Cholesterol

[Blue flash]

Just had blood test and had diabetic review.. and bit stressed/confused again.

So I got my hba1c down to 40ish going low carb, thought everything great.

Then got a bit worried about taking Atorvastatin, so thought try and cut it out.

Suppose was going to happen cholesterol gone from 3.7 to 5.7 guess that's total (I should have got break down) but nurse wasn't happy with me. Oh and hba1c had gone back to 56, possie not commuting by bike anymore and just exercise at weekend

So I just accept living on medication, any healthy diet both low carb and low fat...?.

Just having moment self doubt, diet Vs medication.

Any tips from those with high cholesterol as well as diabetes

 

[Deleted member 21371]

I avoid saturated fat, it pushes my cholesterol through the roof.
I take statins with no problems.
It's not just about "ratios" any more either.
Even high HDL can be bad it seems.

High HDL cholesterol

High Density Lipoprotein (HDL) is commonly referred to as good cholesterol, but it is possible for it to become too high. Although most health professionals were taught the higher the better, recent research suggests that at very high levels it loses its protective effects. Learn about the...

www.heartuk.org.uk

 

[everydayupsanddowns]

If I remember correctly 5.7 is pretty much the average cholesterol level in the UK.

Advice for people without diabetes is to aim for 5 I think, and for people with diabetes (who are considered to have an increased risk of CVD / CHD on average) the guidance is 4 or below if I remember right.

A condensed flow chart version of the NHS lipid management guidance was shared a while ago, which you can browse here if you‘d like to see how you fit into the official recommendations

https://www.england.nhs.uk/aac/wp-content/uploads/sites/50/2020/04/Summary-of-national-guidance-for-lipid-management-for-primary-and-secondary-prevention-of-cardiovascular-disea.pdf

I completely get your self-doubt about medication - It’s something I get too. But weirdly I completely accepted insulin as a permanent fixture immediately at diagnosis.

I think this is part of the challenge where medications are needed in some cases and not others. But I guess it’s really just a matter of perception. Particularly where the optimum outcome of taking a medication is that something doesn’t happen. How can you tell if that is working as an individual when you don’t know what would have happened without??

It doesn’t sound like you were having ill effects from the statins other than a disquiet about taking them?

 

[Lynne888]

Just had blood test and had diabetic review.. and bit stressed/confused again.

So I got my hba1c down to 40ish going low carb, thought everything great.

Then got a bit worried about taking Atorvastatin, so thought try and cut it out.

Suppose was going to happen cholesterol gone from 3.7 to 5.7 guess that's total (I should have got break down) but nurse wasn't happy with me. Oh and hba1c had gone back to 56, possie not commuting by bike anymore and just exercise at weekend

So I just accept living on medication, any healthy diet both low carb and low fat...?.

Just having moment self doubt, diet Vs medication.

Any tips from those with high cholesterol as well as diabetes

Would it just be having less exercise that's caused the rise in hba1c? I'm sure people on here have mentioned they haven't exercised or are unable to exercise and have still reduced their hba1c.. I hope that's the case as I cannot exercise so if it IS lack pf exercise, I'm doomed at reducing mine! I think my last cholesterol was 5.6 and GP wasn't concerned.

 

[Eddy Edson]

This is a pretty good summary of the influence of diet on cholesterol which most experts would agree with: https://sigmanutrition.com/diet-on-lipids/

Briefly:
- Minimise saturated fats - so avoid red meat and processed meat.
- Replace with unsaturated - so nuts, seeds, soy, avocado, tofu, fish.
- Eat lots of fibre - so oats, whole grains, seeds, nuts.
- Avoid refined carbs - added sugar, white bread, food which is obvious c**p.

None of this is likely to have as much impact as statins, which are one of the safest and most effective medications around. The stories about how they cause lots of side effects are mainly rubbish.

They reduce LDL cholesterol by a lot, and over time keeping LDL as low as possible reduces stroke, heart etc risks more & more. Again, the commentary you see about how they don't have much benefit is rubbish.

 

[harbottle]

That’s an excellent article. I did what it said and it brought cholesterol back down, although I think it rose due to sudden weight loss.

My TGs dropped after the months of low carb - hopefully a sign that insulin sensitivity has improved.

 

[Blue flash]

If I remember correctly 5.7 is pretty much the average cholesterol level in the UK.

Advice for people without diabetes is to aim for 5 I think, and for people with diabetes (who are considered to have an increased risk of CVD / CHD on average) the guidance is 4 or below if I remember right.

