Long term effects of high LDL without any other health issues

cholesterol
evidence
ldl
(Bob M) #11

Again, don’t get too excited about Lp(a) (or ApoB for that matter). My last two Lp(a) tests:

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Those levels are somewhere around the top something % of people (the “something” changes depending on study). And I have around that value for the last 10 years, since I got the value tested.

After 5.5 years, my CAC scan score was zero. At least from a “hardened” atherosclerosis as measured by CAC scan, Lp(a) doesn’t seem to be causing this.

Moreover, there’s not much you can do about high Lp(a). Statins increase Lp(a), at least in some studies. You can take a PSCK9i, but even these only lower it so much, maybe 27% or so:

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.037184

But take a look at this figure from the supplementary material:

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If Lp(a) was the deadly killer it’s supposed to be, this shouldn’t be a flat line, which is basically what it is. Ref is the lowest decile, and only two lines are above that.

As for ApoB, I know one can find studies where ApoB is a terrible marker. I was following someone on Twitter who had a ton of studies showin ApoB was not a great marker. Unfortunately, I don’t remember who this was and can’t find his information.

#12
#13

https://www.sciencedirect.com/science/article/pii/S1043661823002293#:~:text=From%20this%20perspective%2C%20apoB%20is,%2C%20metabolic%20syndrome%2C%20insulin%20resistance%2C

(Denise) #14

I’m kind of laughing, but at myself, believe me :sweat_smile: I have/had super high, and I mean high cholesterol since before I ever got on Keto. I remember one time it was 300, and I went on this Oatmeal and niacin thing, it went down very little. Got on Keto, January will be 4 years, and my last Lipid Panel, total cholesterol was 500 something.

I’ve been told so many times if my Trigs/HDL are good, mine are still good at 1.5, not to even worry about the high LDL. So I pretty much forgot about it altogether. My MD, and Cardio NEVER forget about it but I won’t take their 'statins so they probably just write me off :wink: They’re stupid in my opinion because they just ignore the tests that come back “clean” but still want to pump me full of Big Pharma’s drugs. No way.

I’m 71 and the only real dangerous health issue has been T2 Diabetes I was diagnosed with, which helped me to find Keto, and haven’t had any A1c’s over 6.0. I also don’t have any other issues, but had to have a pacemaker put in '97. I’ve had every test pretty much, no clogged arteries, not heart issues except what they call a 3rd degree AV node block. That’s the electrical part of my heart.

I think I still have my last copy of Lipid Panel I’ll put at the bottom. But I’m honestly a very active senior lady at 71. I workout at least 5 days a week with Resistance bands, and when weather is better I walk at about 4 miles an hour. I am 5’2", 112 lbs, building muscle.

I suppose time will tell for me personally, everyone is different, but people like Dr. Ben Bikman, Dr. Ken Berry, are my go to’s about cholesterol, also I like Diet Doctors on Youtube. For now, I just don’t see my ridiculously high cholesterol as being any problem for me.

Glad you found the site, welcome, and doing Keto I believe, has given me a ton of quality of life :wink: Denise PS Just might leave my body to Science, I’d probably end up at Area 51 so no one could know the truth.

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#15

Did you read the conclusion of the study you quoted?
For reference here it is:

"Conclusions:
Higher levels of Lp(a) are associated with an increased risk of cardiovascular events in patients with established cardiovascular disease irrespective of low-density lipoprotein cholesterol. Evolocumab significantly reduced Lp(a) levels, and patients with higher baseline Lp(a) levels experienced greater absolute reductions in Lp(a) and tended to derive greater coronary benefit from PCSK9 inhibition."

(Joey) #16

@Stefana If you haven’t already seen this video (recently posted again by @Goldengirl52) have a look as it addresses your initial concern expressed in this thread…

(You've tried everything else; why not try bacon?) #17

Congratulations! Those are excellent results. Your ratio of triglycerides to HDL is 0.7, which is fantastic. No risk of cardiovascular disease. With such a great ratio, your LDL number is irrelevant, and if you had an NMR done of the particle sizes, they would most definitely fall into the healthy Pattern A.

