Stinting Lipids without Statins (V) - Correlation

My latest numbers from the sample draw last week are in and the chart now has 7 data points spanning 2 years 7 months and 12 days (957 days) with six distinct periods. In this edition of Stinting Lipids without Statins, I will list the conditions during each period, labeled A through F, and seek some correlation. I hope you will be able to extract your own conclusions which may help design your own lipid trajectory. (Click on chart to see larger image.)

Periods A and B were discussed in some detail as part of the Execution segment. To recap, during period A, I attempted to control my lipids without any supplements, relying only on attempted 'lifestyle changes', you can see that the attempt could hardly be called successful. With the threat of having to go Statin, during period B I took on Niacin, taking the dosage all the way to therapeutic levels of 3 gms/day. Each lipid statistic took on the correct direction during period B. The sharp drop in triglycerides (TGl), however, should be attributed only partially to Niacin, I believe the bulk of that reduction came from weight loss. I started period B weighing 156 lbs (71 Kg) and ended it at 140 lbs (63.5 Kg); dropping the weight was a vehement instruction from my physician. FYI, I am 5'9" (175 cm) tall. I attribute my weight loss to frequent snacking of roasted chana, and the quarter tea-spoon of white bean powder before lunch and dinner. Yes, I used to carry the powder in a zip-lock pouch!

I was very encouraged as I started period C, albeit a bit alarmed at the sharp drop. I relaxed dosage across the board. Niacin dropped from 3gms/day down to 1gm/day; and Omega-3 caps from 1gm/day to an average couple of capsules irregularly over the week. The bean powder was taken only on instances when I expected a large carbohydrate intake. I ended period C gaining back 3 pounds weighing 143 lbs (65 Kg). Period C showed an increase in cholesterol, LDL and TGl - though my good HDL continued to improve, perhaps a residual effect of previous period's Niacin dosage. Fortunately, this period was only 2 months long, and I was able to take corrective action quickly.

Rather than writing it all out for each period, look at the table of key variables below:

If you look at this chart along side the lipid chart, it will appear that, in my case, Niacin dosage of 2gm/day with 2gm/day of Omega-3 will continue to deliver the desired results. 1.5 gm/day of Niacin (taken 3gm every alternate day) was not able to hold down the TGl, and a return to 2gm/day achieved the same reduction in period F as it did in D. While each of these variables, and the daily activity level are inter-related, Omega-3 at 2gm/day appears to correlate well with reducing LDL levels.

The Not-So-Good:
My Glucose levels are not coming down and I am now exploring natural ways - without total deprivation beyond what I have already instituted. While my HBA1C is right a the border at 6%, my fasting glucose is elevated - to 121 - again.

Have any of you been able to control glucose levels? One colleague suggests including as much as 35 gms of dietary fiber in the diet everyday - I can see doing that some days, but to do so every day will require some measured means that is palatable - I'm looking for suggestions!

I hope this has been helpful - do comment and if you feel others may benefit, click on the 'ShareThis' icon below to easily send a link using your preferred social medium!

Now on to other subjects!

Header Photo: Halfdome at Sunset from Glacier Point, taken Sept 7, 2006

Stinting Lipids without Statins (IV) - Execution

With only 3 months to show results I took myself on a war path starting in December, '07 to prove to my doctor that I could change the course of my lipid charts.

With my exercise regimen reasonably in place - an hour of yoga twice a week and a decent 3+ hour hike every week - the areas I had to work with were my weight, diet and adding Omega-3 Essential Fatty Acids (EFA) and Niacin to my regimen.
 
Niacin: Perhaps the trickiest part of the plan is how you build up to the therapeutic dose of 3 grams of Niacin per day. Niacin causes a release of histamines when first introduced - causing temporary itching and hot flashes - uncomfortable but not dangerous. There are several methods and tricks to build up the dosage, I'll describe what worked for me.

1. I started with 100mg/day for 2 or 3 days - taken as soon before falling asleep as possible. It helps to take a baby aspirin about 1/2 hour before bedtime. Spicy dinners can aggravate the flush when getting started.
2. Step up the dosage to 200mg/day after a couple of days. I continue to take my Niacin just as I am ready to switch off at night - literally, just before I can't keep my eyes open any longer. The itching and hot flash is rarely strong enough to wake you up.
3. Double to 400mg/day - again for a couple of days before taking it to a gram, then two and finally 3 capsules each night.

