High CAC Score

[ffskier]

I’d rather just use some WhiteOut.

You are certainly entitled to your opinion. Keep in mind that my response was to someone who presented with a CAC score of 1114. Do you understand? 400 is considered high risk. His number was 1114. almost 3x. Very high risk. What would you do if this was you? Keep in mind that this person is otherwise healthy, exercises on a regular basis, and is not overweight.

Thats where I keep coming up short.

Then start spreading your knowledge base outside of your normal sources. Have a look at Dr. Allan Sniderman. A research cadiologist for more than 50 years. He has some very good research that questions the status quo in a number of areas.

[mnl1]

There is no perfect diet. Anybody who makes that claim is a charlanin.

Appreciate the conversation and your detailed replies. Will definitely look at the doctors you referenced. Enjoyed talking with you.

[SomeGuy]

I’m not sure anyone’s doubting the ability of statins to affect lipid panel results. I think the question is, is that “work” necessary and beneficial. Does it meaningfully prolong life or healthspan?

Atherosclerosis-Cholesterol-Causality.pdf (161.3 KB)
CalcSupplement-BenefitsRisks.pdf (534.9 KB)
CoronaryDisease-CloggedPipeModel.pdf (234.5 KB)

… and perhaps most importantly on this thread …

Lack-InverseAssoc-LDL-Mortality-2015.pdf (881.6 KB)

(note: the yellow highlight marker seen in these pdfs is mine / offered for ease of review)

Personally, I find these papers to be well-reasoned, straightforward, thoughtfully structured, and without financial conflicts. Just a sampling of a larger set of papers which all point directionally toward similar conclusions.

It remains unclear to me why lowering LDL-C would be a healthy choice - regardless of one’s current “Agatston” score (see above comments re: calcium density) - if longevity and reduced CVD risk are the desired outcomes.

[ctviggen]

You are certainly entitled to your opinion. Keep in mind that my response was to someone who presented with a CAC score of 1114. Do you understand? 400 is considered high risk. His number was 1114. almost 3x. Very high risk. What would you do if this was you? Keep in mind that this person is otherwise healthy, exercises on a regular basis, and is not overweight.

But it’s him, not us. I got a CAC score of zero after 5.5 years keto. The LMHR study that’s out has people with HUGE LDLs getting very low CCTA scan scores (measures both types of plaque).

And you seem to be placing the blame on keto, when you have no idea what caused his high score. Nor do I. If it was keto, we’d all have high scores, and we don’t.

Should someone be concerned with such a high score? Absolutely. But to go from keto to “Mediterranean” keto or even eating carbs has no basis in fact. It’s highly – I’d say extremely – unlikely keto caused his high score. Again, because if it did, those of us who have been keto for years, over a decade for me, would have similar scores, and we don’t.

And this idea that “genetics” causes it, is garbage without more. I can cite studies to you where many people with FH (familial hypercholesterolemia), who we know have very high levels of LDL for decades, have CAC scores of zero. If LDL was causative, none of them should have zero scores.

Can genetics cause atherosclerosis? Absolutely, things like sickle cell anemia. But absent something like that, I am thinking something like covid as being a MUCH more likely candidate.

I even think that high amounts of exercise could cause it. Consider something like this:

Cardiovascular Damage Resulting from Chronic Excessive Endurance Exercise

Some exercise might be good, but “too much” exercise is probably bad.

[kib1]

Plus, I was pleasant to be around …

And when did that start?

[mnl1]

It’s highly – I’d say extremely – unlikely keto caused his high score.

I didn’t say keto caused my CAC score. I don’t know what caused it. My change in diet plan has more to do with saturated fat intake than the Mediterranean diet. My go to for years was a keto coffee, eggs and bacon, proteins and good fats keeping my carbs around 20-25. No one is attacking keto or your choice to be on keto. I am making a choice, will it help, I don’t know but I am going to give it a try.

[SomeGuy]

I am making a choice, will it help, I don’t know but I am going to give it a try.

Way to go. If you don’t decide what’s right for your body, you’re doing it wrong.

