High cholesterol conundrum

[rosarugosa]

Has anyone succeeded in substantially reducing LDL cholesterol without statins? I've been resistant to taking statins, but I finally agreed to start on my MD's recommendation with 10 mg. atorvastatin. Unfortunately, I'm finding the GI side effects pretty intolerable, and I'm not eager to have a longer and healthier life spent exclusively in the bathroom. I lasted about a week and a half with the meds, then discontinued.
My HDL, triglycerides and ratio have always been good and continue to be good, but my LDL has steadily inched upward to 173 (should be under 130), and my total cholesterol is 278 (should be under 200).
I've been googling alternative meds and I've found a couple that might be better (cholestyramine, pravastatin) although they both list possible GI side effects.
I'm under the impression that diet and lifestyle changes can help, but might not move the needle too much.
Maybe it's just a matter of halfhearted efforts giving unimpressive results.
Wondering if you guys have any wisdom to share. Thanks in advance.

[Yppej]

It is my understanding that the body produces some cholesterol on its own - you don't have to worry about levels ever getting too low - and if you eliminate all dietary cholesterol by going vegan you can lower your numbers.

[iris lilies]

I have 0 advice to give about reducing cholesterol via diet. You don’t strike me as someone who eats much fatty stuff.

You can always work with your dr to try other statin drugs *if* it is important to you to lower the numbers. I would probably try another one before giving up.

But I wouldn’t live with GI disruption, so if it were that or no statin I would choose the “ no statin” route.

[Rogar]

I resisted statins for some time, but finally after some gnashing of teeth I said uncle. I'm basically vegetarian, within my advised weight range (although the upper side), and exercise regularly. My cholesterol was not as high as yours and when I've cracked down ever further with life style adjustments I could nudge my total down maybe 10 or 15 points. What my doctor claimed is that a person with poor lifestyle habits, i.e., overweight, fatty diet, no exercise, etc. can make a big dent in cholesterol. But as we get older, genetics plays an important role and there are some people genetically predisposed to high cholesterol and others who have no issues. Both my parents were on cholesterol medications and both died of cardio vascular related disease, so I'm not fooling around with more lowering attempts.

I've had no adverse reactions to the medications. Doctor says some people have to try a few different statin medications to find one that works and is compatible. I remember having some discussions with Jane who claimed cholesterol medications are an invention of big pharma to generate profits or something like that. That's certainly not mainstream accepted medical science, but I don't think the doctors know everything. There are people who say statins can lower cholesterol, but ultimately do not lower the risk of heart disease (if I have that right). I remember Steve in MN eventually fought the battle to have his cholesterol analyzed by particle size distribution and determined he was not at risk in spite of overall high cholesterol values. I think he was probably onto something, but that requires some research and some help from doctors.

[rosarugosa]

Jeppy: I am not willing to go vegan. I'm not a huge meat eater, but I really love my seafood, for one example, and I believe seafood is actually good for me. Also, this may be TMI, but I have IBS, so I would struggle to get enough protein on a vegan diet and there are so many veggies I cannot eat. I would pretty much be living on nuts and berries.

IL: I think my biggest unhealthy eating challenges are yummy fresh bakery bread and other starchy carbs like pasta and rice. Oh, and don't forget butter. I'm not immune to the siren call of sweets, but they aren't the biggest attraction for me. On Thanksgiving, for example, I ate the tiniest piece of pie imaginable, kind of a token gesture. When we go out to eat, I almost never eat dessert, although I'll sometimes accept a spoon so my dining partner feels more comfortable that we are "sharing" dessert. On the other hand, DH and I developed an unhealthy addiction for (lol) Healthy Choice frozen fudge pops this summer. They earn the name healthy by being only 100 calories, but if you eat the whole Costco-sized box, that's 1800 calories!

Rogar: I actually realized that Jane had a lot to do with my desire to avoid statins, and will all due respect to the late great Jane 2.0, I decided that I should probably weigh my MD's input more heavily. (I have a great MD and I have much confidence in him). I also researched to my satisfaction and found that while statins had not originally been tested on women, they have since been tested and found to be effective on both sexes. I only weigh 100 lbs and I'm pretty active, but I don't have an actual exercise program other than getting my 10,000 steps a day (come hell or high water). I think that's at the heart of my question, is whether it's worth the hard work of pursuing lifestyle changes, or do I focus my efforts on finding a better drug to go with my frozen fudge bars? My mother and sister are both on atorvastatin (DH too), so I think there is probably a hereditary component. They are also talking now about a correlation between cholesterol and dementia, so given Mom's AD, I don't want to be dismissive of that concern. Everyone has to die from something, but AD worries me a hell of a lot more than heart disease.

[iris lilies]

There are many voices here that are anti-statin besides our friend, Jane.

