Close Encounters of the Statin Kind

Mono Lake from Mount Dana 13,200ft - September, '08

Earlier this year I attended a two hour session at Kaiser on prevention of strokes and heart attacks. The doctor delivering the information was quite passionate about the subject and he delivered good information to the 20 or so attendees, none of whom had had an attack but had lipid levels in the high risk bracket.

The presentation was followed by a one on one session with a team of residents. With printouts of my blog and the statistics that you have all seen in hand, I spoke with a resident. He quite appreciated that I had titrated niacin and EFA dosage to achieve the necessary results and encouraged me to stay the course. Before I left he suggested we both have the doctor review the recommendation.

In less than a minute, the presenting doctor dismissed the resident, glanced at my chart and pointed out my peak HbA1C at 6.4 (from Feb, 08) and LDL 159 (from Nov, 07) - and proceeded to prescribe 40mg/day of Lipitor suggesting that I achieve an LDL level below 100. I offered to try to achieve that level using niacin, to which he said, "You'll have to take 7 gms/day to get to those levels."

"Great, I'm happy to do that!" I said, causing him discernible aggravation. 

"No, you should treat yourself as a diabetic and aggressively take Lipitor to bring your LDL down below 100. If you want, you can start with 20mg/day." he said. 

"What's the smallest Lipitor tablet?" I asked and with a little more discussion and I negotiated him down to 10mg/day. With prescription entered on the system, I left.

I emailed my primary care physician, reviewed the interaction and right away he had the Lipitor prescription canceled and encouraged me to continue with my regimen.

Statin mongers are everywhere - if you've experienced an episode, statin is a blessing so that lipids can be quickly controlled. You must follow your doctor's recommendation. If however, you've caught the symptoms early, get on the diet + exercise + EFA + niacin regimen in consultation with your physician to avoid having an episode before you start on a statin regimen - give yourself a chance. You can always fall back on statins.

As corroboration that this statin-free regimen works, look at a good friend's lipid chart below. His numbers are heading the right way after only 4 months on the diet-exercise-EFA-niacin regimen! It works!!

Final word: get a handle on your lipid statistics - get tested every six months, more frequently (every 3 months) if your plan will allow it, especially when getting started. Getting blind-sided thinking all is well when it really isn't would not be a good outcome.

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 - 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