Cholesterol- medicine or diet?

Factual Questions
1

Let me start by giving a disclaimer/absolution of

I know that most Dopers aren’t doctors and that therefore their opinions and suggestions are not legally ‘medical advice’ and I do not regard them as such or hold them to any type of liability.

That said: I was recently diagnosed with high cholesterol. It’s not surprising since I have a family history of it and LOOOOVE meat. However, I also have a family history of men waking up dead in their fifties so I’m willing to make some changes.

I was prescribed Zocor which in two months of use had almost no effect. My doctor (actually a Physician’s Assistant) responded by doubling my dosage, which I don’t really understand (if 20 mg didn’t work, why would 40 mg be much better?)

Some say that dietary changes alone will control cholesterol and are a lot safer than pills. I was wondering if anybody here has significantly reduced their cholesterol levels through diet/exercise alone, or if anybody has had bad experiences with Zocor/Liptor/other chol. medications? And for those who’ve tried both diet and medication, which do you recommend?

2

It depends. It depends on your particular cholesterol profile (relative amounts of LDL, HDL, and triglycerides). Dieting can drop cholesterol levels anywhere from 5 to 15%. But if you’re one of those individuals who has significantly elevated LDL (AKA bad cholesterol) in conjunction with low or low normal HDL (good cholesterol), nothing short of extreme dieting along with extreme exercising will change that much.

Many people’s cholesterol levels are far more a reflection on how their body, particularly their liver, handles cholesterol. If one’s liver just is programmed to crank out a lot of cholesterol, and this results in bad numbers for a person, the best way to treat it is generally with a statin like Zocor. And it’s not unreasonable to push the dose up to 40 or higher to get the desired effect.

My prescribing experiences have been mainly with Mevacor and Lipitor, and I’ve had good results. Occasionally it must be discontinued due to side-effects of muscle inflammation. This goes away when the med is stopped.

Here’s a copy of the latest guidelines about treating elevations of cholesterol. caution! pdf format! http://www.caloptima.org/documents/fp_hyperlipidemia.pdf

3

Can I just pop into say I love Qadgop the Mercotan. Always with the measured, reasonable, why the answer is “it depends” advice. Go Qadgop, go!

4

Why, thank you, j.c.. Nice to be appreciated.

This stuff is fresh in my mind, as I just had to write treatment protocols for getting a handle on over 8000 new patients a year, each one of which gets a cholesterol test. That’s 8000 people I and my assistants and associates have to decide whether need cholesterol treatment or not, and which kind. That pdf file was invaluable in coming up with the protocol.

5

Thanks, Qadgop. Looking at those guidelines, I think I better stick with the medicine.

6

IANAQ (I am not a Qadgop), but I’ve had very high (sometimes in excess of 350) cholesterol for over a decade, and severe dietary restrictions seemed to have little effect. Lowest tested (while experimenting with diets) was 270. So I take Pravachol, but only because my Health Denial Organization took Lipitor off its formulary. Now it’s still in the high 200’s. With me, I think there’s a genetic component at work, because my other heart-disease-related indicators go the opposite way (low blood pressure to the point where my doctors have me drinking Gatorade every day to increase my salt and a resting pulse in the low 50’s).

7

Dear Sampiro,

Let me preface this: I am not a doctor and do not play one on TV. I am not giving medical advice, just an example of what a scientific experiment with grub can do for your body. I am of the belief that some cultures (I’m an Anglo/Germanic/Indian mutt) are unable to properly process meats and dairy, thereby exponentially increasing the cholesterol effect. Add alcohol intake to the mix and the body can often respond by jacking up the output of cholesterol.

I have personal knowledge on this subject: I too have inherited a propensity for developing high cholesterol. My cholesterol, for a 32-year-old white man, was high enough to freak my doctor out and prescribe Lipitor. I am of the opinion statins are terrible for the body, so I began an experiment on March 3, 2003.

The facts, at the onset of the experiment:

  1. 6’4", 202 pounds, moderate to heavy drinker, American diet high in meat and dairy protein, low amount of exercise. Not obese, just slightly jiggly.
  2. My cholesterol: composite - 253, LDL - 192, HDL - 49.
  3. Daily intake of vitamins and herbs, from ginkgo to niacin, aspirin, etc.

Month 1 of the experiment:

  1. No excess alcohol – only wine, one glass a night at most, two on special occasions or weekends.
  2. No meat. I know this sounds terrible, but it’s just for a month. What’s your health worth?
  3. Substitute soy, legume and good fish protein for meat and dairy protein.
  4. Begin by fasting for two days to cleanse the system and induce chitosis.
  5. Eat more than double the recommended amounts of fruit and vegetables, especially broccoli and asparagus, proven to be LDL cleansers.
  6. Include a twice-daily spread like Take Control in your diet – it is proven to reduce LDLs. Eat oats or oat bread (like Oroweat Oat-Nut) at least once a day.
  7. This one is important! Eat no more than 20% of your RDA of cholesterol or saturated fat. Eat fish like salmon, whole tuna or tuna fish, but only once daily, in small amounts.
  8. Keep a food diary.
  9. No vitamins.

I know this sounds tough, but it’s really not. I have thoroughly enjoyed my meals, desserts included, feel better than I ever have – excepting of course times where I was VERY fit but eating poorly – my energy is good, attitude is good, conscience is clearer and my intestines are finally on a healthy track, if you catch my drift.

My results after month 1 (phase 1):

  1. Weight, 192.
  2. Cholesterol: composite - 199, LDL - 126, HDL - 60.
  3. My doctor thought the Lipitor was really working well. He almost soiled himself when I told him the truth.

Phase 2 will include cardio exercise at least 3 times per week, continuing the diet, only upping my calories to keep me heavy enough. I am currently at about 189-190. In a month, I’ll again measure my numbers.

Phase 3 moves to moderate exercise plus weights, continuing the diet, but adding more beneficial fish protein to my diet. Measure my numbers after this period.

I will be happy to hand over full details of a sample diet during this period. I really hope you can benefit from this.

Mr. B

8

And if more people made the lifestyle changes you have Mr.B, we docs would have to prescribe a whole lot less cholesterol lowering medicine! Good job. I hope you continue to follow your program.

Sadly, I have seen many people make significant improvements with lifestyle change, then have 90% of them go back to old habits in two years or less.