About cholesterol and heart disease and dementia: the trick is to have your heart disease take you out before your dementia kicks in at a debilitating level.

[catherine]

I don't have much/any advice either, because you seem to be a very healthy-living person to start with. I would guess genetics has a lot to do with your high LDL. Where does your LDL stand relative to your HDL? My LDL is borderline high, but I have very high HDL, so I figure it all nets out in my favor. My doctor must agree because I haven't been recommended statins.

[rosarugosa]

Catherine: My HDL is 96, my triglycerides are 47, and my ratio is 2.9. Apparently those are all very good, and when my LDL was lower, my MD wasn't too concerned about my total number being high, but now my LDL is higher.

IL: I fully agree, but figuring out how to make it happen is the tricky part.

[iris lilies]

IL: I fully agree, but figuring out how to make it happen is the tricky part.

While we’re at it, we will Die Broke. Living (and dying) the dream is to die suddenly of a heart attack or stroke, having spent my last dollar yesterday.

[catherine]

While we’re at it, we will Die Broke. Living (and dying) the dream is to die suddenly of a heart attack or stroke, having spent my last dollar yesterday.

Sounds good to me!

[Rogar]

My experience with strokes in my family is that you don't just die suddenly. If you like lingering in a nursing home for a few months half paralyzed and unable to speak, it might be a good way out. As they say, you can check out any time you want, but you can never leave.

[catherine]

My experience with strokes in my family is that you don't just die suddenly. If you like lingering in a nursing home for a few months half paralyzed and unable to speak, it might be a good way out.

I agree with that... my mother lived for 20 years in assisted living after experiencing a burst aneurysm in her brain and a subsequent stroke during surgery. I think IL's point was to prefer the ones that take you out completely.

[Rogar]

I agree with that... my mother lived for 20 years in assisted living after experiencing a burst aneurysm in her brain and a subsequent stroke during surgery. I think IL's point was to prefer the ones that take you out completely.

I understand that. My point being that statins reduce the risk of cardiovascular disease, but they don't absolutely prevent it. We can all be so lucky as to have the end come suddenly after a well lived life. Banking on a stroke before Alzheimer's gets you is a pretty lame bet.

[catherine]

I understand that. My point being that statins reduce the risk of cardiovascular disease, but they don't absolutely prevent it. We can all be so lucky as to have the end come suddenly after a well lived life. Banking on a stroke before Alzheimer's gets you is a pretty lame bet.

That's true.

[Yppej]

I have found a way to live worry free. I don't get tested for anything and then I don't have to worry about it.

[iris lilies]

I understand that. My point being that statins reduce the risk of cardiovascular disease, but they don't absolutely prevent it. We can all be so lucky as to have the end come suddenly after a well lived life. Banking on a stroke before Alzheimer's gets you is a pretty lame bet.
Haha, well, I told ya’ll that once I started high blood pressure meds I felt it unlikely that a big stroke would take me out. Nawww, it will be mini strokes that limit me. Oh joy.

[Rogar]

I remembered the details of my path into statins today. I resisted for three or four years thinking I could improve them and getting a doctor discussion every year. Instead, each year it edged up a little. It might go without saying, but I'd not make a choice based on one test and without trying a few things first. My family history weighed on my choices.

[herbgeek]

I lowered my tri's and ldl through fish oil capsules and reducing both sugar and alcohol consumption. Most of the benefit was the first 6 months and now its stabilized. Whole family has high cholesterol although i think mine is lowest among siblings.

[Yossarian]

My levels are elevated, but I don't take statins. Cholesterol plays an important role in your biology, and I think the medical focus on the heart risk is influenced by the availability of pharma solutions. I would encourage you to look into all cause mortality stats. You probably have some risk at your levels, but the risk may not be as high as you think. For me even though my LDL was elevated, the ratio wasn't crazy bad and my corresponding all cause risk isn't actually elevated. https://www.nature.com/articles/s41598-018-38461-y/figures/2

See for example https://www.nature.com/articles/s41598-018-38461-y/figures/2 for the summary

And here for more break out by age and gender https://www.nature.com/articles/s41598-018-38461-y/figures/3

There is actually more risk to being too low than too high.

[frugal-one]

I researched and did a presentation on statins. From everything I have read the risks far outweigh the rewards. The benefit is about 1% but the risk for diabetes, cancer and deterioration of muscle (especially in legs is high). I wish I would have kept my notes so I could give the exact numbers.

I have been taking berberine with unbelievable results. Do your research and see if you think this could benefit you too. YLMV

[iris lilies]

My levels are elevated, but I don't take statins. Cholesterol plays an important role in your biology, and I think the medical focus on the heart risk is influenced by the availability of pharma solutions. I would encourage you to look into all cause mortality stats. You probably have some risk at your levels, but the risk may not be as high as you think. For me even though my LDL was elevated, the ratio wasn't crazy bad and my corresponding all cause risk isn't actually elevated. https://www.nature.com/articles/s41598-018-38461-y/figures/2

See for example https://www.nature.com/articles/s41598-018-38461-y/figures/2 for the summary

And here for more break out by age and gender https://www.nature.com/articles/s41598-018-38461-y/figures/3

There is actually more risk to being too low than too high.

