Doctors should really start checking all of their patients' cholesterol

FRV

Semi-Pro
#1
I'm surprised that not all doctors do this. My most recent doctor did and found I had high cholesterol, which I then managed. I let it get out of control again, but that's another story.
 
#4
I'm surprised that not all doctors do this. My most recent doctor did and found I had high cholesterol, which I then managed. I let it get out of control again, but that's another story.
How old are you? Maybe your doctor considered you too young to screen you.
But currently, thanks to unhealthy eating habits and modern life, younger people are having diseases that appeared at older age before.
 

Ronaldo

Talk Tennis Guru
#5
I'm surprised that not all doctors do this. My most recent doctor did and found I had high cholesterol, which I then managed. I let it get out of control again, but that's another story.
Blood tests are not free..........................................................................yet
 

TnsGuru

Professional
#6
True that, I also recommend a life line screening. https://www.lifelinescreening.com/?...dY2Yf0AX02dnwYD265xFLy1KpD5XWZQhoCPnsQAvD_BwE this screening uses non invasive checks on vital arteries to detect atherosclerosis (clogged arteries)

This would help to detect/prevent heart attacks and strokes early on. I have a friend who had this test and discovered a partially clogged carotid artery and he had an angioplasty and stent installed on the affected vessel. Keep in mind he had no symptoms and if left alone could have eventually blocked the blood flow to his brain.
 
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FRV

Semi-Pro
#7
How old are you? Maybe your doctor considered you too young to screen you.
But currently, thanks to "modern" eating habits and modern life, younger people are having diseases that appeared at older age before.
Around 25. I know far younger people who have had high cholesterol as well. It skyrockets from eating all the junk food today that is loaded with saturated fat (I think).
 
#8
Around 25. I know far younger people who have had high cholesterol as well. It skyrockets from eating all the junk food today that is loaded with saturated fat (I think).
Correct, my sons who are around 18 and 21 had cholesterol slightly high until they changed their diets. They are very conscious now, even more than I am :laughing:
You'd better watch it out, you are very young. Agree with you that the biggest culprits are junk, processed food, and sedentarism as well.
 
#10
The lipid/cholesterol theory as the primary cause of CVD (cardiovascular diseases) had come into question since the 90s (or earlier). Some modern thinking on this has inflammation playing a much greater role in predicting CVD than cholesterol levels. Fairly certain that some with pretty high cholesterol levels never develop CVD while some with "normal" cholesterol levels do.

I 1st became aware of the possible flaw in lipid theory in the early/mid 90s in a well-written, well-researched book, Fats That Heal Fats That Kill. Subsequently, started hearing this from a number of other sources as well.

Study: Inflammation, not Cholesterol, Is a Cause of Chronic Disease
https://www.ihcan-mag.com/if-its-no...owards-a-new-complex-theory-of-heart-disease/
Health.com: The Cholesterol-Inflammation Connection

"Cholesterol is not the problem in heart disease. But in a fascinating review of the science, Chris Masterjohn, PhD, warns against trying to adopt yet another simplistic theory to explain what is a complex disease process, involving both degenerative lipids, oxidation – and much more."
 
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#12
Has anyone ever used the supplement Cholest-off or Niacin? I hear it can help lower cholesterol in addition to eating healthier.
IIRC, niacin improves "good cholesterol" levels. Not sure if it has much, if any, effect on LDL. But then there is the "niacin flush" to contend with even moderate levels of niacin -- not harmful but it can be extremely uncomfortable.
.
 
#14
Does the non-flush niacin work just as well?
Some sources indicate that it has little or no effect on HDL ("good C")

https://www.health.harvard.edu/news...-niacin-as-effective-as-other-kinds-of-niacin

Q. I tried taking niacin to increase my HDL but didn't like the flushing it caused. A friend told me about no-flush niacin, which works like a charm. Why not tell your readers about it?

A. When you say no-flush niacin works like a charm, I assume you mean it doesn't cause any flushing. What you might not know is that it isn't doing your HDL any good...
 

TnsGuru

Professional
#15
Some sources indicate that it has little or no effect on HDL ("good C")

https://www.health.harvard.edu/news...-niacin-as-effective-as-other-kinds-of-niacin

Q. I tried taking niacin to increase my HDL but didn't like the flushing it caused. A friend told me about no-flush niacin, which works like a charm. Why not tell your readers about it?

A. When you say no-flush niacin works like a charm, I assume you mean it doesn't cause any flushing. What you might not know is that it isn't doing your HDL any good...
The "flush" is just a temporary phenomenon right?
 

MathGeek

Hall of Fame
#17
I'm not a fan of "do every lab test every year just in case."

Patient history, family history, and risk factors are important considerations. If the cost-benefit is there, insurance companies will usually pay for the lab tests, because most of these things are much cheaper to manage if caught early.

No one in my family has a history of heart or cholesterol problems before 50, so I don't think it make sense to test my children for these in their teens and 20s. Maybe start once every 5 years or so in their 30s. But there is a significant history of diabetes and a well identified genetic risk, so depending on their BMI, it might make sense to start testing FPG and A1C every year in their 20s.
 
