# Cholesterol



## Lula (Jul 31, 2009)

Hi everyone,

I recently had all my blood tests and was thrilled to get an HBA1c of 5.8, however my cholesterol was 5.2, and it should be under 5.

The nurse told me not to worry about it, and I'm not that worried really, but I would like to bring it down a little. I've been on NHS websites etc and I know the basic rules - less saturated fat and more exercise - but does anyone have tips about how to lower cholesterol successfully?

A realted question - is this likely to be related to my diabetes? I was surprised to hear I have high cholesterol as I think I eat a fairly healthy diet, and I have body mass index in the healthy range. I am twenty-four years old and I hadn't expected cholesterol to be an issue until I was older (please excuse my ignorance!) I must admit I don't do any exercise though, and I know I should.

Anyway, any tips or advice are welcome!!


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## Steff (Jul 31, 2009)

Most people can lower their cholesterol by eating a diet low in fats. They can also be lowered by not smoking losing weight and exercise. Try to stay away from fatty foods. Read labels when you go shopping for food. If you buy meat , buy the less fatty meats. Most grocery stores have the meats labeled as to how much fat is in the meat.

Buy two percent milk. Try to eat no more than two eggs a week. If you like eggs a lot save your two eggs for Sunday breakfast. Instead of butter use a vegetable margarine.

Eat a lot of fruits and vegetables. Have a salad everyday and use a lowfat salad dressing. There are many varieties and they are very tasty. Throw away the frying pan. Boil your meats instead of frying. If you must use cooking oil buy Canola oil or olive oil. Try to take a walk everyday. This will lower your cholesterol and you'll lose weight, too.


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## Pattidevans (Jul 31, 2009)

Actually my total cholesterol is 6.5 and I'm not in the least worried about it and I have no intention of taking any Statin drugs.  The reason I am not worried is that my HDL is 3.6, my LDL 2.5 and Triglycerides 0.6 which means that my "good" cholesterol is high, my HDL to triglyceride ratio is 0.18 which indicates that the LDL has large fluffy particles which are good.  I have discussed this with my Dr who is in agreement that taking anything to reduce it would be counter productive.  You may be unaware that you do actually NEED cholesterol for various functions of your body. 

However if you really wish to improve your ratios then the way to do it is to restrict carbohydrates and not fats - though limiting saturated fats and staying away from transfats is a good idea.  The egg myth has also been debunked.  I am not talking about quack websites here, but if you wish to use google scholar there are many serious studies out there which back up the above information.

Regretfully many GPs only see the total cholesterol figure.


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## C*5_Dodger (Jul 31, 2009)

Pattidevans said:


> Actually my total cholesterol is 6.5 and I'm not in the least worried about it and I have no intention of taking any Statin drugs.  The reason I am not worried is that my HDL is 3.6, my LDL 2.5 and Triglycerides 0.6 which means that my "good" cholesterol is high, my HDL to triglyceride ratio is 0.18 which indicates that the LDL has large fluffy particles which are good.  I have discussed this with my Dr who is in agreement that taking anything to reduce it would be counter productive.  You may be unaware that you do actually NEED cholesterol for various functions of your body.
> 
> However if you really wish to improve your ratios then the way to do it is to restrict carbohydrates and not fats - though limiting saturated fats and staying away from transfats is a good idea.  The egg myth has also been debunked.  I am not talking about quack websites here, but if you wish to use google scholar there are many serious studies out there which back up the above information.
> 
> Regretfully many GPs only see the total cholesterol figure.



Dear Pattidevans,

At last - a kindred spirit, I agree with everything you have written. The only thing that I would add is that there has *never* been a study that shows women benefit from lowering of cholesterol. In fact, in older women, higher cholesterol correlates with a longer life! I too refused to take statins. Here's some reasons why cholesterol is important:

The major building block for the growth, repair and replacement of all body cells
If cholesterol is too low, cell growth is disrupted 
Essential to maintain the integrity of cell membranes 
Used to facilitate communication between brain and nerve cells
The major precursor for hormone production 
Essential for a healthy and effective immune system 
Used to make bile acids 
Used to make vitamin D3 in conjunction with UVB from sunlight on the skin 
So important that most body cells can make it.