I personally prefer the regular Niacin over the slow release or the newer non-flush kind. If you have more discomfort than you'd like to tolerate - try the non-flush variety. I've come to a personal conclusion that the slow release kind puts a sustained load on the liver without respite for recovery on top of that therapeutic concentrations are not achieved.

Omega-3 Essential Fatty Acids: This is the easiest part of the whole regimen. Just get your favorite Omega-3 supplement and take up to 2gm/day. I settled on the one from NSI discounted by Vitacost.com.  

The Diet: I watched out for the Glycemic Index (GI) of foods and began including those with low GI and shunning high GI foods.

1. I kept a bag of these dry roasted small chickpeas with brown skins (chana, चना)  handy and kept popping a few whenever I remembered. With a GI between 10 and 30 (depending in the variety), the chana I was never really very hungry at meal time and was able to get away feeling satisfied with only 1/2 my normal intake. For about a month, I kept a very close watch on my intake and The Daily Plate was extremely useful in keeping track of my intake: calories, fat, carbs, protein, what have you.
2. Replaced most things white with colored alternatives, e.g. refined sugar, white bread, rice, were banished from regular meals. I still take a bite or two to satisfy the taste buds - strictly just the taste buds!

The Weight: Around the time I just happened to come across the book Sugar Busters! Cut Sugar to Trim Fat from which I gained an understanding of how sugar, and most things white, in our diet converted into stored fat within our system. The main steps I took that helped me lose 14 lbs were:

1. Elimination of most things white from my daily diet: refined sugar (replaced by brown sugar and honey); rice (brown rice, on rare occasions; preferred whole wheat tortillas); potatoes.
2. Take about a gram (1/3 tsp) of White Bean Powder along with my 1st bite of any meal that I thought to be high in carbohydrates. These are available in capsule form or in bulk. I poured the gram or so of the power on my first bite of food and if necessary sloshed it all down with liquid. The powder has a mild tolerable taste. If you choose the capsule, it must be taken 1/2 hour before meals. Caveat: Skip taking the bean powder if you are planning any exercise after the meal. (I found out the hard way!).

With this regimen, I was able to achieve the numbers on my chart in 3 months at my February, 08 checkup. IMO, the key is consistency - just stick with the program and results will happen - it gets easier after you see the results!
Remember, if your physical constitution does not cooperate, go take the prescribed statins - keeping the lipids in check is more important than how you get them down!
May the force be with you!

Header Photo: Sunset in Waikoloa, Hawaii - July, 2009.

Stinting Lipids without Statins (III) - The Plan

It took longer than I'd hoped to get this 3rd segment written. In this edition, I'll walk through my 1st lipid panel on April, 07 to my third in Feb, 08. This period during my ongoing journey is the most significant. Refer back to the chart in Segment 1.

In April '07, my doctor raised the flag after reviewing the lipid panel - I was just under the borderline (<239) with cholesterol at 237; and on the better side of the line with HDL (>40) at 47; but my triglycerides (TGl) were 16% too high at 232 (should be <199) which caused my calculated LDL (<129) to be off at 144. The doctor prescribed statins. A little shaken, I left the appointment without filling my prescription. A couple of days later I emailed my doctor and got him to agree to give me six months to try controlling my lipids on my own.

I did what I thought was best, with yoga and hiking and consciously controlling diet; I thought I was doing well. I took seven months instead of six before going back for the next lipid panel. You can tell from the chart that I actually regressed. When I went in to see the doctor in person, I was read the riot act.

Fortunately for me, the results were online a week before I got my appointment. During that week, I met with a few friends who had been there before and had seen good results without using statins (if you are reading this, you know who you are & thank you again!!), I read through reference material, and with help came up with a game plan for myself. At the in-person doctor's appointment, right after I was read the riot act, I presented the plan, asked for his input and permission to try this over the next 6 months. This time around I got permission only for 3 and a strict ban on taking any grace period. Exactly 3 months later on Feb 21st, '08 I went back for the tests. If you recall the chart, you know how that turned out! Let me share that game plan with you - it worked for me. Work with your doctor perhaps he will OK a version of the plan for you. Here goes...