J, good to see you around these parts!

[Rogar]

The Mayo Clinic, Harvard school of medicine, Stanford school of medicine, and John’s Hopkins all seem to share a similar recommendation. I didn't check with Yale, the Cleveland Clinic, or articles from the Lancet.

[nswef]

I am taking sunflower lecithin . It seems to be keeping it level although my dr. wants to check in 6 months to see if it will lower it some.

[frugal-one]

I take lecithin as well but find it mostly helps with memory. When we go on vacation and I don't take it ... I start forgetting words. It obviously helps me for cognition. I take soy vs sunflower mainly based on taste. There is no taste for the soy version.

[pinkytoe]

I remain Jane's sidekick - a skeptic when it comes to most pharmaceuticals. I figure the same thing will happen with Ozempic type drugs as it will be prescribed like candy once the price goes down.The good thing is we all get to decide how we wish to proceed.

[Rogar]

I was talking with a financial adviser the other day and he suggested that people in our parents or maybe grandparents generation had a shorter lifespan and planning for the future was/is is different than now where we have people living well into their eights or nonagenarians. My physician has commented on how he has more patients living into their nineties. Of course there are the anecdotal stories like my great aunt and uncle who almost reached a hundred, but it should be not a secret that people in our age groups may have an expected lifespan a decade or two more than a person born before mid century and later medical advances. One can speculate why that is.

[pinkytoe]

We do live longer but with more chronic morbidities and drugs to keep us afloat but not in a desirable state. Case in point - my MIL. Just turned 89 and is in bad health but still alive. If not for blood thinners, she would have had a stroke a while back. Now she vegetates in assisted living and frequently asks why am I still here?

[Rogar]

My next door neighbor is 96. He and his son painted his house when he was over 90. He did the trim and cut in and his son who is older than me did the rest. He was able to play the short nine with a cart until about a year ago. My accountant takes flowers from the local home and garden show to nursing homes. He said there are a lot of people in nursing homes around our ages. My parents lived into their eighties (and on the usual cocktail of prescription medications). They were both relatively healthy and active until their last year or so.

i suppose if if a person wanted a life expectancy of 60 or so they could live like it was 1940.

[ApatheticNoMore]

I'm not against pharmaceuticals, but I don't think just looking at cholesterol tells the whole story. It's simplistic. It's not the latest science is my understanding. There are markers of inflammation, there is lipoprotein (a), there is breaking down LDL into what kinds of LDL it is (apparently there are several kinds of LDL), and there is looking at the actual condition of one's blood vessels with xrays etc.. So there is a more wholistic picture of risk (of course triglycerides, blood sugar, blood pressure, etc. is all part of that too). Even with statins some think the mechanism of action might not be primarily about cholesterol (which is kind of an aside because who cares how exaclty they work if they work)

[Rogar]

ANM, that’s about exactly what I discussed with my doctor. He waved me off a couple of the extra testing methods with my general approval, but they are all worth discussing. We did talk about the wholistic approach, which seems like a pretty basic thing to review for anyone.

[Yossarian]

J, good to see you around these parts!

Well thanks K :)

It's been a while. Looks like a lot of the folks here are the same as 20 yrs ago. Guess we can all discuss our health getting older :laff:

[Simplemind]

Both my younger siblings are on meds. My DH is on meds and has had multiple strokes and heart issues. He feels he can eat what he wants because he is on meds and his numbers are good. Me, I don't like meds for anything. My doctor has thrown out a statin recommendation for years. I tried it once and had too many side effects. I keep saying no. Last April my numbers were the worst they have ever been. I told him I was going to buckle down and work on it asking to be tested again in three months. If I couldn't turn it around then we would talk about statin alternatives. He told me that numbers really can't be changed much by diet and exercise. I took an honest look at my eating habits and made a couple of significant changes, ones that I knew I could sustain if they worked. At the three month mark I retested and was amazed. I had dropped over 50 points and 15lbs. I went from my worst to the best I've ever had. My doctor even called me at home to ask what I had done. He couldn't believe it. I asked for another at three months to see if the trend continued to go down or if I needed to make additional changes. I test next week. Although I know a lot of people struggle to make life changes it angers me that nutrition isn't worked on before bringing to the prescription pad.

[happystuff]

That's fabulous, Simplemind! Congrats and best of luck going forwar

I need to start examining our diets and make some changes. I'm okay - for now - but dh is having issues.

[frugal-one]

Well done Simplemind!!