#19
I'm not a fan of "do every lab test every year just in case."

Patient history, family history, and risk factors are important considerations. If the cost-benefit is there, insurance companies will usually pay for the lab tests, because most of these things are much cheaper to manage if caught early.

No one in my family has a history of heart or cholesterol problems before 50, so I don't think it make sense to test my children for these in their teens and 20s. Maybe start once every 5 years or so in their 30s. But there is a significant history of diabetes and a well identified genetic risk, so depending on their BMI, it might make sense to start testing FPG and A1C every year in their 20s.
I don't know. I didn't have any history either, but I had a very bad diet. It was a good thing my doctor checks all his patients because I would have just kept doing the same thing otherwise.
 
#20
I don't know. I didn't have any history either, but I had a very bad diet. It was a good thing my doctor checks all his patients because I would have just kept doing the same thing otherwise.
Even if the cholesterol theory is flawed/wrong, still a very good idea to improve your diet. Cut way back on stuff with a lot of added sugar. Also cut down on most vegetable oils & anything with trans fats (often from partially-hydrogenated soybean oil). Vegetable oils, used in cooking & added to many processed foods tends to promote excessive inflammation. (A high consumption of added sugars might result in too much inflammation as well). Some inflammation is good for you but many ppl have too much cuz of diet (& other reasons).

Eat more salmon & sardines and other fish with high omega-3 content. Avoid tilapia tho. Chia seeds (soaked) and flax seeds (freshly ground) could be a good thing to add other food (after cooking). The chia seeds are good in drinks as well. Blueberries, broccoli, colorful bell peppers, olive oil, nuts (walnuts, cashews, etc), fiber (soluble & insoluble), turmeric and kale are some other things to include in your diet. Turmeric is best utilized in cooking (w/black pepper & some fat). Kale is much more palatable when prepared with olive oil, lemon juice (and, perhaps, a bit of pepper). Just a few ideas
 
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#21
I'm surprised that not all doctors do this. My most recent doctor did and found I had high cholesterol, which I then managed. I let it get out of control again, but that's another story.
Cholesterol numbers are NOT as huge as you think

It’s the lipids they don’t even check
The lipids will kill you
 
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TnsGuru

Professional
#23
Even if the cholesterol theory is flawed/wrong, still a very good idea to improve your diet. Cut way back on stuff with a lot of added sugar. Also cut down on most vegetable oils & anything with trans fats (often from partially-hydrogenated soybean oil). Vegetable oils, used in cooking & added to many processed foods tends to promote excessive inflammation. Some inflammation is good but many ppl have too much cuz of diet (& other reasons).

Eat more salmon & sardines and other fish with high omega-3 content. Avoid tilapia tho. Chia seeds (soaked) and flax seeds (freshly ground) could be a good thing to other food (after cooking). The chia seeds are good in drinks as well. Blueberries, broccoli, colorful bell peppers, olive oil, nuts (walnuts, cashews, etc), fiber (soluble & insoluble), turmeric and kale are some other things to include in your diet. Turmeric is best utilized in cooking (w/black pepper & some fat). Kale is much more palatable when prepared with olive oil, lemon juice (and, perhaps, a bit of pepper). Just a few ideas
I have been eating more fish in my diet but what about mercury levels? Certain fish have more than others I hear like tuna for example.
 

TnsGuru

Professional
#24
Metamucil has physilliam husk fiber and when ingested along with meals can help to prevent the absorption of carbs/fats/cholesterol from your intestines so it doesn't get in your bloodstream. I eat oatmeal also for extra fiber in my diet.
 

TnsGuru

Professional
#25
What is the consensus on virgin olive oil in your diet....good or bad to reduce cholesterol? I hear people who cook with this oil have low trygliceride levels. I remember margerine used to have all the hoopla about being so much better for you but has since been deemed not so great. :(
 
#26
What is the consensus on virgin olive oil in your diet....good or bad to reduce cholesterol? I hear people who cook with this oil have low trygliceride levels. I remember margerine used to have all the hoopla about being so much better for you but has since been deemed not so great. :(
For cooking, clarified butter or ghee is probably best, especially for higher temps. Some margarines are better for you than others. Smart Balance (with omega-3 fatty acids and plant sterols) is my favorite margarine. But I would not fry with it. Benecol margarine (buttery spread) is also supposed to promote healthy cholesterol levels.
 
#27
I have been eating more fish in my diet but what about mercury levels? Certain fish have more than others I hear like tuna for example.
Yeah, some fish have much higher Hg (merc) levels than others. Especially older, long-living fish that are higher on the food chain (like shark, swordfish and some types of tuna). Some farmed fish should be avoided -- from China, Chile, Gulf of Mexico and other areas come to mind. Wild-caught or troll-caught is usually better.