1) Sugars in the diet seem to be the main cause for high TGl and the best way to reduce it is by controlling sugars. In the process you may notice that you drop a few pounds.

I am 5' 9" (175 cm) tall and in Nov, '07 I weighed 156 lbs (70.8 Kg). I never thought I was overweight - but dropping the pounds was still recommended - goal was to drop 15 lbs (6.8Kg). I eliminated most things white: refined sugar, rice, white bread, etc. I switched to honey and raw brown sugar, 9 grain, oatnut & whole wheat breads, and I'm continue to avoid rice. I was pre-diabetic with my fasting glucose going from 121 to 127 and then down to 119 at the Feb 08 test.

2) Reducing the bad and further improving the good HDL cholesterol came from introducing Niacin and Omega-3 into the mix. The target was to achieve the therapeutic concentration with 3 gms/day of Niacin. During this period I took one 1gm capsule of Omega-3 a day. Acclimatizing to the Niacin dosage took some effort and pain, more on that in the next blog.

To say the least, I believe I have had some success in getting a handle on my numbers as evidenced by my Feb 21, '08 numbers. The process of putting this little game plan in place is worth a separate edition - and I promise I'll put that up soon.

Please share your thoughts in the mean time - click below and leave a comment.

Header photo: Sunset on Jimbaran Bay, Bali, Indonesia. August 13, 07

Stinting Lipids Without Statins (II) - Resources

In this 2nd segment of the series on my journey stinting lipids without statins, I list below the main set of resources I used to achieve my own outcome. From the mundane to the complex - I hope this list becomes a good collection worth referring to. I'll add to it as I remember them, so do return.
 
Reference material:

1. Sugar Busters! Cut Sugar to Trim Fat - brought clear understanding of how carbohydrates & sugars metabolize. This book helped me pick the right foods.
2. The Daily Plate - Now a Livestrong property - this site has a very rich database of foods, e.g. you don't have to guess the breakdown of samosas! It helped me keep a close track of my calorie intake - I only used this for three weeks - after that I knew. [Update: MyFitnessPal site and their apps for iOS and Android may be the modern day alternative].
3. The Glycemic Index - A reference site to determine the glycemic index and load of common foods.
   
4. Roasted Gram - भुना चना - (black chickpeas roasted) A snack with glycemic index of 31. If consumed with the husk it may provide dietary fiber too. Nutritional info is available here.
5. Kidney Bean White (Phaseolus vulgaris) Powdered - when given with a starchy meal, has been shown to reduce the subsequent rise in blood sugar levels of both healthy people and diabetics. I have a story to tell you - this thing really works! I only used it for about 2 months after which I did not feel the need. This is also available in capsule form under the amylase inhibitor category of nutritional supplements.
6. A balanced multi-vitamin - I have been using is Vitacost Synergy GlucoPower Multi-Vitamin. This composition adds botanical extracts of pomegranate, bitter mellon, turmeric, etc. to aid in diabetic health. Choosing a vitamin can be tricky - this product was recommended and I've not experimented.
7. Essential Fatty Acid (EFA) - I saw my Triglycerides go up during one period when I reduced taking EFAs. I brought it back into my regimen after that to restore levels. I use the Mega EFA® Omega-3 EPA & DHA, I have also tried Krill Oil, Flax seed oil and plain fish oil - I finally settled on this variety. Note: the fastest way to drop triglycerides is to drop some pounds and keep them off. And Finally the main component:
   
8. Niacin - Vitamin B3. Heavily researched, published but poorly promoted, IMO because no one can really make money on it. In order to add value, pharma has come up with a) non-flushing niacin; b) slow-release niacin; etc. so they can charge their preferred prices. I have exclusively used the regular Niacin from Vitacost.