A condensed flow chart version of the NHS lipid management guidance was shared a while ago, which you can browse here if you‘d like to see how you fit into the official recommendations

https://www.england.nhs.uk/aac/wp-content/uploads/sites/50/2020/04/Summary-of-national-guidance-for-lipid-management-for-primary-and-secondary-prevention-of-cardiovascular-disea.pdf

I completely get your self-doubt about medication - It’s something I get too. But weirdly I completely accepted insulin as a permanent fixture immediately at diagnosis.

I think this is part of the challenge where medications are needed in some cases and not others. But I guess it’s really just a matter of perception. Particularly where the optimum outcome of taking a medication is that something doesn’t happen. How can you tell if that is working as an individual when you don’t know what would have happened without??

It doesn’t sound like you were having ill effects from the statins other than a disquiet about taking them?

Thanks, no obvious side effects but was anxious about effects on memory but memory didn't improve.
So no really harm in continuing to take them just seeing how much medication I rely on is disheartening at times.

Will have a read through above later, but can't see any obvious reference to LDL in test results


! Serum cholesterol 5.6 mmol/L 0.00 - 5.10mmol/L
Serum HDL cholesterol level 1 mmol/L 1.00 - 1.60mmol/L
! Serum cholesterol/HDL ratio 5.6 0.00 - 4.50
Se non HDL cholesterol level 4.6 mmol/L

Speaking to pharmacy in 2 weeks for general review, so will ask more details and have a 2nd blood test booked in too

 

[Blue flash]

Would it just be having less exercise that's caused the rise in hba1c? I'm sure people on here have mentioned they haven't exercised or are unable to exercise and have still reduced their hba1c.. I hope that's the case as I cannot exercise so if it IS lack pf exercise, I'm doomed at reducing mine! I think my last cholesterol was 5.6 and GP wasn't concerned.

Think extra exercise might help reduce bit of wait lost 6kg, but put that back on. Nurse said just bit extra weight can impact sugar absorbtion (or something to the effect) I did get my hba1c down to 40+ with just low carb diet.

 

[Blue flash]

This is a pretty good summary of the influence of diet on cholesterol which most experts would agree with: https://sigmanutrition.com/diet-on-lipids/

Briefly:
- Minimise saturated fats - so avoid red meat and processed meat.
- Replace with unsaturated - so nuts, seeds, soy, avocado, tofu, fish.
- Eat lots of fibre - so oats, whole grains, seeds, nuts.
- Avoid refined carbs - added sugar, white bread, food which is obvious c**p.

None of this is likely to have as much impact as statins, which are one of the safest and most effective medications around. The stories about how they cause lots of side effects are mainly rubbish.

They reduce LDL cholesterol by a lot, and over time keeping LDL as low as possible reduces stroke, heart etc risks more & more. Again, the commentary you see about how they don't have much benefit is rubbish.

View attachment 21509

Thanks will try read later going bit o overhead at moment as still bit confused stress

Stick to my last low carb diet and continue pills.

Try change diet, or just live fast and free and to heck with it never smoked quit alcohol 10+years ago, stopped driving and walk or cycle most places 3 years ago.

Trying be good but still get bad blood results bit disappointing

 

[Lucyr]

When I spoke to my consultant about cholesterol he said you really don’t need to worry about cholesterol until you start getting older, at least age 40+ before worrying about it.

He did say that it’s worth making dietary changes to improve cholesterol- more veg, fish, try the cholesterol drinks or spreads, reduce red meat and saturated fats, to establish a good dietary routine for managing cholesterol before you’re the age of worrying about it. If it is still high when in 40s then statins are widely used and would be reccomended then.

 

[Eddy Edson]

When I spoke to my consultant about cholesterol he said you really don’t need to worry about cholesterol until you start getting older, at least age 40+ before worrying about it.

He did say that it’s worth making dietary changes to improve cholesterol- more veg, fish, try the cholesterol drinks or spreads, reduce red meat and saturated fats, to establish a good dietary routine for managing cholesterol before you’re the age of worrying about it. If it is still high when in 40s then statins are widely used and would be reccomended then.

I dunno. Think you might find that expert opinion is shifting towards an earlier start. That graphic I posted above was from a widely-discussed recent paper https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.121.008552

The benefits of LDL-C lowering do not seem to be fixed but increase steadily with longer durations of treatment.

Or in other words: Get LDL as low as possible for as long as possible. Other studies and commentaries over the last few months have supported starting statin treatment very early.

A frequent analogy is with the common concept of "pack-years" for tobacco exposure - lifetime risk is a product of how much you've smoked & for how long. In this view, lifetime cholesterol-related risk correlates with the product of how much yr LDL etc has been elevated above the level seen in infants (~0.5 mmol/l) and for how long ...