Tag Archives: cholesterol

S2E51. Cholesterol? Bah! Humbug!

What kind of a Scrooge blogs about cholesterol on Christmas Eve eve when he should be decking the halls, harking the herald angels and making spirits bright?

Uh…that would be me!

I didn’t plan it this way, it’s just that I had my annual physical last week and my cholesterol is high, so my primary care provider put me on a statin. Some holiday gift, eh?

I’m a bit befuddled by it all. In my late 50s, my cholesterol numbers were good, but of late, they’ve been hovering at the high end of the safe zone or a little above. I have no idea what changed.

About 2 years ago, I tried taking a statin and it worked. Shortly thereafter, though, I began my quest to lose 40 pounds and to eat a brain healthy diet, which includes foods to help control cholesterol. So I came off the medication and did the experiment to see if weight loss, exercise and diet could bring my numbers into line.

I’ve been eating all the right things for about 18 months now: almonds, olive oil, asparagus, beans, blueberries, tomatoes, avocados, cacao powder, eggplant, apples, and salmon. And then last year, I added oats, oat bran and oatmeal to my daily regimen. On the flip side, I don’t eat fatty meats, full-fat dairy products, or junk food, all of which can raise LDL.

I worked out religiously and lost 40 pounds.

I was pretty sure my behavior had earned me a spot on the lipid screen Santa’s “nice” list, but instead, I got coal in my stocking. 

Since it didn’t work, I did a post-mortem.

Getting COVID last April definitely threw a wrench into the works. It left me weaker and unable to do the intensity of workouts I had been doing up until then. To make matters worse, I went off my diet during our cruise last month. I’ve gained back 12 pounds.

I decided to face reality and accept the fact that I probably needed the medication, but there were still a few things that were confusing me, and I wanted some answers.

In spite of the overall bad news, there were two bright spots in my blood work. First, it appeared that my efforts had paid some dividends in terms of raising my good HDL cholesterol level. I had succeeded in raising it to 60 mg/dL, which is very good. Consequently, my LDL/HDL ratio was also an excellent 2.4. 

So I could make the case that the reason my total cholesterol had moved into the danger zone (219) was that my HDL had increased…which is a good thing. 

So why did I need medication?

I asked my PCP about it when we met and she explained that the American Heart Association developed a formula for predicting the likelihood of heart and vascular disease emerging within the next 10 years. It takes into account factors such as age, gender, smoking history, blood pressure and total cholesterol levels. Their guideline is that your risk factor should be below 7.5%

She typed my numbers into her computer and swiveled her display around to show me the results. My risk factor was at 16.7%.

I felt like I had just been visited by the Ghost of Christmas Yet To Come.

That sealed the deal. I’m now taking a statin.

What made the decision easier was that I had checked out the research on statins before going for my check-up. For several years, there had been concern that taking a statin could have a side effect of reversible cognitive problems. On the other hand, there were studies suggesting it could provide protection against age-related cognitive decline. So which was it?

A recent study appears to have resolved the conflict: the negative side effect is more likely to appear in those under 45 while the protective benefits seem to accrue to those over 65. 

What a nice stocking stuffer!

So why does someone interested in brain health care so much about cholesterol anyway?

There are about 100,000 miles of blood vessels in your brain and their primary job is to provide oxygen and nourishment to each and every one of your 100 billion neurons and 1 trillion glial cells. So you want to do your very best to make certain that nothing impedes the ability of those arteries to deliver their precious cargo. Cholesterol is the grinch in this story that can gum up the works by sticking to arterial walls and restricting blood flow which, in turn, damages or kills cells.

So now you know what I know.

And on that note, I’ll close by wishing a Happy Christmas to all, and to all a good night!  

