Saturday, April 01, 2006

Doctor Gives Me Four Months To Get LDL Down

When I solicited feedback from my readers the other day about what I should do regarding my doctor's recommendation that I go back on a statin drug again, I knew there would be a response. Boy, was there ever!

I'll get to those comments I received from so many of you which definitely run the gamut in another blog post. However, first let me tell you how my doctor's appointment went on Friday afternoon. I definitely went to see my doctor resolute in my decision NOT to take another statin prescription no matter what he said. There's just got to be a better way than drugs.

In reviewing my latest blood work numbers, my doctor said he is very "concerned" about my LDL being so high. He said ideally the LDL number should be under 100 mg/dL. I knew that was coming, but I retorted back to him with my HDL and triglyceride numbers.

"But what about my triglyceride/HDL cholesterol ratio, doc? Doesn't that count for anything in a discussion of cholesterol health and my risk for cardiovascular disease?"

Without hesitation, he responded that while those numbers are good and my weight loss has been quite impressive, those are simply IRRELEVANT when you are talking about LDL as a separate measuring stick for the risk of heart disease. He acknowledged that most medical professionals give more weight to the LDL than they do HDL or triglycerides these days and that they want to see that LDL number go as low as possible regardless of what the other numbers are.

Seriously?! Is he kidding me? I'm not a doctor nor do I pretend to understand all the aspects of the cholesterol debate, but that seems just a bit shortsighted to me. Why even measure HDL or triglycerides if they aren't as important as LDL, hmmm?

Rather than encouraging me with the incredible IMPROVEMENTS that I have seen in my HDL going up to 72 from the lower 20s it used to be before I started livin' la vida low-carb and the steady and swift drop in my triglycerides from the 300s down to 42, my doctor dismisses these numbers and even ignores the total cholesterol/HDL ratio which at 3.5 is well within what is considered "safe" range.

But, noooooooooooooo! It's all about the LDL and nothing else. Yikes! Has it really come to THIS in the practice of medicine these days that we live in such a cookie cutter society that everyone must be treated exactly the same? Was losing 180 pounds not enough for ya, doc? Sheeeez! Can you tell I'm just a wee bit perturbed by all of this?

Anywho, I told my doctor point blank, "I'm NOT going back on a statin drug again, so come up with something else that's natural for me to get my LDL down." To my surprise, he did! Well, sort of.

In a pamphlet from the Orlando, FL-based Florida Lipid Institute called "Drug-Free Cholesterol Lowering Plan," Dr. Paul Ziajka developed a program in 2003 to help people like me get our cholesterol down without using prescription drugs. My doctor said he doesn't think I'll see much results from this, but I can try it for four months to see if it helps me get my LDL down. Gee, his confidence in this plan just overwhelms me (maybe he's kicking himself for not making another statin "sale!").

This pamphlet basically recommends a low-fat "lifestyle change" (NOT!) and said to avoid eating eggs, cheese, butter, and red meat while eating more tofu, baked chicken, low-fat cheese, 1% milk and margarine. Yucky poo!

Additionally, the plan calls for a three component plan for getting cholesterol down -- plant stanols, soy, and soluble fiber.

1. Plant stanols, such as Benecol and Take-Control, help the body prevent the absorption of cholesterol.
2. Soy supposedly lowers cholesterol numbers, although that is now being called into question.
3. Soluble fiber, which I already take lots of, helps lower cholesterol in the GI tract.

In six weeks, doing all three of these steps has resulted in a 45% decrease in LDL and 35% decrease in total cholesterol according to Dr. Ziajka.

The last sentence of the pamphlet made me chuckle, though:

"Following our plan AND a low cholesterol, low fat lifestyle can cut your cholesterol level in half! Just remember, these are changes you are going to make the rest of your life."

I don't think so! I've done the low-fat diet before and it didn't work for me. My low-carb lifestyle is doing just fine and dandy for me thank you very much. If I try to do this plan my doctor has given me, then I'll have to abandon most of the lifestyle changes I have made over the last two years. That's NOT gonna happen!

Before I left his office, I asked my doctor about the various kinds of LDL and that perhaps my LDL was of the good variety. He said the only way to know that for sure is to conduct the Berkeley HeartLab test, which costs about $1200 to conduct, the next time I get my cholesterol checked. I told him I DEFINITELY want that test done in August 2006.