Let me add a few links to reading material that I found useful:
1 - Niacin (Vitamin B3) Lowers High Cholesterol Safely. Orthomolecular Medicine News Service, September 30, 2005. A PDF is also available.
2 - See what the American Heart Association says about Lipid-Lowering Therapies (scroll to the middle of the page) - a must read for anyone considering niacin therapy.
3 - While you are at it read what Mayo Clinic has to say about Niacin 

In my next post, I'll walk through the variables that caused my trajectory on the lipid chart - while mine is just one data point - the observed cause and effect may be indicative of a valid correlation.

Caveat Emptor: Notwithstanding anything you read anywhere, your doctor should have the final word. As mine does for me.

Do add your comments below! +1 it on Google+, Like it on Facebook, Tweet it... just share the love!
Header Photo: Sunset in Bodega Bay - April, 2002.

Stinting Lipids without Statins - I

My ongoing campaign to rein in my lipids started soon after I turned fifty when the results from a routine lipid panel and fasting glucose blood test indicated numbers on the wrong side of the borderline. My primary care physician ('PCP') raised the flag, prescribed statins and admonished me to bring about changes to my life-style.

My lipids from April 2007 to August 2013 are shown below:

(click on the image to enlarge).

Between Nov 2007 and August 2013, take a look at the fasting glucose chart:

and the HbA1C chart:

In particular, notice the starting values on the left of the chart - clearly not ideal and heading the wrong way.

To top it off, I was also showing signs of pre-hypertension with my pressure hovering around 140/90 and rising. So, I was dealing with a three pronged situation - pre-diabetes, pre-hypertension and a brewing cholesterol problem; together a potent recipe for heart disease.

I asked my Primary Care Physician (PCP) to allow me 6 months to bring about changes and he agreed to retract the statin prescription and ordered me a fresh lipid panel test 6 months out.

You can tell from the charts that my initial attempt to rein in my lipids and fasting glucose levels failed miserably. I should add, throughout those 6 months I was feeling confident of being able to control my numbers strictly through the exercise regimen, yoga, and dietary changes I was making. My PCP appointment of Nov, 2007 was not a happy one. Though you'll agree that the statistics from Feb 2008 were exciting - that large drop in Triglycerides!
 
In the next several postings, I will take you along my journey. Identifying all the resources I used along the way, how I used them, and the results I continue to see - without the use of statins. What you'll see is just one example of what is possible. I must state that this is not a prescription but just one person's result - your own result WILL vary. I have kept my PCP in the loop at every stage and if you do decide to embark on your own statin free journey, keep your PCP informed of your proposed regimen - and ideally get his support.

NEXT: List of resources used so far - drugs, dietary supplements, books, web resources, etc.


Please share your thoughts in comments below! Like the blog post, share it with others who may benefit. The link to the complete 5 blog series is http://bit.ly/bundles/eyeks/2 - feel free to share!


Header photo: Sunset in Monterey near Lone Cypress

I Own My Phone, My Number AND My Dialtone!

For most of us who have grown up having a telephone, hearing a dial-tone when you lift the receiver is a sign of being privileged and prosperous. From the early days, it has been a big deal and often a reason for pride, to order and, after a waiting period, be provisioned to receive a dial-tone that would connect you to a loved one after the dialtone had been interrupted by multiple pulses manually, or by using a rotary dial or more recently, by DTMF tones.

In the mid-80's I recall letting go of my leased phone unit - going to a store and buying my first physical device that I could connect to the wall was a bold step. My friends called me brave to take responsibility if the unit went bad - no Ma-Bell to replace it 'for free' if it broke. I owned my own phone and not having to pay a monthly lease fee was liberating!

Notwithstanding, the ability to use the telephone continues to be a privilege for which a monthly fee is entirely expected and never questioned. An entire world population remains accustomed to paying a monthly fee for this privilege.

Yesterday, I took ownership of my number, the one I have had for almost 20 years. A few weeks back I took ownership of my dialtone. I bought it - It's mine; it is created in my home. I am now ultimately responsible if it does not work - much like when in 1984 I became responsible for my telephone unit. Except, I think this is bigger - because now we are changing a paradigm - not having to pay a monthly fee for the privilege - is a huge shift. Can it even be called a privilege any more?

