have to eventually change his diet more than he anticipates to get into safe levels.
However as I said, some people respond well to changes and are willing.
Perhaps you and I come from two different perspectives.
I lowered my cholesterol without drugs even though I began at a fairly safe level. You used drugs as you saw fit.
I am certainly not against the use of drugs but I would, in my own life, be willing to become quite radical in dietary change to lower my cholesterol naturally.
I don't think my posts are unduly influencing this poster.
Clearly there are lots of people who cannot get results from only diet.
Often others are unwilling to make large changes and stick with them.
Humans were not designed to need statins, stents and bypasses, but given our modern lifestyle, the need for these has arisen.
We weren't in on the discussion he had with his doctor. Only he knows how adamant and immediate his doctor's suggestions were.
It is unclear if his doctor was OK with him giving lifestyle changes a try over a few months.
He might find the following study of interest regarding the people of Nepal who share his genetics.
http://www.nmcth.edu/images/gallery/Editorial/VoZ2Iyrlimbu.pdf
Under any circumstances, he should learn all he can about the subject of cholesterol, diet and living in healthy manner.
As he noted, there is diabetes and high blood pressure in his family.
He stands a good chance to avoid or minimize these problems with significant changes in lifestyle, if he so chooses.
Obviously he should discuss all changes he makes with his doctor.
Hopefully in any case, which ever path he chooses, or if he uses diet, exercise, and drugs, his future cholesterol tests will much better than his most recent one.
COMMUNITY LEADER
My point is simple, cutting certain fats and cholesterol laden foods will have a minimal effect on serum cholesterol. Agreed, there are other foods that can be substituted that will get more results.
Having said that, this is an individual with a very high LDL with very low HDL. These numbers need immediate treatment and not just trying lifestyle changes that may or may not help in the short term. Medical intervention makes sense and has been prescribed by the medical professional that knows this person's history and risk factors, and has weighed the risk versus benefit. We are not here to try to place a doubt on a doctor's orders, we are not trained medical professionals ourselves. This person needs to do two things in my mind. First go on the meds and get the numbers in line. Secondly work with their doctor on a diet and exercise plan that fits their personal condition.
In time they can jump off the meds for a while and see how their body has responded.
Having said that, this is an individual with a very high LDL with very low HDL. These numbers need immediate treatment and not just trying lifestyle changes that may or may not help in the short term. Medical intervention makes sense and has been prescribed by the medical professional that knows this person's history and risk factors, and has weighed the risk versus benefit. We are not here to try to place a doubt on a doctor's orders, we are not trained medical professionals ourselves. This person needs to do two things in my mind. First go on the meds and get the numbers in line. Secondly work with their doctor on a diet and exercise plan that fits their personal condition.
In time they can jump off the meds for a while and see how their body has responded.
"Talk about life style changes is nice and you certainly need to make some, however only about 10% of your serum cholesterol are the results of what you eat."
Are you suggesting that significant dietary changes can only reduce cholesterol about 10%..
Meaning this individual, via diet, could only bring down the Total Cholesterol of 242, down to about 218 ?
Perhaps that isn't what you mean.
Because there are loads of people who get results far greater than that.
Obviously, there are and have been tens of millions of people in Nepal who didn't need meds to live long healthy lives.
Lifestyles have changed, especially in those who have emigrated to the West.
I wouldn't be so quick to put a person on what will end up being a lifetime of meds, prior to making a significant effort to alter their diet and exercise.
Say at least a 6 month trial.
Yes I know you can do both, then try to go off the meds, but far too often, the lifestyle changes are minimized when the meds are there to back you up. I don't think there is much danger in doing a great lifestyle change for 6 or 12 months before giving up.
Sometimes significant change can be accomplished in only the first couple months.
Depends on how motivated the patient is.
Certainly there are lots of people who could lower their cholesterol more than 10% via diet.
Again, I'm not sure if you used that figure to mean that, or only as the sourced of cholesterol.
Just eliminating cholesterol from the diet is not the only avenue for lowering the cholesterol reading.
Personally if I were Ramesh, I'd do a full on change and test again in perhaps 3 to 6 months, just to see what lifestyle alone could accomplish.
Even after that, subsequent weight loss would help even more.
I do realize that if a doctor has 100 patients, and gives lifestyle changes to them, he'll only get less than 10 that will make drastic changes.
Thus, from his perspective, he advises the meds right from the beginning.
