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I Have High Cholesterol

By On · Add Comment · In blood pressure, cardiovascular disease, cholesterol, HDL cholesterol, health care crisis, LDL, medical paradigm, statins

I want to share with you a personal story about my health, which I think will be a great illustration of the conundrum facing the modern medical paradigm.

I just got my annual physical results from my doctor. He told me that my numbers all came back perfect. All except one: You have high cholesterol. Yawn. OK, how high. 270. This is high despite your HDL being pretty high also. And your LDLs, which are your bad cholesterol are 181. In the absence of other factors–like you are not 40 lbs overweight, and your blood pressure is good, and you don’t smoke–it probably won’t go down with diet and exercise alone, so…you’ll probably want to get that treated.

And my HDLs are at what number? 89.

And my total/HDL ratio? Oh…hmmm….well, that’s actually pretty good. It’s 3.1.

For those who don’t know, HDLs are “good” cholesterol; they remove the so-called “bad” cholesterol (don’t know how a substance produced by the body, and needed to break down and digest fats can be considered bad, but, whatever). HDLs in the 40 range are considered “normal”. 89, might I say, is outstanding…thank you very much.

The total cholesterol to HDL ratio is a good determinant of the risk for cardiovascular disease. Just for a little perspective, 5.0 is “average” risk. Anything under 3.4 is “very low” risk. I’m 3.1.

Here’s the problem: My caring doctor–bless his heart–knows damn well that I’m at a low risk for cardiovascular disease. I’m 41-years-old and in the best shape of my life. I’m 155 lbs, have stellar blood pressure (120/70), don’t smoke, don’t drink, don’t do drugs; I’m on no medications; I do not partake in risky behavior. Why the bleep is he recommending treatment* (which is prophylactic statin medication, if you didn’t know)?

I’ll tell you why–for liabilities sake. He knows that if he doesn’t tell me that I have high cholesterol, and he doesn’t recommend “treatment” (frickin’ treatment, lol), and I drop dead of a heart attack, even if it’s because I snort a gram and a half of cocaine! he’s liable. That’s right–tort litigation! Just ask Billy Mays’ doctor. Coroners found cocaine in his system; but nooo, his family insists it was high blood pressure that killed him. Not saying that they are seeking damages; but it’s the potential I’m talking about. Every doctor is afraid of being sued. Medical malpractice insurance is one of the highest costs facing doctors today. So what do they do to keep their premiums down? Order every frickin’ test humanly possible. Cha-ching.

And they “treat” 41-year-old males in great health with statins, otherwise known as, “the best selling drugs of all time.“

It’s not doctor greed, I tell you–it’s attorney greed. And public ignorance. There I’ve said it. Nobody is talking about that part of the health care crisis.

*Just so you know: I’m not taking them.

A Case Against Statins

By On · Add Comment · In atherosclerosis, bad cholesterol, cardiovascular disease, essential fatty acids, good cholesterol, HDL, heart disease, LDL, magic bullets, statins
One of the first things doctors learn in rudimentary physiology class is that, when it comes to preventing heart disease, high HDL or “good” cholesterol is more important than low LDL or “bad” cholesterol. In fact, HDL levels are four times greater than LDL levels in their ability to predict the development of coronary atherosclerosis. Basic, basic, basic physiology.

But an interesting thing happens between doctor school and practicing–it’s called influence from the outside world. In the case of doctors, that influence often comes from pharmaceutical industry. C’mon Campos, not another evil pharmaceutical industry story (hey, I haven’t written one yet, please). No, no–it’s more like another example of how we’ve come to worship outside factors when it comes to our health. Check this one out.

Recent research published in the New England Journal of Medicine shows that no matter how much bad cholesterol is lowered in the blood, it’s the amount of good cholesterol that still reigns supreme. Yes, the concentration of your HDLs (high density lipoproteins) plays a vital part in preventing cardiovascular diseases, like heart attacks and strokes.

Yeah, so? Well if you haven’t heard yet, those hyper-pedastalized miracle drugs known as statins are some of the most prescribed drugs of our day. Statins work by lowering LDL (low density lipoproteins) levels in the blood, and this, it has been promised, will lower our risk of heart disease. Great! Prescribe them like crazy. People don’t work out. People don’t eat right. Who cares? Give ’em statins. You’ve got boderline high cholesterol. Statins. You’re almost diabetic? Statins. You’ve seen the cholesterol commercial and you’re concerned? Statins.

Statins. Statins. Statins.

Well I’ve got news for you. You want to lower your risk of cardiovasular disease? You’ve got to watch what you eat and work out, period. Oh yeah…it’ll help if you quit smoking too, but how about just starting with exercise? You see, I’ve got a real problem with the idea of looking for magic bullets. They are illusions, people–ILLUSIONS! They give false security and false hopes. Nothing in life is free. You’ve got to work for everything. Exercise. Diet. That’s the real answer. Not statins.

OK, I’ll be fair. For people who have dangerously high levels of LDLs–if I was their MD–I’d give them statins for a very brief period, and I’d absolutely prescribe heavy doses of lifestyle management (read: nutrition and exercise). But I wouldn’t perscribe statins for people with boderline normal cholesterol levels as some Dr. Idiots are recommending (also read this–effin’ scary).

According to Dr. Philip Barter of the Heart Research Institute in Sydney, one of the lead authors of the study, “Even when LDL is taken down to very low levels, the kind of levels people say should be the aggressive targets, having a low HDL is still associated with a substantial increase in risk. (emphasis mine)” So, basically, you’ve got to work to bring your HDL levels up to par. And here’s the beauty: It’s the ratio of total cholesterol to HDL that really matters (see this brilliant explanation here), where total cholesterol = HDL+LDL. Therefore, HDL+LDL/HDL. So, if you bring up your HDL levels, you don’t need statins. Duh.

OK, here’s how you can raise your HDL levels–exercise regularly, eat wholesome foods, take essential fatty acids, and moderate your smoking and drinking habits. And you can naturally decrease your LDL levels by decreasing saturated fat intake, maintaining good body composition, increasing dietary fiber, and increasing aerobic exercise. Booyah!

But wait…fugdat. Ain’t there a drug I can take, Homey?

Sure Pfizer is working on one. It’s called torcetrapib. Oh wait. It killed people in a large drug trial. Oh well–I guess you’ve gotta work out. Says Barter again: The alternative is to “become lean and become very active. That’s probably as effective as anything we have at the moment. But most people who try don’t succeed,” Barter said. “The biggest frustration is that we don’t have the magic bullet like we do for the LDL.”

Ah yes, the ‘ol magic bullet. Well, keep looking–it’s your time, your money, and your health. If you want to believe, then be my guest. But I’ll just be over here dancing with the Tooth Fairy.

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