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Medical Forum / General / Cardiology / April 2008Stellar Lipid Results -- and a Question
After my bout with ACS and resulting angioplasty/3 stent insertions last October (2007) , I got serious about being proactive in improving my health and doing all that I can to improve my chances for remaining free of further CAD incidents. This is what I've been doing in the past few months: Medications (relating to cholesterol): I was put on 210 mg Lipitor (to lower LDL) and 145 mg Tricor (to lower triglycerides) , as well as 1000 mg of Niaspan (to raise HDL). Nutrition: I've followed my cardiologist's recommended heart-healthy diet (under 50 mg fat daily, less than 15 mg saturated fat, no simple starches or sugar, plenty of low-glycemic fruit and berries, lots of non-starchy vegetables, whole grain cereals and breads and reasonable portions of fish and skinless chicken -- no red meat). So far I have lost 52 pounds since October with just 38 more pounds to go to reach my recommended BMI. (Male, 6'1", I've gone from 270 to 218 pounds). Exercise: I've also been exercising as much as possible. A 1998 stroke made it difficult for me to even walk fast or do aerobic type exercises, so I committed to a new round of physical therapy with a goal of being able to walk better to improve my ability to exercise. This PT has just ended, and I now do 30 minutes of reasonable home exercises each day. The bottom line of all this is ... I expected an improvement with this combination of changes but I was downright shocked at the stellar results in 5 months. I had read that nutrition alone can only lower cholesterol a certain %, same with the statins and fenofibrates. I'm 56 years old, and my cholesterol has *never* been anywhere near this low in my entire adult life; it has literally been cut in half in 5 months. This was completely unexpected. Ironically, the first set of readings that follow were taken just a couple of weeks before my ACS incident and stent insertions: 10/2007 3/2008 Total Cholesterol: 234 117 HDL Cholesterol: 35 38 LDL Cholesterol: 122 56 LDL/HDL Ratio: 3.6 1.5 VLDL Cholesterol: 77 23 Triglycerides: 359 117 CRP was 2.1 ("average") on the last test -- not measured on the first one. Obviously I'm very excited about these results, and psychologically feel great about my health future now that I'm on the right track. But one question is bugging me, and I realize that this may be the proverbial $64,000 question: I've been a bit surprised that my HDL has not risen more than the 3 points that it has, even though the LDL/HDL ratio has improved tremendously. What else can I do that I'm not doing already to improve the HDL? Exercise, Niaspan, diet haven't seemed to help much. The more I read, the more I'm convinced that the scrubbing effect of the HDL may be the ultimate key to my continued cardiovascular health and ultimate longevity. (I've been wondering if the statins or fenofibrates also tend to minimize HDL along with LDL). I realize there is no magic bullet, but I'd appreciate any ideas about anything else -- or any combination of things -- that I could try to get that HDL higher. Or even any suggested reading on the subject. Thanks in advance for your thoughts. Zob > I was put on 210 mg Lipitor (sorry, typo -- that should read, "20 mg of Lipitor.") Zob It remains our collective clinical experience that HDL does not become optimally more than 50 mg/dL in many people until all the black fat (VAT) is gone: http://HeartMDPhD.com/BlackFat Therefore, it remains smarter to eat less, down to the right amount: http://HeartMDPhD.com/BeSmart Here is a simple parable given in hopes of promoting understanding: http://HeartMDPhD.com/Parable But of course, what good is a high HDL if you still end up losing your soul: http://HeartMDPhD.com/Convicts You do not have much longer, dear neighbor Zob: http://HeartMDPhD.com/HolySpirit/Prophecy May you wisely choose to repent soon by publicly declaring with your mouth that "Jesus is LORD:" http://HeartMDPhD.com/HolySpirit/TheWay Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow > After my bout with ACS and resulting angioplasty/3 stent insertions > last October (2007) , I got serious about being proactive in improving [quoted text clipped - 64 lines] > > Zob Way to go Zob! Stellar performance. Like you, I cut my TC in half after my 9/30/07 attack & angio stents. Unlike you, by HDL went down, from 38 to 30 IIRC. Since learning that in December, I started adding more specific **good** fat containing foods as per suggestions from nurses & nutritionists. I now eat a fair amount of: Walnuts, Avocados, freshly ground Flax seed, grape juice, high cocoa dark chocolate in moderation, pecans, and even some peanut butter. Smart Balance brand fake butter was also recommended, and it tastes pretty decent. Of all the above, I think Avocados offer the most benefit, and certainly the most satisfaction, for me anyway. I should have my latest blood work results midweek to see if this has made a difference. How do you exercise at home? I invested in a recumbent bike recently, which is a great machine for folks who don't handle the impact of treadmill usage well. This thing can really get my heart rate up quickly with the variable resistance programs. I still do most of my exercise on a treadmill, mostly warm up on the bike. Keep up the good work, David in MD > Way to go Zob! Stellar performance. Actually his low HDL < 50 mg/dl remains a concern. > Like you, I cut my TC in half after my 9/30/07 attack & angio stents. > Unlike you, by HDL went down, from 38 to 30 IIRC. Suboptimal. > Since learning that in > December, I started adding more specific **good** fat containing foods > as per suggestions from nurses & nutritionists. This will not remove the black fat (VAT) that you have as evident by your low HDL. > I now eat a fair amount of: Walnuts, Avocados, freshly ground Flax seed, > grape juice, high cocoa dark chocolate in moderation, pecans, and even > some peanut butter. Smart Balance brand fake butter was also > recommended, and it tastes pretty decent. Of all the above, I think > Avocados offer the most benefit, and certainly the most satisfaction, > for me anyway. When something makes one full thereby killing the hunger, one should be dissatisfied rather than satisfied. This is because it is only when we are hungry that our bodies get rid of the VAT. There is only one exercise that burns the black fat and that is the exercise your stomach does when it sings and laughs out loud. May you and other dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be healthier: http://TheWellnessFoundation.com/BeHealthier Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow On Apr 5, 7:23 am, "Andrew B. Chung, MD/PhD" the frigging quack interrupted and spewed: > > Way to go Zob! Stellar performance. > [quoted text clipped - 4 lines] > > Suboptimal. Screw you Chung. I know what my numbers are, and what they should be. I don't want your bullshit attached to my reply to a fellow sufferer. You really are a waste of ectoplasm. Please shrivel up & drift away http://HeartMDPhD.com/HolySpirit/Proof http://HeartMDPhD.com/HolySpirit/KnowingHIM It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in article <80a8134a-c331-41ae-adfd-4110ac719e0d@a22g2000hsc.googlegroups.com>: >> Way to go Zob! Stellar performance. > >Actually his low HDL < 50 mg/dl remains a concern. Not nearly the concern it would be if his risk factor were in mid-range instead of as low as it is. >> Like you, I cut my TC in half after my 9/30/07 attack & angio stents. >> Unlike you, by HDL went down, from 38 to 30 IIRC. >Suboptimal. But not nearly as bad as it would be for someone with a normal risk factor. >> Since learning that in >> December, I started adding more specific **good** fat containing foods >> as per suggestions from nurses & nutritionists. >This will not remove the black fat (VAT) that you have as evident by >your low HDL. Since there is no such thing as "black fat" this should not be a concern for any of us patients. :-). You could counter this assertion by citing a peer-reviewed study establishing "black fat" as a medical issue. >> I now eat a fair amount of: Walnuts, Avocados, freshly ground Flax seed, >> grape juice, high cocoa dark chocolate in moderation, pecans, and even >> some peanut butter. Smart Balance brand fake butter was also >> recommended, and it tastes pretty decent. Of all the above, I think >> Avocados offer the most benefit, and certainly the most satisfaction, >> for me anyway. >When something makes one full thereby killing the hunger, one should >be dissatisfied rather than satisfied. This is because it is only >when we are hungry that our bodies get rid of the VAT. There is only >one exercise that burns the black fat and that is the exercise your >stomach does when it sings and laughs out loud. Publish or cite some science that supports anything in this paragraph. http://HeartMDPhD.com/Convicts/PrayForDon >It seems to me I heard somewhere that Andrew B. Chung, MD/PhD wrote in article ><80a8134a-c331-41ae-adfd-4110ac719e0d@a22g2000hsc.googlegroups.com>: [quoted text clipped - 5 lines] >Not nearly the concern it would be if his risk factor were in mid-range instead >of as low as it is. Yep, I'm concentrating on the positive. Considering that in 5 months I've improved my LDL/HDL ratio from 3.6 to 1.5, I'd say that I've pretty dramatically decreased cholesterol-related risk. I'm not where I want to be yet -- the whole point of my original post in this thread was to get suggestions on increasing my HDL level some more. But I'm very happy with the results of the changes I've made in lifestyle and diet and the impact on my overall health that these changes have made. Zob >Way to go Zob! Stellar performance. >Like you, I cut my TC in half after my 9/30/07 attack & angio stents. [quoted text clipped - 7 lines] >Avocados offer the most benefit, and certainly the most satisfaction, >for me anyway. I've started using Smart Balance also. I was eating my vegetables, etc. plain, but I've started using two or three tablespoons a day now. Flax seed sounds like a great idea; I eat a lot of oatmeal and it would be easy to mix it in or sprinkle it on top. I think I'll also start eating more nuts -- I love pecans and walnuts, and will wee how I can work them into my diet plan. > I should have my latest blood work results midweek to see if this has >made a difference. Let us know how it turned out! Zob > After my bout with ACS and resulting angioplasty/3 stent insertions > last October (2007) , I got serious about being proactive in improving [quoted text clipped - 64 lines] > > Zob Hi Zob. I'm a Board Certified Internist. You did wonderfully well with what you've done so far. As for improving your HDL, possibly crestor instead of lipitor. It theoretically can increase HDL. Also consider omega 3 fish oils and a diet high in salmon. Sometimes it's just genetics, and hard to change. I am really impressed with the changes you've made. You must feel wonderful. I'd recommend adding some gentle yoga or some meditation to your other lifestyle changes. http://HeartMDPhD.com/CrazySockPuppet of http://HeartMDPhD.com/Frustratedsatan >http://HeartMDPhD.com/CrazySockPuppet > >of > >http://HeartMDPhD.com/Frustratedsatan What's your point here, Chung ? Yamantaka provides valuable advice -- and you are mocking him. > Andrew, in the Holy Spirit, boldly wrote: > [quoted text clipped - 5 lines] > > What's your point here, Chung ? Rebuking satan. > Yamantaka provides valuable advice As if satan could provide anything valuable: http://en.wikipedia.org/wiki/Yamantaka > -- and you are mocking him. Rebuking is not mocking: http://HeartMDPhD.com/Convicts/Rebukesatan Bottom line: You are pathologically untruthful. This simply shows that the Holy Spirit is absolutely right to convict you: http://HeartMDPhD.com/Convicts May we, who are Christians, continue to pray for your perishing soul: http://HeartMDPhD.com/Convicts/PrayForPoellot Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow >> http://HeartMDPhD.com/CrazySockPuppet >> [quoted text clipped - 4 lines] > What's your point here, Chung ? Yamantaka provides valuable advice > -- and you are mocking him. Be prepared to