Warmest Regards   Dodger


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## insulinaddict09 (Jul 31, 2009)

Well I avoid Carbs and load up on proteins and fats and Ive not had a problem


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## rossi_mac (Jul 31, 2009)

I don't think anyone can avoid certain things, our bodies are made the way they are, I've had a friend who is very healthy but his cholesterol has always been high, like blood pressure etc I believe it can be in the family or just given out. 

Can I ask how long have you been diagnosed, I'm still newish to all of this, when I was diagnosed by Cholestral was over 6! But I was told not to worry about it! It soon settled down and I'm in good range now.

I guess the benefit is that we get our bloods tested and can react to try and "improve" a few things.

Good luck,


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## Lula (Aug 2, 2009)

Thank you so much everyone for your advice. It seems as if there is much more to a cholesterol reading than meets the eye. I'll try to see if I can get a breakdown of the finer details. I suppose it won't do me any harm to try to cut down on the saturated fats though!

Rossi_mac - I was diagnosed exactly a year ago. I think my cholesterol has been about 5.2 ever since then. I suppose my doctor doesn't think its worth worrying about as she hasn't mentioned it to me at all - I only know it's above 5 from reading the form myself!


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## C*5_Dodger (Aug 2, 2009)

Lula said:


> Thank you so much everyone for your advice. It seems as if there is much more to a cholesterol reading than meets the eye. I'll try to see if I can get a breakdown of the finer details. I suppose it won't do me any harm to try to cut down on the saturated fats though!
> 
> Rossi_mac - I was diagnosed exactly a year ago. I think my cholesterol has been about 5.2 ever since then. I suppose my doctor doesn't think its worth worrying about as she hasn't mentioned it to me at all - I only know it's above 5 from reading the form myself!



Dear Lula,

There sure is a lot about cholesterol have a look at the sites below, the first is a lecture and covers why we get fat and the second covers CVD, cholesterol, Metformin and more!. BTW that saturated fat is bad for you is only a hypothesis it has never been proved definitively that it is bad for you!

http://www.dhslides.org/mgr/mgr060509f/f.htm

http://www.phlaunt.com/diabetes/15945839.php


Warmest Regards   Dodger


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## runner (Aug 2, 2009)

C*5_Dodger said:


> Dear Pattidevans,
> 
> At last - a kindred spirit, I agree with everything you have written. The only thing that I would add is that there has *never* been a study that shows women benefit from lowering of cholesterol. In fact fact, in older women, higher cholesterol correlates with a longer life! I too refused to take statins.Warmest Regards   Dodger



I'm another statin-dodger, Dodger and Pattidevans.  Surgery policy is statins for diabetics as preventive measure, but hospital DSN agrees with me - not necessary  - no significant family histlry and high low-cholesterol count.


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## runner (Aug 2, 2009)

steff09 said:


> Most people can lower their cholesterol by eating a diet low in fats. They can also be lowered by not smoking losing weight and exercise. Try to stay away from fatty foods. Read labels when you go shopping for food. If you buy meat , buy the less fatty meats. Most grocery stores have the meats labeled as to how much fat is in the meat.
> 
> Buy two percent milk. Try to eat no more than two eggs a week. If you like eggs a lot save your two eggs for Sunday breakfast. Instead of butter use a vegetable margarine.
> 
> Eat a lot of fruits and vegetables. Have a salad everyday and use a lowfat salad dressing. There are many varieties and they are very tasty. Throw away the frying pan. Boil your meats instead of frying. If you must use cooking oil buy Canola oil or olive oil. Try to take a walk everyday. This will lower your cholesterol and you'll lose weight, too.



Hi Steff!  Advice about eggs has changed (for the time being anyway LOL!: http://www.bhf.org.uk/keeping_your_heart_healthy/preventing_heart_disease/cholesterol.aspx
http://lowerbloodpressurecheap.com/eggs-cleared-of-causing-high-cholesterol


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## sofaraway (Aug 3, 2009)

Would like you cholesterol experts opinion on my situation if you get to read this.
I have a family history of cardiac problems at youngish ages this is because of my MODY diabetes and my protective cholesterol HDL is misshapen so does not provide the protection the blood test would indicate it should. Dr's have said that I will have to take statins in the future because of this. How would statins help this problem?


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## VBH (Aug 3, 2009)

It wouldn't.  Statins have no effect on HDL.


