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  • I have high cholesterol and I’m NOT going on statins

    Before I tell you my personal cholesterol story, I think it is important that you know why I’m telling you this story. On August 5, 2015 I lost my father, age 78, to heart attack. Just 10 days later I lost one of my best friends, Scott Ellis. These experiences sent me on a long, investigative journey to learn more about heart disease and early detection. In January, I wrote a blog on some of what I found in a story about Scott.

    But there was more. So much more. I had many, many questions about our health care system.

    I am going to share more about what I have learned in the weeks since I published Scott’s story. I’m doing this so you can be better informed and ask more questions to your health care provider. No matter whether you are a competitive athlete or a non-athlete, good health always comes first. You must optimize health before you can be a high-performing human or a high-performing athlete.

    My cholesterol numbers

    I’ve followed a moderate to high-fat diet since 1990. I wrote about my terrible experiences with a low-fat diet in my first book, The Female Cyclist. Between 1990 and 2013, total cholesterol was roughly 200 +/- 10. There were a couple of dips to 160 and 180 – but almost always around that 200 mark. My HDL cholesterol to total cholesterol ratio was always around 2.3-2.5 (anything below 5 is good).

    Between 1990 to 2013, spot checking macronutrients typically put fat at around 30% of my diet. In 2013 I started playing around with higher levels of fat in my diet and that sent my total cholesterol level to 229 in February of 2014. At my highest levels of fat intake (60% to 70% of total calories) my highest cholesterol was 283. For most of 2015 and now, my fat intake bounces around between 40% and 60% of total daily diet. My last cholesterol test, and my first VAP test, put my total cholesterol at 264.

    With total cholesterol numbers between 264 and 283, many primary care physicians would slap a patient on statins immediately. I would like to believe this decision is always based on what’s best for the patient, but now I’m not so sure.

    What my primary care provider said

    I am very, very fortunate to have a forward-thinking and care-about-the-patient primary care physician. All along, he kept an eye on my HDL cholesterol to total cholesterol numbers and did not express concern or suggest medications. He reviewed the detailed results of my VAP blood profile test and told me all the key variables looked great. He would not recommended statins, unless I insisted. If I insisted on statins, he still wanted a discussion with me.

    I did not want to be on statins for no good reason. He said, “Good! Go live your life and be happy. I think you’re healthy.”

    Seven profiles

    In the few weeks since I published Scott’s story and my VAP blood profile test, several people read the story and gave me feedback. Here are some summary numbers:

    • 2 people (one is me) have total cholesterol above 200. Both people have been consuming a diet high (40% to 60%) in fat for at least one year. (Scans explained at this link.)
      • One person had a CIMT scan with good results.
      • One person had the CT Calcium Scan, without contrast die, with good results. This is me, my CT Calcium score was zero (no calcified plaque) and my arteries measure normal diameter (no soft plaque).
    • 5 people have total cholesterol numbers at 200 or below. As far as I know, only one person has been consuming a high-fat diet for around one year.
      • One person has had the VAP test and a contrast CT Calcium scan, with good results.
      • Two people ended up in the hospital with cardiac issues resulting in a stent. (One person had cardiac scans done prior to the stent, the second showed up in the emergency room with unusual symptoms. The second person went home from the hospital with a new stent.)
      • Two people have recently had CT Calcium scans and one of them had the contrast scan. Both of them are currently evaluating options for health care.

     

    What I can tell you with absolute certainty

    Based on a very small sample size, the presence or even risk of heart disease is NOT determined by a high or low total cholesterol result. People that have taken very good care of themselves (exercise and “good diet”) are devastated because they thought they were “doing the right thing” – yet ended up with significant heart disease. How can this be?

    I don’t know.

    What do statins do?

    Statin medications lower cholesterol levels in the blood. The thought is that lower cholesterol levels can reduce the chances of a heart attack, stroke or premature death in people that have an elevated risk of heart disease.

    But – what if your cholesterol is high and there is NO evidence of heart disease? Why would you be put on a statin?

    What I wonder about

    Why doesn’t our health care system (insurance companies) recommend CT Calcium Scans for everyone beginning at age 40 (or 45 or 50)? The cost of a CT Calcium Scan is $200. This scan has the potential of keeping people off of statins – which cost some $300 to $1400 PER YEAR per person in the US.