be convicted and prayed for by Chung - you will be entering a very intelligent and thinking group of people. The goal is to become a member of the elite group of sockpuppets of Satan. >>> http://HeartMDPhD.com/CrazySockPuppet >>> [quoted text clipped - 8 lines] >very intelligent and thinking group of people. The goal is to become a >member of the elite group of sockpuppets of Satan. Chung convicted me last year and predicted that I won't have much longer :-) He also prays for my perishing soul. http://HeartMDPhD.com/Convicts/PrayForPoellot > http://HeartMDPhD.com/Convicts/PrayForPoellot Congratulations Poellot. You are now in a group of wonderful and thinking and intelligent people. http://HeartMDPhD.com/Convicts/Idioticsatan >> After my bout with ACS and resulting angioplasty/3 stent insertions >> last October (2007) , I got serious about being proactive in improving [quoted text clipped - 72 lines] >you've made. You must feel wonderful. I'd recommend adding some gentle >yoga or some meditation to your other lifestyle changes. Thanks. And yep, one of the reasons I'm being so pro-active is because I have a heavy family history (on both sides) of early death from CAD. My father died in his 50's from a stroke after having had two heart attacks in his 40's, and my mother died in her 60's from a heart attack. My younger brother has had quintuple bypass surgery in his 40's as well as 6 stent insertions since, and my sister has diabetic-related CAD. So I know that there are some genetic factors in play that I can do absolutely nothing about. However, that's all the more reason for me to be motivated to maximize my options in the health issues over which I *do* directly have some control. You're right, it's a good feeling to see the pretty dramatic results that simple nutrition has made. My primary care physician is using my results as an example for his other patients as to what can be accomplished with a little perseverance and determination. I'm proud of what I've done, and results like this are self-motivating and makes it easier to continue. The doctors can do only so much; I'm finding that we really each hold our destinies in our own hands to a large degree where our cardiac health is concerned. As far as meditation goes... I've addressed the spiritual aspect of my life as well in conjunction with the physical changes I'm making. I recently started visiting churches, and found one that I love and feel very much at home and at peace in. I'm joining the church next Sunday. Zob > I'm proud > of what I've done, and results like this are self-motivating and makes > it easier to continue. The doctors can do only so much; I'm finding > that we really each hold our destinies in our own hands to a large > degree where our cardiac health is concerned. A motivated, educated patient who realizes his/her responsiblity is always better. With the internet today, and being careful as to what you read, you can learn a lot which helps you. There are some good starting points, like the web site for the American Heart (Diabetic,etc) Association and many of the universities have sites which end in "edu" and there are some good sites like WebMD and eMedicine. There are some good private-type sites, but need to be very careful and these groups, be very careful - do NOT trust (private sites and groups) until you have varified it with one reliable source or even more. Also need to realize, that there is not uniform agreement in medicine and there is still the science and the art in the practice of medicine. So pick a good doctor, be informed and compliant and stick with that doctor. Do not be afraid of asking for a second opinion - a good doctor should not mind that - if your doctors does object, time to look for a new doctor. Good work on what you have done, keep it up and I hope you continue to do well. http://HeartMDPhD.com/Charlatansatan > After my bout with ACS and resulting angioplasty/3 stent insertions > last October (2007) , I got serious about being proactive in improving [quoted text clipped - 64 lines] > > Zob Therapeutic doseages of niacin start at 1500 mg/day according to a publication on Niacin in my cardiologist's office. Niacin also improves cholesterol quality typically increasing LDL particle size to more healthy levels. One needs a VAP test to determine particle size and sub fractions. Not eating enough fat, particularly saturated fat, will keep your HDL low. Your total cholesterol is too low at this point. Optimum according to the life extension foundation is between 180-200. Lower than 180 and other causes of mortality increase. Above 200 and other cause of mortality increase but in this case it looks like one needs to get well above 240 total, perhaps closer to 300. Anything with trans fats will lower HDL and decrease LDL particle size and often whole grain products use trans fats. I would avoid processed foods like that an decrease my consumption of grains because evolutionary wise, man has only had 10,000 years to adapt genetically to grains and that is far too short a time. I would also work to get more fat in the diet as that will increase your HDL numbers. I would eat some read meat. Have you had a VAP test, homocysteine test, and checked thyroid which can increase cholesterol numbers?  