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## C*5_Dodger (Aug 3, 2009)

sofaraway said:


> Would like you cholesterol experts opinion on my situation if you get to read this.
> I have a family history of cardiac problems at youngish ages this is because of my MODY diabetes and my protective cholesterol HDL is misshapen so does not provide the protection the blood test would indicate it should. Dr's have said that I will have to take statins in the future because of this. How would statins help this problem?



Dear sofaraway,

This is not medical advice it's just what I learned about the science.
The full name for Statins is HMG-CoA reductase inhibitors. The pathway for cholesterol production starts with Acetyl CoA. At about the 4th step  HMG-CoA is converted to  HMG-CoA Reductase. Statins inhibit  HMG-CoA Reductase and hence the production of cholesterol (and other essential substances like CoQ10 (Co-Enzyme Q10), dolichols, selenoproteins, Rho, glutathione and normal phosphorylation). In a nutshell:

1.They lower cholesterol synthesis in the liver
2.The liver starts running out of the cholesterol needed to make VLDLs
3.The liver then has to increase the number of LDL receptors to pull cholesterol back in to make more VLDLs
4.More LDL is dragged back into the liver, as a result of which...
5.The LDL level in the blood falls – Simples!

So in point of fact it has nothing to do with HDL. The only thing I can see that is relevant is that the total amount of cholesterol is reduced. Of-course you have to believe that artificially lowering it is beneficial – I don't believe it is! Lipoproteins (Chylomicrons, VLDLs, LDLs and HDLs) are spherical proteins and so are they saying that because your HDL is misshapen it is no longer capable of ferrying cholesterol back to the liver for re-use? I believe that in certain circumstances Statins are useful but NOT because of their cholesterol lowering abilities but because they are powerful  anti-inflammatory drugs and should be prescribed, not on the basis of cholesterol but on the detection of elevated high sensitivity C-reactive protein and even then only in limited circumstances.

Warmest Regards  Dodger


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## sofaraway (Aug 3, 2009)

VBH and Dodger thank you for your input it is much appreciated.


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## Pattidevans (Aug 4, 2009)

Hi there

I am pleased to see someone else is singing from the same hymn sheet as myself regarding the cholesterol issue.  I get rather angry at the way diabetics are bullied into taking statins simply because they are diabetic and their total cholesterol is over 4.  The "under 4" advice comes from a remote tribe in China who seemingly do not suffer heart disease and have total chol results under 4.  Of course it could be any other circumstance of their lives which reduces the heart disease.  I have seen ample evidence and many studies which say that having total chol under 4 is of no benefit (and is probably a bad thing) in women.  But Dodger has eloquently summed up the case for having healthy cholesterol (by which I don't mean low).  Many GPs seem unaware of this factor as was my own, but once I mentioned to her the relationship of HDL to Triglycerides she did go off and find out, and I admire her greatly for being generous and respectful enough to give me credence.  Do not forget, not knowing about something does not make a bad GP - they need to know a little about a lot of ailments, refusing to learn does make a poor GP!

As to Statins, I am completely unconvinced of their safety and from personal experience I know that they can affect memory.  Not to mention the many people who suffer muscle and joint pain as a side effect.  Since taking myself off them in March of this year the problem with forgetting words and names which I had put down to my age has completely gone.  Read http://www.telegraph.co.uk/health/4974840/Wonder-drug-that-stole-my-memory.html and http://www.telegraph.co.uk/health/5257744/Statins-life-saving-wonder-drugs-or-just-life-damaging.html


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## Peter C (Aug 4, 2009)

sofaraway said:


> Would like you cholesterol experts opinion on my situation if you get to read this.
> I have a family history of cardiac problems at youngish ages this is because of my MODY diabetes and my protective cholesterol HDL is misshapen so does not provide the protection the blood test would indicate it should. Dr's have said that I will have to take statins in the future because of this. How would statins help this problem?



HDL helps clear up the mess made by LDL in the endothelium (the space between the first and second layers of artery walls). If your Cadburys mis-shapes can't do the honours and your LDL begins to rise then statins would be a way of keeping LDL in check and reducing their damage. in effect a replacement for the defective HDL.
Diabetic Dyslipidemia is common - HDL falls and LDL rises in diabetics - because of inter-reactions between insulin resistance and lipids.