[ffskier]

And you seem to be placing the blame on keto, when you have no idea what caused his high score. Nor do I.

According to him, his blood profiles were normal before keto. Again, nothing changed except his diet. Maybe there are other things that contributed to his CAC score that we are not aware of.

If it was keto, we’d all have high scores, and we don’t.

Not everyone thrives on keto. Some actually gain weight on keto. Some even have their blood markers, such as CRP, go up. It is not one size fits all. We all react differently.

Should someone be concerned with such a high score? Absolutely. But to go from keto to “Mediterranean” keto or even eating carbs has no basis in fact. It’s highly – I’d say extremely – unlikely keto caused his high score. Again, because if it did, those of us who have been keto for years, over a decade for me, would have similar scores, and we don’t.

Really. How are you so certain that it is not his diet? Are you a doctor of lipidology? Tell me what you would do under the same circumstances, knowing that the only known change is his diet.

I can cite studies to you where many people with FH (familial hypercholesterolemia), who we know have very high levels of LDL for decades, have CAC scores of zero.

And their risk of all causes of mortality is higher in all groups than that of those who don’t have it. A study from Norway showed there was an exception in the group of 60-67 year olds, and the researchers do not know why.

Some exercise might be good, but “too much” exercise is probably bad.

As with everything, there is duality. Too little is not good, and too much is not good.

[Bellyman]

As one who raises cattle I can assure you that they are all grass fed or silage fed for 99% of their lifespan. It is only in the last few months they are put on a grain diet to put more fat on them.

Thank you!!

It’s one of those arguments that goes around and around and around often by people who have no clue what cattle normally eat.

[VirginiaEdie]

Really. How are you so certain that it is not his diet?

during my hospitalization I had two CT scans on my lungs that indicated minimal plaque in my arteries. Granted they were looking at my lungs but at that point my life was on the line I would think that if something was concerning the doctors would have tried to address it.

@mnl1 mentioned that he started eating low carb in 2013. While in the hospital for Covid, he said there was minimal plaque. So, if it was the diet, I’m guessing 8 years of low carb most likely would have caused plaque buildup by then? So… what changed since 2021… well, almost dying from Covid and all the accompanying inflammation. Will anyone ever know the truth about what caused his massive CAC build up? Maybe there are or will be some studies someday.
There are numerous papers about Covid and heart damage. I couldn’t find anything specific to increased CAC, but if CAC is a scab to heal damage, they may pertain.

[ffskier]

I had two CT scans on my lungs that indicated minimal plaque in my arteries.

Mike, I think your doctors were talking about pleural plaques not artieral plaques.

[ffskier]

I think that Mike was told that there are no pleural plaque in his lungs not arterial plaque.

[PaulL]

My CAC score came back 1114!!! I am blown away my doctor says it is most likely genetic. So my questions are do I change my eating to minimal saturated fats which definitely would not be Keto? I don’t want to take a statin but feel with a score this high that I should. Really at a loss right now. Not looking for medical advise just wondering if anyone might have an experience close to this and what your plan of action was?

Plenty of people have reduced their burden of calcified plaque on a ketogenic diet. It’s an assumption that keto “caused” your plaque score; it could just as easily be the result of all those years of high-glucose eating before you started keto.

Unless you have a previous score to compare to, it’s not time to panic yet. A stable or declining CAC score is fine; it’s only bad if it starts going up, and a statin is likely to cause further calcification.

Stabilised (i.e., calcified) plaque is not a bad thing, certainly it’s much better than having lots of soft plaques. However, the existence of calcification shows that the patient has been experiencing arterial damage at a rate greater than normal, hence it’s value as an indicator of cardiovascular risk.

But unless you know for sure that your CAC score was 600 ten years ago, and it’s now 1114 from eating keto, then it could just as easily be the case that your score was 2000 ten years ago. We don’t regularly do CAC scans (because there’s no drug to sell to alleviate the “problem”), so having is necessary for the full picture. Get tested again in six months to a year, and see what your score is then. Other tests I’d want would be a CIMT (coronary intima media thickness) scan and some other measures of arterial occlusion. In the meantime, I personally would be eating keto/carnivore.