In May, I embraced VoIP letting go of POTS by taking on AT&T's U-Verse Voice service. I have to say, my wife is not handling that bereavement well. From U-Verse I've now moved to ooma (I wrote about how AT&T Lost My Voice). Now with my number ported over, I have a definite sense of ownership - I wonder if sharing this feeling will replace her sense of deprivation of POTS with the pride of ownership of our own number on our own dialtone WITHOUT monthly fees! Will it?

Porting my number from AT&T U-Verse to ooma was entirely transparent and seamless. I'll write more about my ooma configuration over U-Verse in a future post.

Do you remain apprehensive of letting POTS go? Would eliminating an entire monthly bill get you over the hump? Am I making too big a deal about 'ownership' of my dialtone?

Banner: Parorama of Crater Lake, taken in July, 2007.

Why AT&T Lost My Voice

I have been a Plain Old Telephone Service (POTS) customer for decades.

My original service consisted of basic POTS: dial-tone and long distance; then came caller-ID, I paid for that. For a small additional fee call waiting caller-ID followed. Enhanced calling features came next, busy redial, three-way calling, call forwarding, selective call forwarding, and I paid for them too. With my phone service bill bloating, I called 611 and was introduced to bundled pricing for about a 30% saving. Privacy Manager and Unified Messaging were late entrants that helped rebloat my monthly bill bringing telemarketeer freedom, our voice messages in email as attachments and incoming FAXes. We had it all - for about $48/month. I've paid at that level for more years than I care to remember.

Then came U-Verse - AT&T's new bundled service delivering TV, broadband and VoIP on a single copper pair. In late April - U-Verse became available and the AT&T tech verified that I was the first one on the block to help light the fiber to our curb.

With UVerse installed on May 7th, I found the voice service much below par. I could hear myself talk, my own voice was clipped and came with a chirp - a call to 611 helped a little. There was no Privacy Manager, but that was acceptable. They allowed an online address book, but there was no way to import - like they think users were going to type in contacts by hand. Not happening. The killer was voicemail which did not come as an attachment - a feature my wife and I had gotten used to. No FAX either - an entire service removed. And I was now paying $30 per month. Considering the service reduction, I was not really saving anything. How does AT&T expect to introduce a lesser product and keep customers?

So - I have gone with Ooma and AT&T lost my voice business. For $229 one time charge, I get almost everything. Voicemail as an email attachment is part of their $99/yr annual option and I'll have to give up on receiving FAXes. My 20 year old number is currently being ported over to Ooma for a one time $39.99 fee - and then I am done! No more monthly bills.

What are you doing with your landline service? Are you as apprehensive letting go of POTS for VoIP as some of us? From up to $600/year to nothing - is that incentive enough to switch? Does the Ooma business model have legs?

In a future post, I'll talk about my Ooma experience. Stay tuned.

PS: In AT&T's defence - I have to say, UVerse broadband and TV service are excellent.

About the banner: A fascinating piece of architecture - if you recognize it, leave your answer in a comment!

Did the iPhone Stay?

When my last smart-phone, the Sony Ericsson P910 began to die mid last year after four and a half years, I went hunting. A friend, (thanks, Joel), let me use his Nokia N95 after he took on the then new iPhone 3G qualifying that the N95 was the best he'd ever owned. Soon after I heard of the Nokia N96 and decided to order that. The N95 went back to Joel in December when I got the N96.

Unfortunately, the N96 took a back seat to the N95 in usability, so while still able, I sent the N96 packing. Right around then, Google gave out their annual bonus in kind - the unlocked G1. I got to use the G1 on the AT&T network for a few months (thanks, SBG). Nokia had announced the N97 in Dec 08 just as I had got the N96.

To cut the story short, SBG wanted his annual bonus back before the N97 was shipping, to fill the gap, I borrowed an old SE P1i - ouch! I got antsy, ordered the Nokia 5800XM which some claimed to be an iPhone killer - NOT! That went back and I then got the Nokia E75. I have to admit, I liked the E75 - a solid player if you are ok with a non-touch, small screen phone. Solid performer. I had pre-ordered the N97 so the E75 had to go. Then Nokia messed up my pre-order - long story - and in retaliation, I found myself in line on June 22nd at the Apple store.