[catherine]

Both my younger siblings are on meds. My DH is on meds and has had multiple strokes and heart issues. He feels he can eat what he wants because he is on meds and his numbers are good. Me, I don't like meds for anything. My doctor has thrown out a statin recommendation for years. I tried it once and had too many side effects. I keep saying no. Last April my numbers were the worst they have ever been. I told him I was going to buckle down and work on it asking to be tested again in three months. If I couldn't turn it around then we would talk about statin alternatives. He told me that numbers really can't be changed much by diet and exercise. I took an honest look at my eating habits and made a couple of significant changes, ones that I knew I could sustain if they worked. At the three month mark I retested and was amazed. I had dropped over 50 points and 15lbs. I went from my worst to the best I've ever had. My doctor even called me at home to ask what I had done. He couldn't believe it. I asked for another at three months to see if the trend continued to go down or if I needed to make additional changes. I test next week. Although I know a lot of people struggle to make life changes it angers me that nutrition isn't worked on before bringing to the prescription pad.

So please share your lifestyle changes that resulted in such a great change in your numbers!

[mamalatte]

Great job, Simplemind! I achieved similar results by eating vegan but then I wasn't on top of it enough to both be vegan and eat in a nutritious way.

[Simplemind]

I did a few things but I'll put them in list of what I felt made the most difference. First was research to know what was causing what. Saturated fats for the LDL and sugar/carbs for Triglycerides. I knew I could immediately improve in those areas. I had a high fat diet left over from keto which works if you keep your carbs down and I had slipped. I was having a tawdry affair with butter (I am my mother's daughter) and cheese. Basically I was downing dairy in some form from sun up to sundown. I stripped it down to almost nothing. I swapped olive oil for butter. I eat very little cheese (she says through tears) and I stopped the glasses of milk and cream in my coffee. I got one of those fancy plant milk makers from Amazon and I drink all kinds of nut and oat milk now. It saves a TON of money over buying it. I cut way way WAY back on any white carb (potatoes,rice,bread). We eat pretty clean, working to stay away from processed foods and although I have not stopped eating meat I keep an eye on the cut, how much and how often. I try to keep my saturated fats from animals under 10g a day. I throw ground flax seeds or chia seeds in and on everything. I try to drink more water. We do intermittent fasting so I get up and go work out, come home and eat a meal at 10a. We putter around with the yard and errands, lighter physical stuff until we eat again at 2p. If we snack (and we really try to talk ourselves out of it) we might do a handful of nuts, apple maybe with peanut butter or some popcorn popped in olive oil at 6p. Then we are done. So it will be interesting to see if the numbers continued to go down. If they stayed the same then I would look at dropping back on that glass of wine with dinner, putting a no meat meal in the weekly rotation, cutting further back on the carbs. I'm not a fan of oatmeal unless it is in cookie form so I don't eat the tried and true bowl of oats in the morning. I'm more of an avocado or peanut butter toast gal. I do supplement with beta glucans in the morning which is what is supposed to be the magic bullet in the oats. Oh and I forgot to add - I was prediabetic and had a fatty liver. My numbers went back to normal in those areas as well. The best since we had been testing. Win/win/win!!

[catherine]

Congratulations!!! Reminds me when DH and I also tried to limit severely our simple carbohydrates so that we could both fit into the outfits we wanted to wear to our son's wedding. In 3 months, we both lost weight (I went from 137 to 117) and DH went from full-blown diabetic to pre-diabetic levels. He has actually stopped drinking entirely and he is no longer diabetic at all.

Doctors must get so tired of the mantra "eat well, and exercise" but that is the trick. People just don't want to put in the work. They'd rather have the magic pill.

[Rogar]

Doctors must get so tired of the mantra "eat well, and exercise" but that is the trick. People just don't want to put in the work. They'd rather have the magic pill.

That is my take also. Not only to do the up front life style changes, but the stick to it ness to keep up new habits. There is also a genetic factor that is different among us.

[catherine]

That is my take also. Not only to do the up front life style changes, but the stick to it ness to keep up new habits. There is also a genetic factor that is different among us.

Oh, definitely genetics comes into play. And it definitely isn't easy to change, but it can be done with the right motivation. And the results will definitely vary.

[Simplemind]

I have had some very negative medication experiences the last few years. I am very motivated to do everything possible to stay off them. None of the changes I made have been hard to stick with. If I fall off the wagon a bit (I'm talking about you Thanksgiving...) then I just jump back on the next day. I have found that with time and better eating, I'm not much attracted to the shady stuff and when I do eat it, it doesn't taste as good as I thought it would and I don't feel good after I eat it. Another positive that keeps me on track.

[rosarugosa]

Update: I'm trying the pravastatin, and I'm tolerating it well so far. I still intend to work on lifestyle changes, but Mom and Sis both had really high cholesterol (now on statins), so I do think there is a genetic component.