    My friend Michele Stumbaugh mentioned to me this morning that doctors are given good incentives to prescribe medications. Prescribing medications increases their pay and currently there is more incentive to prescribe higher priced medications.

    What is the incentive for some insurance companies to keep, recommend, or put people on medications they don’t need? Are there financial incentives between pharmaceutical companies and insurance companies?

    What you should consider

    As I mentioned in Scott’s column, I think it is prudent to get the VAP or NMR blood profile tests as a good place to start.

    Talk to your doctor about the CT Calcium Scan and the CIMT scan because these present more evidence of actual heart disease.

    If your doctor is quick to pull out the prescription pad, ask more questions.

    If you feel your doctor doesn’t have your health as his or her first interest, find another doctor.

    My situation

    I have high cholesterol and I am not going on statins because the purpose of statins is to reduce cholesterol in order to reduce heart disease. I have no evidence of heart disease.

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  • Comments on this post (9 comments)

    • Denny McKenney says...

      “

      I’m reading a book titled “The Big Fat Surprise: Why Butter Meat & Cheese Belong in a Healthy Diet”. The author is Nina Teicholz. Examines the research (or lack thereof) and the forceful personalities behind the misguided “low-fat/heart-healthy” diet we’ve all pursued over the last 40 years. Well researched & easy to read. Lots about cholesterol and how it became villainized.

      On April 19, 2016

    • Judi says...

      “

      There’s folks at work that have been discussing this and one man is taking Niacin instead of Statins.
      Have you heard of this?

      On March 11, 2016

    • Johnny Chapin says...

      “

      I should apologize for posting an NNT number too low that was biased toward my own status. Low NNT numbers are for people at high risk. The charts in this article show this: http://www.medicine.ox.ac.uk/bandolier/booth/cardiac/statcalc.html

      On March 11, 2016

    • Gale says...

      “

      Hey Johnny,

      A friend sent me a Ted Talk that said the NNT for statins is 1/300, while 15/300 have side effects.

      You can watch the entire video, or get right to 6:33 where he talks about statins. His point was to make medical decisions when you aren’t stressed.

      https://www.ted.com/talks/daniel_levitin_how_to_stay_calm_when_you_know_you_ll_be_stressed#t-33860

      No easy answers…

      Gale

      On March 11, 2016

    • Johnny Chapin says...

      “

      My doctor doesn’t have heart disease, but he takes a low dose statin. He also says that half of people find out they have heart disease when they have a heart attack. Half of those die from that first attack.

      There’s no clear cut answers about statins because high cholesterol is only one of the risk factors. The others are age, genetics, bad diet, smoking, lack of exercise, high blood pressure, etc. Plus it seems to becoming recognized that inflammation from foods, infections, etc is a risk factor.

      A statistic you read in med literature is NNTT (number needed to treat). That is, how many people treated with statins saves one heart attack, for example. For the general population it’s 11. For someone with heart disease it’s 8. That doesn’t sound like much of an improvement, unless you’re the one out of 11 or 8.

      On March 10, 2016

    • Gale says...

      “

      Christophe ~

      If the reason for the prescription is heart disease – you can do one of the tests to see if you currently have any heart disease. Then decide whether or not to take the meds.

      Due to the diabetes complication – you can check in a year (or so) to see if your condition changed at all.

      On March 10, 2016

    • Gale says...

      “

      Dianne ~ My pleasure to help and thank you for the compliments.

      On March 10, 2016

    • Dianne Peterson says...

      “

      Gale,

      Thank you for writing this! Even more, THANK YOU for your kindness, friendship and caring to talk to me this morning (all wet, cold and freezing as you were!) This article pesents a very balanced approach to giving many of us excellent information and food (high in good fats, of course) for thought. Will keep you posted on my doctor appointment in a few weeks.

      On March 10, 2016

    • Christophe says...

      “

      As part of my newly diagnosed type 1 diabetes treatment, my endocrinologist, whom I trust with great reluctance and skepticism, was quick to prescribe me Lipitor for my moderately high cholesterol levels. Every night I look at the bottle of pills and leave them untouched. Can’t bring myself to take them.

      On March 10, 2016

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