So basically my doctor is giving me four months to get my LDL down. Since nothing else seems to matter to him, I guess I will take every necessary action I can to make it happen. But I WILL NOT stop livin' la vida low-carb with the excellent results I have seen with getting my obesity under control, my triglycerides down and my HDL up, among other factors. I'm still not convinced these things just aren't just as important as LDL.

In my next blog post I will highlight many of YOUR responses to my question regarding cholesterol and whether statin drugs are the answer. Of all the e-mails and comments sent to me, only ONE said I should get back on a statin drug again. The rest of you were either supportive of my current numbers or felt there were some natural remedies to help me get my LDL to drop. I think you'll like what everyone said and that's coming up next.

Now it's tick-tock-tick-tock time for me to get to work on lowering my LDL. I KNOW it can happen with a few additional tweaks in my diet. I'm gonna do everything I can to make it happen and look forward to shocking the boo-boo out of my doctor in four months. Stay tuned...

4-02-2006 UPDATE: Okay, after listening to a LOT of recommendations and suggestions from my readers about how I can get my LDL cholesterol to come down, here is what I finally decided to do.

As you can see, I have a supply of red yeast rice, a plant stenol product, and garlic tablets to add to my low-carb lifestyle, daily vitamin supplementation which already includes a soluble fiber, and regular exercise. I bought a 4-month supply of products to coincide with my return to the doctor's office in August. Wish me luck!


Blogger Alex said...

Good for you Jimmy! Most people would have fallen right off the low carb wagon..because the Dr. said it's not good for me....blah blah blah. I am proud that you decided to show him...there's a better way!


4/01/2006 4:43 PM  
Blogger sly_foxx68 said...


Do you use alot of low carb so called frankenfoods. I am wondering if these may trigger the rise in your ldl levels? Just fishing for ideas!


4/01/2006 8:30 PM  
Blogger Jimmy Moore said...

No, not a "lot" of them, but I am prone to eat an occasional low-carb chocolate bar or protein bar from time to time. I don't get into the processed foods too much, but I do enjoy them sometimes for a treat.

4/01/2006 8:55 PM  
Blogger Gary said...

Jimmy, I think many doctors are too fast to dismiss "alternative" modalities and treatments - and very fast to go for the statins. A recent study on the newest statin drugs (notably Crestor) indicate that arterial disease may actually be reversible with high doses of these drugs - but we don't know what the side effects of such doses might be on the brain and other organs.

As you know, I recently decided not to choose Atkins as a means of weight loss, but have decided to use Barry Sears' Zone diet instead. Dr. Sears is a medical scientist whose research has led him to propose a diet in which 40% of daily caloric intake comes from carbohydrates, 30% comes from protein, and 30% from friendly fats. In so doing, he has classified all diets as basically belonging to one of four categories:

- Atkins: High protein / Low carbohydrate / Moderate fat

- Zone: Moderate protein / Moderate carbohydrate / Moderate fat

- American Heart Association: Moderate protein / High carbohydrate / Low fat

- Ornish: Low protein / Very high carbohydrate / Very low fat

Of course, we should also understand that all these diets restrict in varying degrees high-sugar and starchy carbs with little fiber - and emphasize the selection of healthy fats, particularly monounsaturated and certain polyunsaturated fats. Even Atkins has qualified its recommendations a bit, such that eating unlimited amounts of saturated fats is discouraged and eating healthful fats (e.g. olive oil) is recommended.

Dr. Sears discusses in his various books why he thinks his plan is the best for long-term health and long-term diet maintenance, and it all makes sense to me, but I think you can probably achieve similar results with Atkins. But here is where Sears now differs. His latest writings are combining this diet with a daily dose of high-grade fish oil, and he makes compelling arguments for why fish oil is so beneficial. Among them are the effects that these Omega-3 fatty acids have on blood lipids (fats) in general, and in particular he speaks about the beneficial effects of these nutrients for the brain, the heart, and the arteries. I also note that fish oil is now given by doctors for both rhumatoid- and osteoarthritis and is being tried as a treatment for bipolar disorder.

I know this long list may give the impression that fish oil is good for whatever ails you - and indeed Dr. Sears has a lab that produces high-grade fish oil (balanced EPA and DHA fatty acids less the contaminants that you would get from eating large amounts of fish, e.g. mercury, dioxin, etc.). You can take it either way: If you are very skeptical, you could say that he is pushing fish oil so that he can sell it; on the other hand, you could say he believes in his own science enough to produce a nutrient of sufficient quality not widely available on the market. (Yes, fish oil is widely available, but not in pharmaceutical grade.)