SignaturePramesh Rutaji p297tongue6221@newsguy.com - remove tongue to reply It seems to me I heard somewhere that Pramesh Rutaji wrote in article <ft8d8s017oq@news1.newsguy.com>: >> After my bout with ACS and resulting angioplasty/3 stent insertions >> last October (2007) , I got serious about being proactive in improving >> my health and doing all that I can to improve my chances for remaining >> free of further CAD incidents. >> This is what I've been doing in the past few months: >> Medications (relating to cholesterol): >> I was put on 210 mg Lipitor (to lower LDL) and 145 mg Tricor (to >> lower triglycerides) , as well as 1000 mg of Niaspan (to raise HDL). >> Nutrition: >> I've followed my cardiologist's recommended heart-healthy diet (under [quoted text clipped - 4 lines] >> pounds since October with just 38 more pounds to go to reach my >> recommended BMI. (Male, 6'1", I've gone from 270 to 218 pounds). [. . .] >> Obviously I'm very excited about these results, and psychologically >> feel great about my health future now that I'm on the right track. But [quoted text clipped - 11 lines] >> things -- that I could try to get that HDL higher. Or even any >> suggested reading on the subject. >Therapeutic doseages of niacin start at 1500 mg/day according to a >publication on Niacin in my cardiologist's office. I guess my first, excellent, cardiologist didn't know that. He started me at 1000mg/day, and one of his successors lowered it to 500mg when my blood work stabilized. >Your total cholesterol is too low at this point. Are you medically qualified to make such a definite statement about a patient you know only from some numbers? >> Therapeutic doseages of niacin start at 1500 mg/day according to a >> publication on Niacin in my cardiologist's office. > > I guess my first, excellent, cardiologist didn't know that. He started me at > 1000mg/day, and one of his successors lowered it to 500mg when my blood work > stabilized. I was wondering about that 1500 mg statement. My Doc started me on 500 mg/day last December, at the same time he cut my Lipitor from 80mg to 40mg. Most of the stuff I have read seems to be saying low doses of Niaspan coupled with low doses of Crestor show good results in raising HDL levels. I'm still on the 500 mg, but Doc switched me to Crestor 10mg quite recently. > >> Therapeutic doseages of niacin start at 1500 mg/day according to a > >> publication on Niacin in my cardiologist's office. > > > > I guess my first, excellent, cardiologist didn't know that. He started me at > > 1000mg/day, and one of his successors lowered it to 500mg when my blood work > > stabilized. http://HeartMDPhD.com/Convicts/PrayForDon > I was wondering about that 1500 mg statement. > My Doc started me on 500 mg/day last December, at the same time he cut > my Lipitor from 80mg to 40mg. Most of the stuff I have read seems to be > saying low doses of Niaspan coupled with low doses of Crestor show good > results in raising HDL levels. I'm still on the 500 mg, but Doc switched > me to Crestor 10mg quite recently. It remains smarter to eat less, down to the right amount, in order to lose the VAT thereby increasing HDL (typically by more than 100%): http://HeartMDPhD.com/BeSmart A simple parable given in hopes of promoting understanding: http://HeartMDPhD.com/Parable May you and other dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 Be hungry... be healthy... be hungrier... be healthier: http://TheWellnessFoundation.com/BeHealthier Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow > I was wondering about that 1500 mg statement. > My Doc started me on 500 mg/day last December, at the same time he cut > my Lipitor from 80mg to 40mg. Most of the stuff I have read seems to be > saying low doses of Niaspan coupled with low doses of Crestor show good > results in raising HDL levels. I'm still on the 500 mg, but Doc switched > me to Crestor 10mg quite recently. The labels on most niacin sold for this say 500mg qd and not to take more without checking with your doctor http://HeartMDPhD.com/Pretendersatan who is http://HeartMDPhD.com/Wailingsatan is also still http://HeartMDPhD.com/Doomedsatan forevermore http://HeartMDPhD.com/HolySpirit/Alpha_Omega guaranteed: http://HeartMDPhD.com/HolySpirit/ProofsByGOD <>< May dear neighbors, friends, and brethren have a blessedly wonderful 2008th year since the birth of our LORD Jesus Christ as the Son of Man ... ... by being hungrier: http://TruthRUS.org/KnowingGOD Hunger is wonderful: http://HeartMDPhD.com/Hunger It's how we know what GOD wants, which is what is good. Yes, hunger is our knowledge of good versus evil that Adam and Eve paid for with their and our immortal lives. Those who suffer from the powerful delusion predicted by the prophecy of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! ) forever ... http://HeartMDPhD.com/Convicts/CrazyOne http://HeartMDPhD.com/Convicts/CrazyTwo http://HeartMDPhD.com/Convicts/CrazyThree http://HeartMDPhD.com/Convicts/CrazyFour http://HeartMDPhD.com/Convicts/Bob ... gone: http://YouTube.com/watch?v=Qb6d_z5C35E Such will be the demise of all those who refuse to know **and** love the truth, Who is LORD Jesus Christ: http://HeartMDPhD.com/Love/TheTruth Be hungry... be healthy... be hungrier... be blessed: http://HeartMDPhD.com/HolySpirit/BeBlessed "Blessed are you who hunger NOW... ... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21) Amen. http://HeartMDPhD.com/HolySpirit/Luke6_21 A simple parable for the wise and discerning: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be healthier: http://TheWellnessFoundation.com/BeHealthier Marana tha Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow >> I was wondering about that 1500 mg statement. >> My Doc started me on 500 mg/day last December, at the same time he cut [quoted text clipped - 5 lines] >The labels on most niacin sold for this say 500mg qd and not to take more >without checking with your doctor I'm taking Niaspan, a prescription-only version of niacin. Zob > satan via a sockpuppet (corporeal demon) hissed: > > newsreader wrote : [quoted text clipped - 11 lines] > > I'm taking Niaspan, a prescription-only version of niacin. Pretenders would continue to not have a clue: http://HeartMDPhD.com/Pretendersatan You would still be smarter to ignore satan's sockpuppets and eat less, down to the right amount... http://HeartMDPhD.com/BeSmart And, wisely repent by publicly declaring with your mouth that "Jesus is LORD:" http://HeartMDPhD.com/HolySpirit/TheWay May we, who are Christians, continue to pray for your perishing soul: http://HeartMDPhD.com/Convicts/PrayForZob Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow > Pretenders would continue to not have a clue: > > http://HeartMDPhD.com/Pretendersatan And those who are delusional continue not to have right answers. http://HeartMDPhD.com/DelusionalChung http://HeartMDPhD.com/Flailingsatan > It seems to me I heard somewhere that Pramesh Rutaji wrote in article > <ft8d8s017oq@news1.newsguy.com>: [quoted text clipped - 43 lines] > 1000mg/day, and one of his successors lowered it to 500mg when my blood work > stabilized. Taking 500 mg/day of Niacin didn't solve my small particle problem as measured with a vap test. Neither did any increments until I got to at least 2500 mg/day. Initially my cardiologist refused to even order the VAP test so I ordered it myself and then got another cardiologist who had a clue what a VAP test and small particle LDL was. One think I like about niacin is that I can but the product over the counter and not pay the 10-50 times drug mark ups, I can order my own blood work and track my own results. I can do what's best for me and place my cardiologist in the position of having to make his case that I should change what I'm doing; He has to treat me individually instead of as another patient statistic. >> Your total cholesterol is too low at this point. > > Are you medically qualified to make such a definite statement about a patient > you know only from some numbers? Statistically speaking, when people are divided into 4 quartiles based on total cholesterol, those in the lowest quartile die at greater than twice the rate as those in the highest quartile using the end point all-cause-mortality. One may look at cardiovascular events if they exclude heart failure and find benefits to lowering cholesterol, but death rates from other causes increased. Science in health has most often been about "statistical" models. I have never been to a doctor that just treated me; doctors have an "assembly line" mentality and their patents get the down side of that mentality. If you have cholesterol that happens to be above the drug influenced limits, you will be prescribed medication with no regard to it's ultimate effect on you personally. If A then B;if not B;then C;etc. Try a web search for "risks low cholesterol". A total cholesterol of 117 is way below the point where health problems start occurring. The recommendation that LDL be lowered below 70 is thin at best, bullshit at worst. When the one study used all-cause-mortality as the end point, not just cardiovascular events, mortality INCREASED when LDL was lowered to 70 or below although that increase did not reach statistical significance. There is no good evidence to lower LDL to 70 or below and a lot of reason to keep total cholesterol above 180; if or course, your goal is to live the longest and healthiest life possible, statistically speaking. If you don't care about death from any other cause, only cardiovascular events, then go for it. Given the choice between surviving a heart attack or a stroke, I much rather have a weak heart and all my cognitive facilities. Low cholesterol lowers IQ. I would be screwed if I had depended on cardiologists for my cardiovascular health care. They have to look at a lot of issues, I get to be focused on mine. As a result, I'm a "consumer" of cardio related services, not a patient. SignaturePramesh Rutaji p297tongue6221@newsguy.com - remove tongue to reply http://HeartMDPhD.com/Doomedsatan It seems to me I heard somewhere that Pramesh Rutaji wrote in article <ftcgjb02nca@news4.newsguy.com>: >> It seems to me I heard somewhere that Pramesh Rutaji wrote in article >> <ft8d8s017oq@news1.newsguy.com>: >>> Therapeutic doseages of niacin start at 1500 mg/day according to a >>> publication on Niacin in my cardiologist's office. >> I guess my first, excellent, cardiologist didn't know that. He started me at >> 1000mg/day, and one of his successors lowered it to 500mg when my blood work >> stabilized. >Taking 500 mg/day of Niacin didn't solve my small particle problem as >measured with a vap test. Neither did any increments until I got to at >least 2500 mg/day. Initially my cardiologist refused to even order the >VAP test so I ordered it myself and then got another cardiologist who >had a clue what a VAP test and small particle LDL was. >One think I like about niacin is that I can but the product over the >counter and not pay the 10-50 times drug mark ups, I can order my own >blood work and track my own results. I can do what's best for me and >place my cardiologist in the position of having to make his case that I >should change what I'm doing; He has to treat me individually instead of >as another patient statistic. Your response has nothing to do with my rebuttal of your statement that "[t"]herapeutic doseages of niacin start at 1500 mg/day." >>> Your total cholesterol is too low at this point. >> Are you medically qualified to make such a definite statement about a patient >> you know only from some numbers? >Statistically speaking, when people are divided into 4 quartiles based >on total cholesterol, those in the lowest quartile die at greater than [quoted text clipped - 8 lines] >will be prescribed medication with no regard to it's ultimate effect on >you personally. If A then B;if not B;then C;etc. Your essay on statistical analysis has nothing to with your claim that zob's cholesterol is too low (statistics can't say anything very meaningful about one individual case) nor about your medical qualifications to diagnose an unseen individual. > It seems to me I heard somewhere that Pramesh Rutaji wrote in article > <ftcgjb02nca@news4.newsguy.com>: [quoted text clipped - 47 lines] > individual case) nor about your medical qualifications to diagnose an unseen > individual. Perhaps zob should ask his his cardiologist, the one with all the 'qualified' answers, instead of fishing for possibilities from the general internet population. But, as we both know, doctors often and frequently fail at their task and when they succeed, it most often is the case that body healed itself and would have done so regardless of the "qualifications" of the doctor. Zob has quite a number of venues he can address for information on his case and his expectations should be appropriately adjusted. Zob's low cholesterol is "statistically" speaking very very very likely to degrade his intellectual capacity over time and if his cholesterol is undiagnosed small particle LDL, then no matter how low he takes it, it will still continue to clog his arteries getting