Not much else can be done with the average patient in a 20 minute visit.
Different people respond differently to lifestyle change. Some get minor results and others get amazing results.
Statins are a relatively new invention. Billions of people lived long healthy lives for centuries before they existed.
They are very useful in those that need them, but they are not without side effects, as is the case with all medicines.
Sounds like Ramesh is the type of person who could be highly motivated and educated about this entire aspect of his health.
Might become a "health nut" :-) more than willing to approach this from a largely natural perspective.
Are you suggesting that significant dietary changes can only reduce cholesterol about 10%..
Meaning this individual, via diet, could only bring down the Total Cholesterol of 242, down to about 218 ?
Perhaps that isn't what you mean.
Because there are loads of people who get results far greater than that.
Obviously, there are and have been tens of millions of people in Nepal who didn't need meds to live long healthy lives.
Lifestyles have changed, especially in those who have emigrated to the West.
I wouldn't be so quick to put a person on what will end up being a lifetime of meds, prior to making a significant effort to alter their diet and exercise.
Say at least a 6 month trial.
Yes I know you can do both, then try to go off the meds, but far too often, the lifestyle changes are minimized when the meds are there to back you up. I don't think there is much danger in doing a great lifestyle change for 6 or 12 months before giving up.
Sometimes significant change can be accomplished in only the first couple months.
Depends on how motivated the patient is.
Certainly there are lots of people who could lower their cholesterol more than 10% via diet.
Again, I'm not sure if you used that figure to mean that, or only as the sourced of cholesterol.
Just eliminating cholesterol from the diet is not the only avenue for lowering the cholesterol reading.
Personally if I were Ramesh, I'd do a full on change and test again in perhaps 3 to 6 months, just to see what lifestyle alone could accomplish.
Even after that, subsequent weight loss would help even more.
I do realize that if a doctor has 100 patients, and gives lifestyle changes to them, he'll only get less than 10 that will make drastic changes.
Thus, from his perspective, he advises the meds right from the beginning.
Not much else can be done with the average patient in a 20 minute visit.
Different people respond differently to lifestyle change. Some get minor results and others get amazing results.
Statins are a relatively new invention. Billions of people lived long healthy lives for centuries before they existed.
They are very useful in those that need them, but they are not without side effects, as is the case with all medicines.
Sounds like Ramesh is the type of person who could be highly motivated and educated about this entire aspect of his health.
Might become a "health nut" :-) more than willing to approach this from a largely natural perspective.
COMMUNITY LEADER
Let's look realistically at your numbers. You are 38 years of age and predisposed for heart disease. Your LDL is way too high, your HDL is way too low and your cholesterol ratio is way out of whack.
Talk about life style changes is nice and you certainly need to make some, however only about 10% of your serum cholesterol are the results of what you eat. Your body is creating too much cholesterol and you need medical intervention to resolve it. It is not a life sentence, you can also make some life style changes while on the meds and stop for a while and see how you're doing but you need immediate changes.
Also, your Tri's are not that high. Although 250 is well above the recommended level of 150, most people with what is considered high tri's are numbers over 1,000. Get off the empty carbs like pasta, bread and sugar and you'll see it drop rapidly.
Your doctor seems to be taking the safe treatment option with you. Get them to suggest some exercise and get your diet under control and lose some weight. Then hop off the meds and see how you do.
Good luck.
Talk about life style changes is nice and you certainly need to make some, however only about 10% of your serum cholesterol are the results of what you eat. Your body is creating too much cholesterol and you need medical intervention to resolve it. It is not a life sentence, you can also make some life style changes while on the meds and stop for a while and see how you're doing but you need immediate changes.
Also, your Tri's are not that high. Although 250 is well above the recommended level of 150, most people with what is considered high tri's are numbers over 1,000. Get off the empty carbs like pasta, bread and sugar and you'll see it drop rapidly.
Your doctor seems to be taking the safe treatment option with you. Get them to suggest some exercise and get your diet under control and lose some weight. Then hop off the meds and see how you do.
Good luck.
Yes, I would indeed make significant and lasting changes.
It seems the Nepalese genetics can predispose you to many dangerous health conditions.
http://www.ncbi.nlm.nih.gov/pubmed/21629873
"The high incidence of dyslipidemia and abdominal obesity could be the major contributors to MS in Nepal." (MS meaning metabolic syndrome)
Wow, your triglycerides are high. Were you aware that fruits and especially fruit juices will drive those up?