Now, why am I talking about all this? Because Dr. Sears goes into a fair amount of detail (albeit written for the layman) about the role of Omega-3 fatty acids and olive oil (an Omega-6 fatty acid) in normalizing human blood lipids. I would recommend that you do some outside reading on this as the epidemiological studies (not drug trials) back this up. Every heard of the Mediterranean diet? Or the French paradox?

It all seems to be coming together now and I think that mainstream doctors are reluctant to chance recommending our diets (Atkins, Zone) and are quick to prescribe the statins instead. But, I'm not a professional and I am only left with intuitive impressions about all of this, so I'm going to work first to adhere to the Zone and take fish oil. My naturopath and I will be watching the results over time and be learning from them.

Jimmy, you might consider studying up about fish oil before taking some of those more esoteric supplements that you are thinking about using.

4/02/2006 9:12 PM  
Blogger Andy said...

I’m in the same boat with my physician regarding serum LDL value. I recently obtained the results of my annual tests and the ‘doc’ wants me to come in and discuss my “high’ values (TC = 249; LDL = 177; HDL = 59; Tri = 63). After spending the past year reading everything I could find on the subject of cholesterol and serum lipoproteins, I’m ready to have a ‘discussion’ with the good doctor, if he’s willing?? I also refuse to reinitiate statin therapy because of the negative effects I and many others have experienced with this class of drugs.

Anyhow, here are several resources I found that provided what I consider logical and unbiased information about cholesterol and lipoproteins:
Anthony Colpo’s paper LDL Cholesterol: “Bad” Cholesterol or Bad Science. (You can find Anthony’s article at
The Cholesterol Myths by Dr. Uffe Ravnskov.
Appropriate chapter(s) in Protein Power and Protein Power LifePlan by Drs. Michael and Mary Eades.
The International Network of Cholesterol Skeptics website at

I checked out the Berkeley HeartLab (BHL) website and reviewed all info provided. No doubt about it they provide an in-depth analysis of those factors ‘associated’ with coronary atherosclerosis. However, if cost is an issue there are less expensive alternatives. Both Atherotech (the VAP Cholesterol Test; and LipoScience Inc (NMR LipoProfile Test; provide lipoprotein profiles, somewhat different than BHL. But of course BHL says their test methodology is far superior! BHL also provides a number of additional tests associated with cardio vascular disease which are listed on one of the pages at the website. You can get any of these tests done by the lab(s) your doctor uses. Dr. Ron Rosedale provides a listing and an explanation of appropriate tests in his book The Rosedale Diet. My main reason for bringing this all up is that if you plan on doing frequent follow-up testing to evaluate any non-statin treatment(s) you initiate, the cost using BHL is going to be high!

You appear to have developed a strategy for reducing your cholesterol/LDL. I suggest you investigate the use of niacin (no-flush), also.

And now for my stump speech……What is the cause of coronary atherosclerosis? The medical profession has defined this as “the process of fatty substances, cholesterol, cellular waste products, calcium and fibrin building up in the inner lining of an artery. This buildup is called plaque, which can cause coronary heart disease.” But what allows these substances to get into the inner lining of an artery? And what role, if any, does LDL have in the formation of plaque? It seems that a majority of the medical community believes LDL plays a significant role and must be controlled. But yet there are a number of scientists and medical professionals who say the ‘evidence’ does not support this conclusion. So where does that leave us? Read what the doubters have say and form your own opinion.

All the best!

4/03/2006 5:20 PM  
Blogger Cindy said...

Jimmy....are you aware that Red yeast Rice is a statin? A naturally occuring one, but still a statin.

Please be sure to increase your CoQ10 dose as all statins, manufactured or natural interferes with your body's ability to produce CoQ10.

4/16/2006 3:04 PM  
Anonymous nimblethimble53 said...

I am reading this a couple of years later....what ever happened when you went back to the doctor...I hate not knowing the end of the story.

6/27/2008 12:30 PM  
Blogger Jimmy Moore said...

THANKS Georgia! The end of the story is I NEVER went back to the doctor to worry about my LDL cholesterol ever again. The more I've read about LDL and the particle size being most important rather than the number itself in conjunction with the focus on the better measures of heart health--HDL and triglycerides--and I'm not worrying myself about LDL or total cholesterol anymore. Here's my most recent blog post about my cholesterol as of June 2008.

THANKS for reading! :)

6/27/2008 12:42 PM  

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