worse and worse in spite of his limited but better than average diet. One place he shouldn't be getting diet advise from is the AHA, an organization designed to keep physicians in business and highly paid. Saturated fats raised HDL and zob continues to limit his on the dubious advise of the AHA. He should get a copy of "Good Calories, Bad Calories" by Taub and then he will understand why 'qualifications' are failing him in significant ways. In my personal case, my HDL was 31 on day of a heart attack and it now reads in the high 60s. My trigs run in the 90s without taking any medications specifically to lower it and my hsCRP run between 0.22 and 0.27. Other blood parameters show similar quality values. NONE of the advise I got from several cardiologists would have made much of a difference in those numbers and NONE of the cardiologist was too concerned about elevating HDL. So, whatever 'qualifications' do for you, they certainly are not very effective in addressing real concerns that are not profitable to drug companies. My qualifications are that I have achieved excellent blood work in areas where zob and his physicians continue to fail. If you Don want to start your own moderated medical list and limit contributions to a narrow range of qualifications, they by all means, get it on. I will continue to provide feedback on this list as I see fit. I don't charge and no one has to listen. SignaturePramesh Rutaji p297tongue6221@newsguy.com - remove tongue to reply It seems to me I heard somewhere that Pramesh Rutaji wrote in article <fteo2b0cph@news5.newsguy.com>: >> It seems to me I heard somewhere that Pramesh Rutaji wrote in article >> <ftcgjb02nca@news4.newsguy.com>: >>>> It seems to me I heard somewhere that Pramesh Rutaji wrote in article >>>> <ft8d8s017oq@news1.newsguy.com>: >>>>> Therapeutic doseages of niacin start at 1500 mg/day according to a >>>>> publication on Niacin in my cardiologist's office. >>>> I guess my first, excellent, cardiologist didn't know that. He started me at >>>> 1000mg/day, and one of his successors lowered it to 500mg when my blood work >>>> stabilized. [. . .] >If you Don want to start your own moderated medical list and limit >contributions to a narrow range of qualifications, they by all means, >get it on. I will continue to provide feedback on this list as I see >fit. I don't charge and no one has to listen. I've never tried to moderate any newsgroup I participate in. I do, however, challenge information and experience that don't seem credible and/or that are not supportable by recognized studies, just as I've done with some of your statements. So far you have not offered support for them; in fact you have repeated your diagnosis that zob has dangerously low HDL. You also seem to be making your individual experience a model for others. >> It seems to me I heard somewhere that Pramesh Rutaji wrote in article >> <ftcgjb02nca@news4.newsguy.com>: [quoted text clipped - 34 lines] >>> twice the rate as those in the highest quartile using the end point >>> all-cause-mortality. That would make sense to me,and nothing mysterious. If low cholesterol though nutrition,diet and exercise is making people feel better,t hey're getting more active. The statistics that you site include things like plane crashes and getting hit by cars while jogging. I promise not to do crazy things once I'm at my weight goal ;-D. >>> One may look at cardiovascular events if they exclude heart failure and find benefits to lowering cholesterol, but >>> death rates from other causes increased. Science in health has most [quoted text clipped - 13 lines] >'qualified' answers, instead of fishing for possibilities from the >general internet population. I'm not sure I understand this statement or condescending attitude. Why do you post on the usenet if not to share and discuss ideas? That's what I'm here for. To get as much information as possible to assimilate into my ever-weaking LDL-starved brain cells <g> so that I can make intelligent decisions based on both input from my cardiologist --in whom I have great faith, by the way -- from my own research, and from conversations with those who are knowledgeable and experienced in the area. >But, as we both know, doctors often and frequently fail at their task and when they succeed, it most often is >the case that body healed itself and would have done so regardless of >the "qualifications" of the doctor. >Zob has quite a number of venues he can address for information on his >case and his expectations should be appropriately adjusted. Zob's low [quoted text clipped - 3 lines] >will still continue to clog his arteries getting worse and worse in >spite of his limited but better than average diet. >One place he shouldn't be getting diet advise from is the AHA, an >organization designed to keep physicians in business and highly paid. >Saturated fats raised HDL and zob continues to limit his on the dubious >advise of the AHA. I disagree. You do not know me as an individual. The single most important thing for me right now is to lose 90 - 100 pounds. Obesity=daibetes=cAD=heart attack as far as I'm concerned. The calorie-dense saturated fat , (along with sugar), is the worst thing I can eat right now. The very best thing I can do for my health is to continue to do what I am lose the weight.. Than I can begin to fine tune the micro nutrients a bit more. >He should get a copy of "Good Calories, Bad Calories" by Taub and then he will understand why 'qualifications' are >failing him in significant ways. My Cardiologist is not a traditionalist. The diet that I'm on is more like (but not exactly) a South Beach type, from which Taub seems to have taken many of his ideas. (Isn't Taubs a journalist, not a scientist?) I eat fats, but good fats - and I eat carbs, but low-glycemic carbs. I eat starches, but complex, not simple starches. Same principles. I eat protein, but see absolutely no advantage to eating red meat fat over healthy omega-righ fats in fish. And I've never seen a study that even remotely supports eating red meat over fish. ( This is just what works for me, I'm not advocating it for everybody). My