The body eventually deals with calcified plaques, just as it deals with any scab. Supplementing with vitamins D and K should eventually help the calcium get back to the bones, where we really want it. However, that is a slow process.

Here’s hoping your next CAC will show an improvement.

[PaulL]

My understanding at this point is that statins do cause the CAC scores to go up because it calcifies the plaque.

If we consider calcification to be bad, then the obvious conclusion is that if something makes calcification worse, it is a bad idea.

However, statin manufacturers argue that if the statin causes your CAC score to go up, then that’s a good thing. But it is clear they have a strong financial interest in saying so.

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.”—Upton Sinclair

[PaulL]

I may just be being a little dense here. The vitamins D3 and K2 help keep the calcium from being deposited into places it doesn’t belong such as arteries and soft tissue.

I believe Joey was trying to say that arterial calcification may be needed, in order to stabilise soft plaques, but the presence of arterial scarring and the need for the plaques to form in the first place is not ideal. So the presence of calcification is a necessary evil, because the calcium is also needed in the bones.

Ravnskov and Diamond posit that the arteries are continually undergoing a certain amount of damage, and that the body has evolved mechanisms for dealing with it. However, plaques start to form when the rate of immediate repair cannot keep up with the rate at which new damage is occurring. We don’t ordinarily notice the damage/repair cycle when we eat properly, but a high-glucose diet seems to accelerate the damage, necessitating more extreme repairs to keep up with it.

So calcification in plaques is a good thing, in the sense that it keeps the plaques from causing problems elsewhere in the body, but it would be better if there were no need for plaques to form in the first place and we could keep our calcium in our bones and elsewhere that it’s needed.

[SomeGuy]

… It’s an assumption that keto “caused” your plaque score; it could just as easily be the result of all those years of high-glucose eating before you started keto.

[lfod14]

Unless you’re a LMHR, what you eat has little to do with it, it’s what your body is doing with it, where you don’t eat fat, your liver makes more.

There’s a handful of interviews on the Ben Greenfield podcast with a doc who has had really good results lowering peoples CAC’s, it is a cocktail of crap, including low dosing 2 different Statins at different times, he’s a cardiologist and very much of the mindset that Statins are WAY over prescribed to people that don’t actually need them, however he doesn’t ignore that they can have there place, and he’s played with his protocol a lot and what he’s doing now has proven to be the most efficacious. They went over what he uses and how he does it. If you searched the podcast for CAC it should come up.

Many say a ton of Vitamin K, but I’ve never seen anybody actually post labs/CAC’s, showing before and afters of how much movement they had, so who knows there.

Have you ever done an NMR / CardioIQ and seen your cholesterol breakdown? Either way you know your CAC, but seeing what your bodys cholesterol makeup is would probably be helpful in the long run.

[PaulL]

These are just my musings and I haven’t researched it, but I’m wondering, do statins actually stop the progression of calcium build up in the arteries?

In fact, there is evidence to suggest that increased calcification is one of the effects of taking a statin. Naturally, statin manufacturers argue that a high level of arterial calcification is a very bad thing, therefore you need to be taking a statin. However, if the statin increases your arterial calcification, that is a good thing.

Moreover, the evidence clearly shows that the more people who take statins, the better the pharmaceutical companies’ executive bonuses are at the end of the year, so we all need to do our duty and take our statins.

[PaulL]

It remains unclear to me why lowering LDL-C would be a healthy choice - regardless of one’s current “Agatston” score (see above comments re: calcium density) - if longevity and reduced CVD risk are the desired outcomes.

It works in the same way as putting your thermometer in ice water lowers your fever.

[PaulL]

According to him, his blood profiles were normal before keto. Again, nothing changed except his diet. Maybe there are other things that contributed to his CAC score that we are not aware of.

Such as, perhaps, the powerful drugs used to treat his bout of COVID?