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## C*5_Dodger (Aug 18, 2009)

Hi All,

Hope you don't mind my resurrecting this thread, but I just found these:

http://www.youtube.com/watch?v=9_Q0EuLv0hs

http://www.youtube.com/watch?v=zxWeFrvy7vc

Regards   Dodger


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## insulinaddict09 (Aug 18, 2009)

C*5_Dodger said:


> Hi All,
> 
> Hope you don't mind my resurrecting this thread, but I just found these:
> 
> ...



Thanks Dodger


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## C*5_Dodger (Sep 1, 2009)

*More on Cholesterol*

Dear All,

I just came across this, apologies for resurrecting this thread but if this doesn't make you think twice about taking Statins nothing will! Two drug Companies have (I believe they were forced but they wouldn't have done it if it were not so) put this on their adverts: "*Lipitor/Crestor has not been shown to prevent heart disease or heart attack.*" Have a look at this:

http://www.cholesterol-and-health.org.uk/statins-6.html

Warmest Regards  Dodger


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## HelenP (Sep 4, 2009)

Hi - I had my first appointment since diaagnosis 5 wks ago with my DSN today and practically the first thing she said was that next month she wants me to take start taking Statins.  My cholesterol level, when taken last month, was 4.4, which my doctor informed me was pretty good.

I remembered reading this thread a few days ago, so I queried the necessity for statins with her, and she answered as I'd expected her to, with all the stuff about impending heart attacks, keeping cholesterol low to prevent heart disease, etc.  

As I've never been on tablets for ANYthing in my 53 years until now (Metformin, which she also said she might increase next time, despite the fact that my BG levels have come RIGHT down from 19.something to 6.something!), I'm a bit wary of suddenly being on 3 lots (she also mentioned something about another tablet to keep kidneys healthy). (I DID start to wonder if she was on a backhander from the drugs companies!!)

I must confess, a lot of the stuff in this thread is WAYYYY over my head, but even I can see that the concessus is that Statins are not deemed to be a good thing.  But, she has scared me with talks of heart attacks and kidney disease (I have about 5 stone to lose, which doesn't help), so now I'm worried about taking them, but equally worried about rejecting them.

I'm SOOOO confused!! 

xx


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## Northerner (Sep 4, 2009)

Helen, I'm with you totally there - it's very difficult to know whether you are getting good advice or not. I was just like you - no pills at all for 49 years, then suddenly I was on 11 different ones every day. I've gradually whittled that down to 3 - aspirin, statins and a blood pressure pill. But I've been reading stuff about the aspirin and statins for over a year now and still can't decide whether I should or shouldn't be taking them.

I know that some of the posters here have found research and studies that say they don't do you any good, but I also find it impossible to believe that the entire medical establishment is completely erroneous in prescribing them. If the research against them was irrefutable then they wouldn't prescribe them, surely?

So, not much help I'm afraid. What I will say is that I have now got used to taking them and don't suffer the side-effects that people talk about, so that aspect did become easier for me. I'm just hoping that they are doing me more good than harm!


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## HelenP (Sep 4, 2009)

Northerner said:


> What I will say is that I have now got used to taking them and don't suffer the side-effects that people talk about,



Thanks for your speedy reply Northerner!!  If it's not too personal, may I ask if you'd 'fill me in' on the possible side effects (other than the memory thing) ?  That might help in making my decision!!

Cheers.

xx


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## VBH (Sep 4, 2009)

Helen,

They started out by thinking:
High total cholesterol gives you a greater chance of heart disease

Then they did some more research and decided:
Cholesterol comprises HDL, LDL and Triglicerides. High LDL gives you a greater chance of heart disease

Then they did some more research and concluded:
High levels of small-particle LDL gives you a greater chance of heart disease.

And that's the point we've reached so far.  

So taking action against cholesterol based on the total cholesterol number is a bit out of date, as you can see.

The way to estimate the level of small-particle LDL is to take the trigs and divide by HDL.  The target is under 1.3.  So if you had trigs of 1.2 and HDL of 1.0 you would be fine (1.2/1.0 = 1.2).  Lower trigs and higher HDL are better since there will be less small-particle LDL.

Statins reduce the amount of LDL generally being produced.  This may sound good at first glance, but you have to remember that LDL performs some vital functions.  Smokers for instance have raised LDL levels - but thats in order to repair the damage from smoking.  LDL is also essential for brain function and many other functions in the body.

Low cholesterol, particularly low LDL is associated with higher death rates.