hunger is satisfied and I've been losing about 10 pounds a month for the past 5 months with no stalls, plateaus or cravings. I'm also eating well-nutritionally balanced food and tracking the calories, fat, cholesterol, saturated fat, vitamins, minerals and micro nutrients that I eat every single day. I can't imagine anyone being more self-conscious or proactive about their diet than I am being. My doctor appreciates that I'm being proactive and making suggestions and taking control of my own eating patterns. >In my personal case, my HDL was 31 on day of a heart attack and it now >reads in the high 60s. My trigs run in the 90s without taking any >medications specifically to lower it and my hsCRP run between 0.22 and >0.27. I fully expect that when I reach my goal weight of my ideal BMI, Iwill be able to kick the Tricor to the curb also. I've had classic metabolic syndrome -- all my extra weight in the midsection, slightly elevated blood glucose, high blood pressure, high LDL and low HDL cholesterol. That is what I'm devising my diet to overcome. I strongly believe I can completely reverse this, and am well on my way to doing this. I was shocked when I saw how low my cholesterol had gone after 3 or 4 months between the meds, nutritional intake and weight loss. It did strike me as too low. This is exactly why I'm having discussions like these, trying to get some input form others besides my doctors as to how to raise my HDL -- since the AHA recommendations aren't working- or are working only slightly - for me. >Other blood parameters show similar quality values. NONE of the advise I got from several cardiologists would have made much of a >difference in those numbers and NONE of the cardiologist was too [quoted text clipped - 8 lines] >get it on. I will continue to provide feedback on this list as I see >fit. I don't charge and no one has to listen. http://www.mayoclinic.com/health/cholesterol-level/AN01394 "Some research suggests that LDL cholesterol levels between 60 and 70 mg/dL are not only safe but can help slow or even reverse coronary artery disease." The question in my original post was to look for advice on other ways that I can raise my HDL, and I appreciate the answers I've been given. My (LDL + VLDL) of 79 seems to be just fine for now. Zob It remains our collective clinical experience that HDL does not become optimal until after all the VAT (black fat) is gone: http://HeartMDPhD.com/BlackFat Personally, my own HDL has increased from 54 to 94 mg/dl after eating less, down to the right amount: http://HeartMDPhD.com/BeSmart This completely free Approach comes with free cardiologist support via usenet and includes an unprecedented 2 million dollar guarantee... http://HearftMDPhD.com/Guarantee ... whose criteria has been freely posted and discussed in sci.med.cardiology: http://HeartMDPhD.com/Guarantee/Criteria Here is a simple parable given in hopes of promoting understanding: http://HeartMDPhD.com/Parable Be hungry... be healthy... be hungrier... be healthier: http://TheWellnessFoundation.com/BeHealthier Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow http://HeartMDPhD.com/Convicts/PrayForZob > satan via a sockpuppet (corporeal demon) hissed: http://HeartMDPhD.com/Convicts/PrayForDon > >> satan via a sockpuppet (corporeal demon) hissed: > >>>> satan via a sockpuppet corporeal demon) hissed:: [quoted text clipped - 153 lines] > > Zob On Apr 8, 3:06 am, "Andrew B. Chung, MD/PhD" <heartdo...@emorycardiology.com> wrote: > It remains our collective clinical experience that HDL does not become > optimal until after all the VAT (black fat) is gone: Simple question for Chung. How does one measure VAT? What units are used? How does one know if it's gone? Please cite a medical journal or text book source for this. Please also show where human VAT is called "black fat." Citing your own bullshit websites or avoiding answering this question will prove that you are a charlatan and a fraud who is giving medical misinformation. http://HeartMDPhD.com/Ignorantsatan is still http://HeartMDPhD.com/Doomedsatan > http://www.mayoclinic.com/health/cholesterol-level/AN01394 > "Some research suggests that LDL cholesterol levels between 60 and 70 [quoted text clipped - 6 lines] > > Zob "[a]fter performing an exhaustive review of existing research on LDL cholesterol and heart health, they [the researchers] conclude that there is no scientifically valid evidence to support the ultra-low LDL target of 70 milligrams/deciliter for very high-risk patients that has been advocated by some members of the federal government’s National Cholesterol Education Program. Further, they suggest that the evidence previously cited to support an LDL goal of less than 100mg/dL for high risk patients also has major flaws;" every marketing and advertising campaign for statins would need a major over-haul?" OR "If they remain quiet, the public may not hear about how the researchers found "For those with LDL cholesterol levels less than 3.36 mmol/L (less than 130 mg/dL), the authors found no clinical trial subgroup analyses or valid cohort or case–control analyses suggesting that the degree to which LDL cholesterol responds to a statin independently predicts the degree of cardiovascular risk reduction." "As is clear in this review, lowering LDL cholesterol below 130 or below 100 or below the new target of 70, has no support in the data, is not based on evidence and is a target without foundation for the marketing or promotion of statins." http://weightoftheevidence.blogspot.com/2006/10/study-lowering-ldl-not-supported -by.html Value of Cholesterol Targets Is Disputed http://www.nytimes.com/2006/10/17/health/17chol.html SignaturePramesh Rutaji p297tongue6221@newsguy.com - remove tongue to reply http://HeartMDPhD.com/Charlatansatan >Therapeutic doseages of niacin start at 1500 mg/day according to a >publication on Niacin in my cardiologist's office. Niacin also improves >cholesterol quality typically increasing LDL particle size to more >healthy levels. One needs a VAP test to determine particle size and sub >fractions. Not eating enough fat, particularly saturated fat, will keep >your HDL low. I eat enough fat. In fact, I faithfully weight, measure, record and track every single thing I eat using Fitday nutritional software. My cardiologist recommended I follow the AHA's guideline of less than 50 mg of fat per day and less than 15 mg of saturated fat. Over the past 5 months, my fat intake has been 49g and saturated fat has been 14g. I've been controlling it very carefully to stay within the recommended limits yet not eat too little. >Your total cholesterol is too low at this point. Optimum >according to the life extension foundation is between 180-200. Lower >than 180 and other causes of mortality increase. My LDL cholesterol is in the range that studies have shown can minimize -- or even possible reverse -- CAD. THe Mayo clinic recommends LDL being in the 60 - 70 mg range, and mine is lightly low now at 56. But it's far better than being too high. As far as total cholesterol goes, again the Mayo clinic research shows 140 - 150 being the optimal range. ANd this was the exact reason for my original post. I need to somehow get my HDL level raised significantly, almost doubled from what it is now. This will put my HDL *and* my total cholesterol exactly in the optimal range. > Above 200 and other >cause of mortality increase but in this case it looks like one needs to >get well above 240 total, perhaps closer to 300. Anything with trans >fats will lower HDL and decrease LDL particle size and often whole grain >products use trans fats. I don't eat any transfats or any products that use transfats whatsoever. > I would avoid processed foods like that an >decrease my consumption of grains because evolutionary wise, man has >only had 10,000 years to adapt genetically to grains and that is far too >short a time. I would also work to get more fat in the diet as that >will increase your HDL numbers. Not necessary. I eat grain products in moderation. I have exactly one cup of whole-grain Cheerios (as recommended by my cardiologist) with 1/2 cup of skim milk and fresh berries every day for lunch, and have one or two slices of whole grain, double-fiber bread every other day or so. This is it for processed grains. I do eat non-processed grains more often, I enjoy rolled oats several times a week with cinnamon and sliced banana. > I would eat some read meat. 'Why? The fats in the fish I'm eating nearly daily are unsaturated and high in the Omega oils that are heart-healthy -- much more so than the fats in a hamburger or steak. Again, I'm following my cardiologist's recommendations for now in this area. I have no problem actually with eating red meat; I've just gotten out of the habit. I've gotten so I much prefer a grilled salmon steak or broiled Tilapia over a hunk of pot roast or barbeque ribs. What could the advantage be of eating the red meat over the fish? It seems to be the opposite of what the AHA recommends. >Have you had a VAP test, homocysteine test, and checked thyroid which >can increase cholesterol numbers? I have not had a VAP or homocysteine test. My cardiologist told me that new, extensive studies showed little correlation between homocysteine levels and heart attack or death from CAD, and as a result he no longer recommends this test for is patients. (I get plenty of B vitamins and folic acid anyway, so I'm not too worried about it). The same studies, however, have shown that C-Reactive Protein *does* have a direct correlation to heart attack and sudden CAD death -- so he is more concerned about controlling arterial inflammation. My latest CRP level is now in the center of the median for risk, not bad for someone who had Acute Coronary Syndrome just a few months ago. Aside from the low HDL, the only other thing out of the normal range on my blood tests were elevated EOS and "absolute EOS." My doctor said that the elevated reading is probably due to seasonal allergies (for which I take Zyretc). Everything else is normal. When I have my next Dr. appointment - which is in two months - I'm going to request a VAP test for further breakdown of the cholesterol. After reading your post I did some online research and found that the test is fairly new and may have to be requested by patients. I'll do exactly that. Thanks for the suggestion. Zob It seems to me I heard somewhere that zob wrote in article <tivdv3dnmm7vfunk122eu986h7gaf52ju4@4ax.com>: >After my bout with ACS and resulting angioplasty/3 stent insertions >last October (2007) , I got serious about being proactive in improving >my health and doing all that I can to improve my chances for remaining >free of further CAD incidents. > >This is what I've been doing in the past few months: >Medications (relating to cholesterol): > I was put on 210 mg Lipitor (to lower LDL) and 145 mg Tricor (to >lower triglycerides) , as well as 1000 mg of Niaspan (to raise HDL). >Nutrition: > I've followed my cardiologist's recommended heart-healthy diet . . . >Exercise: > I've also been exercising as much as possible. >The bottom line of all this is ... I expected an improvement with this >combination of changes but I was downright shocked at the stellar [quoted text clipped - 5 lines] >of readings that follow were taken just a couple of weeks before my >ACS incident and stent insertions: > 10/2007 3/2008 >Total Cholesterol: 234 117 [quoted text clipped - 3 lines] >VLDL Cholesterol: 77 23 >Triglycerides: 359 117 >CRP was 2.1 ("average") on the last test -- not measured on the first >one. >Obviously I'm very excited about these results, and psychologically >feel great about my health future now that I'm on the right track. But [quoted text clipped - 11 lines] >things -- that I could try to get that HDL higher. Or even any >suggested reading on the subject. >Thanks in advance for your thoughts. Congratulations and two "attaboys," Zob. Great readings and a very fast adjustment! Your results and numbers profile is similar to mine, although my HDL may be just a tad higher. My risk factor is also similar to yours--now--and had been well above average when I first started my much longer treatment program. Continue on in good health! |
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