You would do well to spend some serious time studying up on all of this.
Take control of your own health. The doctor doesn't have time to educate you on all the details. That is why they often resort to just giving you a pill.
Its easier, and as I mentioned before, they've found in the past that few patients will take the time to sustain serious change in their health habits.
Again, in Nepal, look at how the changes take place as age increases.
Very dramatic
http://www.ncbi.nlm.nih.gov/pubmed/18092429
It seems the Nepalese genetics can predispose you to many dangerous health conditions.
http://www.ncbi.nlm.nih.gov/pubmed/21629873
"The high incidence of dyslipidemia and abdominal obesity could be the major contributors to MS in Nepal." (MS meaning metabolic syndrome)
Wow, your triglycerides are high. Were you aware that fruits and especially fruit juices will drive those up?
You would do well to spend some serious time studying up on all of this.
Take control of your own health. The doctor doesn't have time to educate you on all the details. That is why they often resort to just giving you a pill.
Its easier, and as I mentioned before, they've found in the past that few patients will take the time to sustain serious change in their health habits.
Again, in Nepal, look at how the changes take place as age increases.
Very dramatic
http://www.ncbi.nlm.nih.gov/pubmed/18092429
Thanx Circa49,
Yes my blood pressure reading shows (most of the times) 110/70. My father and mother doesn't have diabetes so far, but both are taking high blood pressure medicine. 3 of my uncles have diabetes.
I have started going for morning walk (40 min/day) which includes 10 minutes of stair climbing in nearby hill (150 stairs).
I am not taking rice any more in my lunch and dinner (Rice is main part of Nepalese food), I take pulses, vegetables, carrots, fruits instead, stopped drinking tea, but some time in gathering with friends and family I eat everything (that is 2-3 times a month).
Yes my blood pressure reading shows (most of the times) 110/70. My father and mother doesn't have diabetes so far, but both are taking high blood pressure medicine. 3 of my uncles have diabetes.
I have started going for morning walk (40 min/day) which includes 10 minutes of stair climbing in nearby hill (150 stairs).
I am not taking rice any more in my lunch and dinner (Rice is main part of Nepalese food), I take pulses, vegetables, carrots, fruits instead, stopped drinking tea, but some time in gathering with friends and family I eat everything (that is 2-3 times a month).
Well, good that your BP is normal.
I hope by that you mean no higher than 120.
Still, given all your other test results, along with your weight, you would still be greatly advised to make significant changes if you intend to avoid heart disease and/or possible Type 2 diabetes.
With your levels I certainly wouldn't wait another 5 or 10 years to begin your lifestyle changes.
A little bit of this and a little bit of that won't lead you to long term health.
Drugs, needed by some, are a poor substitute for true lifestyle changes.
Aside from that, for goodness sakes, you'll just feel so much better day to day. That alone would make me want to change.
BTW, with a name like Ramesh, you may well be South Asian.
There is a very high susceptibility of Indians etc. to Type 2 diabetes.
You might have already seen that in family members??
I hope by that you mean no higher than 120.
Still, given all your other test results, along with your weight, you would still be greatly advised to make significant changes if you intend to avoid heart disease and/or possible Type 2 diabetes.
With your levels I certainly wouldn't wait another 5 or 10 years to begin your lifestyle changes.
A little bit of this and a little bit of that won't lead you to long term health.
Drugs, needed by some, are a poor substitute for true lifestyle changes.
Aside from that, for goodness sakes, you'll just feel so much better day to day. That alone would make me want to change.
BTW, with a name like Ramesh, you may well be South Asian.
There is a very high susceptibility of Indians etc. to Type 2 diabetes.
You might have already seen that in family members??
Thanx for the suggestion Circa49,
I am so sorry that I posted wrong medicine name, it is infact Aztor 10mg that my doctor prescribed me.
My blood pressure in normal, so far.
I am so sorry that I posted wrong medicine name, it is infact Aztor 10mg that my doctor prescribed me.
My blood pressure in normal, so far.
You seem a bit mixed up perhaps.
The Azur 10mg is not for your high cholesterol.
It would seem you also have high blood pressure and the Azur 10mg is to control that.
You are only 38 years old.
You are overweight, you have high blood pressure, and you have very poor cholesterol.
I don't know your family history but in most instances you are on a very poor health path.
On other hand you are only 38 years old.