Sardines, esp from the pristine water off the coast of Portugal, should be very low. Salmon is pretty low on the food-chain, I believe, and is usually very low in Hg. Some farmed salmon might not be quite as good but is, generally, very safe. Unfortunately, tuna with the highest omega-3 levels, albacore, also tends to be higher in Hg than other tuna. However, this might be dependent on the season caught, the age of the albacore as well as how and where they were caught. Eating albacore every once in a while is probably not going to be very harmful.

https://www.verywellfit.com/the-best-types-of-fish-for-health-2223830
https://www.consumerreports.org/cro...at-higher-risk-for-mercury-exposure/index.htm
 
#28
True that, I also recommend a life line screening. https://www.lifelinescreening.com/?...dY2Yf0AX02dnwYD265xFLy1KpD5XWZQhoCPnsQAvD_BwE this screening uses non invasive checks on vital arteries to detect atherosclerosis (clogged arteries)

This would help to detect/prevent heart attacks and strokes early on. I have a friend who had this test and discovered a partially clogged carotid artery and he had an angioplasty and stent installed on the affected vessel. Keep in mind he had no symptoms and if left alone could have eventually blocked the blood flow to his brain.
I guess cholesterol levels are not a risk factor for strokes. At least that is what I've read. It is curious in the sense that heart attacks and most causes of strokes have the same mechanism.

A little on what I've read:

https://drmalcolmkendrick.org/2019/01/15/what-causes-heart-disease-part-61-strokes/

excerpt:

....However, if we move away from heart disease, to strokes. FH has never been found to be a risk factor for stroke – at any age. Here, for example is a study done in Norway, and published in the Journal Stroke. It was called ‘Risk of ischaemic stroke and total cerebrovascular disease in familial hypercholesterolaemia.’

A total of 46 cases (19 women and 27 men) of cerebrovascular disease were observed in the cohort of people with FH, with no increased risk of cerebrovascular disease compared with the general population (standardized incidence ratio, 1.0; 95% CI, 0.8–1.4). Total number of ischemic strokes in the cohort of people with FH was 26 (9 women and 17 men), with no increased risk compared with the general population (standardized incidence ratio, 1.0; 95% CI, 0.7–1.5).3

In 2010 the Lancet published a major study looking at risk factor for stroke in the non-FH population3. They used the term population attributable risk factors (PAF), which ‘weights’ the factors, depending on how prevalent they are (i.e., how many people have got the various risk factors). Their list of PARs for stroke was as follows:

  • 51.8% – Hypertension (self-reported history of hypertension or blood pressure >160/90mmHg)
  • 18.9% – Smoking status
  • 26.5% – Waist-to-hip ratio
  • 18.8% – Diet risk score
  • 28.5% – Regular physical activity
  • 5% – Diabetes mellitus
  • 3.8% – Alcohol intake
  • 4.6% – Psychosocial stress
  • 5.2% – Depression
  • 6.7% – Cardiac causes (atrial fibrillation, previous MI, rheumatic valve disease, prosthetic heart valve)
  • 24.9% – Ratio of ApoB to ApoA (reflecting cholesterol levels)
You will see that LDL is not in that list. The ratio of ApoB to ApoA is. However, this is primarily the ratio of VLDL (triglycerides) to HDL (‘good’ cholesterol), which is an accurate reflection of ‘insulin resistance’ and bears no relationship to LDL. As I always say to people who ask me for advice on reviewing clinical research…’the most important thing to focus on is not what is there, it is what is not there.’

Any study on CVD will be examining LDL levels very closely. If a relationship were found it would be shouted from the rooftops. The fact that you hear nothing about LDL in this paper means that there was no correlation – at all.

You can, if you wish, try to find some evidence that the risk of stroke is increased by a raised LDL level. I must warn you that you will look for a long time, because there is no evidence, anywhere – at all. It has interested me for many years that this issue is simply swept under the carpet.

Now, write out one hundred times:

  • Raised LDL is not a risk factor for stroke
  • Raised LDL is not a risk factor for stroke
  • Raised LDL is not a risk factor for stroke….
Then, ask yourself the question. How can a raised LDL be a risk factor for heart disease and not stroke – as the two conditions are, essentially, the same condition? Atherosclerotic plaques in medium sized arteries with the critical/final event being the formation of a blood clot – on top of the plaque....
 
#29
Was going to recommend fish oil pills but apparently it doesn't lower LDL (and I know now that LDL is not a risk factor for a stroke :))
 
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#30
Was going to recommend fish oil pills but apparently it doesn't lower LDL
Don't know if that is true but they should help to reduce inflammation in many individuals -- which could/might be much more important than lowering LDL. Salmon oil & krill oil should be very good sources of DHA (and EPA). Not sure it ppl who don't eat DHA-rich fish are taking enough fish oil capsules tho'.

Vegetarian DHA (an important omega-3 fat) is available from algae in supplement form.
@FRV
 
#39
Don't wimp out, whatarush!
Prefer to get my rushes elsewhere. I got some 750 mg niacin capsules very cheap (on closeout). Wow. I can dump out 80% of the contents of one of these capsules and still get a "rush".

Would think that you would need to ingest MASSIVE quantities of peanuts to get any inkling of a rush at all.
.
 
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