Brandyn J at the Valley Fair Apple store took great care of me as a customer - I was totally impressed, he assured me I'd have no trouble bringing it back after trying it for 30 days - that's now! Will I go back to the Apple store today?

To all who read my last blog, 'i' Feel Squished by the iPhone thank you! Special thanks to reinharden for his elaborate comments, and PBG - you have it spot on - you captured how I feel and I too hope companies put products out there that are not artificially debilitated like the 3Gs.

If I were to take the iPhone back, I would have to get the N97 from Nokia nothing else comes close on the AT&T network. Unfortunately, being a gen-1 device, it needs much work - the blog post:

• 4 Bugs on Nokia N97 That Give Me a Headache along with the
• PCMagazine article by Sean Ludwig
  

sealed the deal. Sean says it well and while he has not taken "the iPhone plunge (blasted contracts!)", I completely relate.

The iPhone deserves to be my 1st contract phone on over 10 years and my very 1st Apple product EVER - and I will continue to rile about my displeasure with the hope of getting others to join in make noise; collectively becoming the squeaky wheel.

My iPhone stays!

About the Banner: Tioga Lake looking looking West from the Eastern shore in June, 2009.

'i' Feel Squished by the iPhone

The iPhone 3Gs - I've had it now for just under a month and in the next couple of days I must decide if I am to keep it.

Why is it that such a remarkable piece of technology leaves me feeling squished and small inside? Like being given rules to live by that you fundamentally disagree with. In order to keep using the iPhone, I must surrender to the whims of, not one but two, corporations: AT&T and Apple. Let me express my thoughts - so you can share my dilemma.

• iPhones require the $30/mo for unlimited data plan, instead of $15/mo; and if I select podcasts larger than 10Mb, the download is unilaterally blocked until I connect to iTunes or have a WiFi connection. No recourse; No options; no way out. Leaves me feeling cheated.
• Being able to tether a laptop while traveling is a huge benefit - i was able to get it working during my last trip, but with the next update it will be shutdown; Leaves me feeling cheated, again. Unfortunately, I could jailbreak, but I feel subjecting users to need to do so is just plain wrong.
  
• Oh, the new 3Gs has video capture! I shoot a video and there is no way, that I know, to pull the video off in its raw form so I can edit it using tools of my choice. I'm told, if I have iMovie on a Mac, I'm home free. Not happening.
• Try sending a picture you just took with the camera - without warning, the picture is down sampled to 800x600 before being sent. Come on, give me a choice! Ask, seek permission - give the user the credit he is due, allow user to set defaults. Respect the user.
  
• iTunes - an iPhone user is FORCED to use iTunes - iTunes tries to take over my music library and promptly begins to convert my files.I have to iTunes to subscribe to podcasts and use sync to refresh the iPhone. I have not found a way to have the iPhone refresh over the air... I feel cheated, yet again.
• Frankly, I can't stand iTunes - how did it get to be so popular. Or perhaps it isnt, just because everyone has a ball and chain around their ankle wouldn't make it "popular". Why should I need iTunes even to delete consumed content on the iPhone?
• The processor on the iPhone 3Gs is plenty powerful - why can't I listen to streaming music while checking my email? Why must each application quit, most without keeping context, when a new activity is started. Multi-tasking and task switching is painfully absent on the iPhone.
• Battery life leaves much to be desired - I have had to resort to keeping the iPhone plugged in whenever I'm near a source and using an external battery pack.
• And then there is this: ATT has had system wide iPhone visual voicemail failures: http://shar.es/JzvV

There is more. Don't get me wrong, I could expand on things likable about the iPhone too: the App Store the UI, the browser, are all top notch; none of them would be empowering though and would make for a very long first blog!

So, without further ado, would you share your thoughts? What should I do about feeling 2nd class, about being subjected to arbitrary restrictions, about paying for undelivered service, about being 'squished'?

Please take the poll, add a comment and share your thoughts about the subject AND my very 1st blog! Thanks!

About the Banner: A Partially frozen Saddlebag Lake, off 120 Tioga Pass Road, late June, 2009.