So if you were to have very high LDL levels then statins may be a good idea.  If the breakdown of your cholesterol is ok however, then it may do more harm than good.  Statins have also been shown to cause weakness in the heart because of the interaction with co-enzyme Q10.  (taking expensive Q10 supplements doesn't actually help).

So the question you need to be asking really is what the breakdown of your cholesterol is.  Without knowing that, statins may be shooting at the wrong target entirely.

HDL can be raised by eating more fish, nuts and other "good" fats.

Trigs are produced in the body from carbs.  So a reduction in carbs lowers the trigs level.

The most common statin side effect appears to be muscle pain.  There are also a lot of questions at the moment about their effect on memory.  As Dodger mentioned, they have not been demonstrated to reduce the chances of heart problems - which is odd since they have been used for over 10 years.

On the subject of kidneys - the class of drug the nurse is talking about is ACE inhibitors I think.  These are nothing to be worried about.  High BGs cause damage to small blood vessels such as those in the kidneys.  ACE inhibitors help to prevent damage to these blood vessels in the long term.  Side effects are rare and the most common is a dry cough, at which point you can switch to another ACE inhibitor or a similar drug.  The ACE inhibitors all end with ~pril such as Ramipril or Enalopril.

So the kidney thing is about long term protection, not dealing with an actual problem right now.  I can't see any reason not to take em.

Hope that helps.

Note to Northerner - aspirin only helps when people have _already_ had a heart attack or stroke.  If not then they provide no benefit whatsoever and use of aspirin risks irritation or damage to the stomach lining.  My GP took all his diabetic patients off aspirin some time ago, not long after the research demonstrating this was published.


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## Corrine (Sep 4, 2009)

Thats really helpful VBH - thank you.  I'm getting my results on Monday and want to stop taking the statins as I'm sure they are contributing at least to pains I have in my left arm!  Once I get the breakdown of my HDL/LDL/Trigs I can then make an informed decision.


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## HelenP (Sep 4, 2009)

Thanks very much VBH - I _think_ I actually understood that !!

xx


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## Northerner (Sep 4, 2009)

Thanks VBH. It does sound by all accounts that I shouldn't be taking the aspirin or statin. My last total cholesterol was 2.4, which I'm thinking means that I have low amounts of good coupled with low amounts of the still-necessary 'bad'. As for the aspirin, they put me on it originally because they thought I'd had a heart attack in hospital, but three months later decided it was myocarditis. I asked the GP about it and she said that the heart specialist at the hospital had advised I keep taking it because an angiogram had shown 'slight furring' on one of my arteries - probably from 20 years of smoking.

Gah! I suppose what I really need is a fasting blood test so they can tell me the component parts of my cholesterol. I have my 6-monthly appointment in October, so might try and get one done for that.


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## C*5_Dodger (Sep 4, 2009)

*Just to add to VBHs post*

There is only one cholesterol and it is ferried in bloodstream (along with other things like fats/triglycerides) by the following spherical lipoproteins:

VLDL:  Very-Low-Density Lipoproteins. It is this that is measured for your triglyceride level
LDL:  Low-Density Lipoproteins. This is difficult to measure directly (needs an ultracentrifuge) and so is *estimated* using the Friedewald formula
IDL:  Intermediate-Density Lipoproteins 
HDL: High-Density Lipoproteins. This is a scavenger lipoprotein it mops up cholesterol and returns it to the liver for re-use. 
Lp(a): Lipoprotein a. Very like LDL except for the apolipoprotein(a) protein.

The three most important are: VLDL, LDL and HDL.  LDL cholesterol carries most of the circulating cholesterol. Given the foregoing, why did we evolve to recycle cholesterol and not to excrete it? Surely we would not do this if our cholesterol levels were too high. It is much more logical that our cholesterol is at a level that the body needs it to be. Adopting a “one size fits all” level and using powerful drugs (Statins) to try and achieve it is crackers, but it makes billions of dollars for “Big Pharma”

Regards   Dodger


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## Northerner (Sep 4, 2009)

Thanks for expanding my knowledge even further Dodger!


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## insulinaddict09 (Sep 4, 2009)

*Thank you VBH and Dodger  Informative and interesting posts yet again  *


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## HelenP (Sep 5, 2009)

Thanks for all the explanations.  Such a lot to take in !

xx


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