__________

S1E50. An Early Present

I can’t recall ever being this eager (and anxious) about my annual physical and blood tests, but this year is different. My last check-up was in June, shortly after I began changing my diet and exercising on a regular basis. My blood sugar (A1C) was hovering around pre-diabetic levels, I was taking medicine (a statin) to lower my cholesterol, I was overweight at 180 pounds and I knew I had to do something about it. And so I did.

My expectations were pretty high this time around. I took myself off the statin about a month into the new regime. That was a pretty risky bet on my part because the numbers showed it was clearly doing a great job, with my cholesterol coming in lower than ever before. But I wanted to test the theory that I could control it with diet and exercise without exposing myself to potential side effects of a statin. I had worked into my diet pretty much every food identified as raising HDL (good cholesterol) and lowering LDL (bad cholesterol) and I was exercising an average of 60 minutes per day, 6 days per week. And as I’ve mentioned in previous posts, I had lost a shit-ton of weight!

The first thing I did in my new diet was to eliminate all added sugars. No more coffee with 2 teaspoons of sugar in the morning for me; I switched to tea. I carefully read labels on everything I bought and rejected anything with added sugar. By the time I finished, there were only 2 items I was eating with added sugar: herring in wine sauce and seaweed salad, but I figured the benefits they provided far outweighed the costs of ingesting the trace amounts of sugar I was getting in the quantities I was eating. When I did need to sweeten something, I used stevia, but that happened infrequently because I soon discovered that the natural sugars in the foods I was eating satisfied any cravings I had for sweets.

I also eliminated all refined flours which are quickly converted to sugar in your bloodstream. I was convinced that my glucose and A1C numbers would show significant improvement.

All these dietary changes did not come without a modicum of anxiety. Was it possible that I wasn’t getting enough of some essential vitamins or nutrients? I had no idea, so I was looking forward to seeing if things like my calcium and protein levels were holding up.

I had my physical last week and the results were good. My blood pressure was 116/64, my pulse was 57, my BMI (body-mass index) was 22.8 (down from the overweight range and squarely planted in the ‘normal’ zone), and my oxygen saturation level was 99%. I don’t recall ever having a resting heart rate below 60 beats/minute, and that oxygen reading is as good as it gets (also a personal best for me). I took all this to mean that my exercise program was working. In terms of brain health, it meant I was getting plenty of oxygen and my heart was supplying it with ease. I could scratch high blood pressure, anoxia and obesity/belly fat off my ‘eliminating dementia risk factors’ to-do list.

The results of my blood work came in on Wednesday. Logging in to my account and clicking through to the report felt like opening a present on Christmas morning!

I made a beeline for the glucose and A1C page…and wasn’t disappointed. My sugar numbers showed a dramatic drop, so much so that I had exited the pre-diabetic zone and entered the normal range for the first time in several years. The diet was working! 

Next I checked my cholesterol numbers. The good news was that they were all in the normal range, albeit at the high end. I was disappointed, though, to see a noticeable spike in my LDL without the medication. My HDL showed a substantial rise, too, which is a good thing. I was a bit befuddled, to say the least.

I did a little googling and found that the more meaningful metric is the ratio of total cholesterol to HDL, in which higher HDL generates a lower ratio and a lower ratio is better for you. Mine was not that much different from the one I recorded when I was taking the statin, and better than prior years’ readings. So something good was apparently coming from my lifestyle changes. Nonetheless, I decided right then and there to add oats back into my granola to try to knock down that LDL number.

I scratched off my list diabetes and high cholesterol as dementia risk factors.  😀

Finally, I looked at a variety of other indicators to see if I was lacking in anything. Potassium, protein and calcium were all fine. So were all the other readings, but to be honest, I have no idea what they measure. Bottom line: I’m not depriving myself of anything important.

The icing on the cake, though, arrived yesterday when my doctor followed up with this message:

“Hello Wayne,

I received your lab results…Overall, your labs are good…Your cholesterol and A1C were all within normal range…No indication to initiate any medications at this time…Keep up the great work!”

What a nice present.

Merry Christmas, everyone! 

__________