If you make your health a high priority (before you are forced to), then you can very likely manage all of your poor results without needing a lifetime of drugs for both high blood pressure and high cholesterol.
Your doctor probably won't advise you in that path because his past history with hundreds of patients tells him only a small percentage will make real, significant, and long term changes.
Most will just nibble around the edge of health and end up on a life of drugs and ineffective dieting, along with occasional short bouts of exercise.
So, you have 40 to 50 years in front of you, what will you do?
Most books on lifestyle one could advise instantly leap to one end of the chart, telling you to overnight change everything and become pure.
The reality is if you begin heading in the right direction, then over perhaps a year or two, you can improve most of your problems with a change in lifestyle. And if the numbers don't back you up, then you can always go the drug route.
Here is one notable doctor who offers you a spectrum. In fact, the book is called The Spectrum.
You can begin using it to head in the right direction but not needing to jump into the deep end of the pool overnight.
Slow steady progress can lead you to amazing gains in health.
Think about it. IF you were to lose, on average, only 1 ounce a day, less than 2 pounds a month, within 1 year your weight would be in the normal range at about 66 kg.
That alone would drop your blood pressure and cholesterol readings as you proceeded to gain even more health with your evolving diet and exercise.
Don't fall for programs that suggest dropping 6 or 8 pounds a month.
Those almost always fail in the long run.
OK... up to you. That book which offers a spectrum is written by Dean Ornish, and called The Spectrum.
Note, he also has more radical books for folks in danger now.
You are young and don't need to change everything overnight.
Start on a path of healthy eating, and gradually increasing physical activity (walking etc) and you can regain your natural health.
Or continue on your current path and start taking multiple drugs for blood pressure and cholesterol. Just be aware those drugs, as a solution, are for 40 to 50 years, not 4 or 5 months.
Which path do you think would make your life better?
There are other books and other paths to be sure.
Don't fall for those that promise amazing results in short time frames.
You don't need instant results, you need long term changes that produce gradual health.
BTW, you didn't give us your blood pressure readings.
Start your journey.
The Azur 10mg is not for your high cholesterol.
It would seem you also have high blood pressure and the Azur 10mg is to control that.
You are only 38 years old.
You are overweight, you have high blood pressure, and you have very poor cholesterol.
I don't know your family history but in most instances you are on a very poor health path.
On other hand you are only 38 years old.
If you make your health a high priority (before you are forced to), then you can very likely manage all of your poor results without needing a lifetime of drugs for both high blood pressure and high cholesterol.
Your doctor probably won't advise you in that path because his past history with hundreds of patients tells him only a small percentage will make real, significant, and long term changes.
Most will just nibble around the edge of health and end up on a life of drugs and ineffective dieting, along with occasional short bouts of exercise.
So, you have 40 to 50 years in front of you, what will you do?
Most books on lifestyle one could advise instantly leap to one end of the chart, telling you to overnight change everything and become pure.
The reality is if you begin heading in the right direction, then over perhaps a year or two, you can improve most of your problems with a change in lifestyle. And if the numbers don't back you up, then you can always go the drug route.
Here is one notable doctor who offers you a spectrum. In fact, the book is called The Spectrum.
You can begin using it to head in the right direction but not needing to jump into the deep end of the pool overnight.
Slow steady progress can lead you to amazing gains in health.
Think about it. IF you were to lose, on average, only 1 ounce a day, less than 2 pounds a month, within 1 year your weight would be in the normal range at about 66 kg.
That alone would drop your blood pressure and cholesterol readings as you proceeded to gain even more health with your evolving diet and exercise.
Don't fall for programs that suggest dropping 6 or 8 pounds a month.
Those almost always fail in the long run.
OK... up to you. That book which offers a spectrum is written by Dean Ornish, and called The Spectrum.
Note, he also has more radical books for folks in danger now.
You are young and don't need to change everything overnight.
Start on a path of healthy eating, and gradually increasing physical activity (walking etc) and you can regain your natural health.
Or continue on your current path and start taking multiple drugs for blood pressure and cholesterol. Just be aware those drugs, as a solution, are for 40 to 50 years, not 4 or 5 months.
Which path do you think would make your life better?
There are other books and other paths to be sure.
Don't fall for those that promise amazing results in short time frames.
You don't need instant results, you need long term changes that produce gradual health.
BTW, you didn't give us your blood pressure readings.
Start your journey.
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