I don’t know what my LDL is currently. It was 148 last time it was checked. My current doctor refuses to order a lipid panel, I suspect because he doesn’t want to have to go through the charade of trying to prescribe a statin, and my having to refuse it. (He knows I’m keto and supports it.)

In 2018, the limit for LDL was 150 (and it used to be much higher before that), but I understand that the statin manufacturers now recommend treating patients with LDL over 90. It’s pretty clear that LDL level does not cause cardiovascular disease, so I refuse to worry. In fact, several large, well-funded studies have shown an inverse correlation between LDL level and cardiovascular disease, or between LDL level and all-cause mortality, so it certainly appears that high LDL may very well have a protective effect, especially in women over the age of 50.

Studies of people with familial hypercholesterolaemia have shown that it isn’t the high LDL that is the problem, it’s whether people also have genetic variants of fibrinogen and clotting factor VIII that make their blood readier to clot. These genes tend to associate with the gene for FH, but only half of the FH population has them. The people with FH who don’t have those variants live long lives and die of causes other than cardiovascular disease. In fact, one study showed that people with FH who live into their 70’s have a higher life-expectancy than the general population.

Dave Feldman and his team are currently running a study designed to test the hypothesis of whether LDL in lean patients is a cardiovascular risk or not. The early data look promising. Their LMHR’s all have very high LDL levels, yet their CAC scores are very close to 0, if not actually 0. And even the most die-hard statin advocate is forced to admit that a CAC score under 100 is a contra-indication for taking a statin.

Personally, I value my brain function and my muscles too much to want to put them at risk by taking a statin. I would prefer to be cognizant and functional right up till the fatal heart attack (if any), than to live a longer life of dementia and physical incapacity. I have also reversed my pre-diabetes and don’t want to put myself at risk of diabetes again.

(Stefana) #18

Thanks will do!!

(Stefana) #19

Thank you for your comment :heartbeat::heartbeat::heartbeat:

(Stefana) #20

Thank you for your response :heartbeat::heartbeat::heartbeat::heartbeat:

(Joey) #21

I wish this were true, but I’d propose this clarification …

My understanding of the results as presented is not that LMHRs have lower CAC scores eating carb-restricted diets than other (well-matched) cohorts (participants in the Miami study) … it’s that they are effectively no different.

Some have higher CAC scores, some do not. There’s a range that’s roughly equivalent to the range of those who do not eat keto-style diets. The CAC score distributions of the (carb-restricted) LMHRs vs non-keto Miami study subjects were statistically no different.

This does allow us to conclude that high LDL attributable to low-carb eating does not (over the timeframe studied) cause elevated CAC scores. But I believe that’s about as far as we can go. :thinking:

(Bob M) #22

The other thing is that there was no relationship between whatever you get from their fancy test and LDL. That is, if LDL (or ApoB or whatever is the deadly lipid-du jour) is causing atherosclerosis, then higher LDL should mean more calcified and non-calcified plaque. But that doesn’t appear to be the case.

Meaning that something else is causative.

Something I’ve always wondered. Say we find a “cause”. If there were two people, one with LDL of 250 and one with LDL of 500, and they have the exact same “level” of the “cause”, would the person with LDL of 500 have twice the atherosclerosis of the person with LDL of 250? My guess: no. But I’m not sure.

(You've tried everything else; why not try bacon?) #23

Sorry to be unclear, so thanks for the clarification.

All I really meant to say or imply was that they didn’t have any calcification–yet. We’ll see what the results are when everyone is re-checked in a year’s time.

(You've tried everything else; why not try bacon?) #24

Well, I’m sure that the answer is no, but of course, that’s based on a complete and utter absence of evidence. :grin: :bacon:

(Bob M) #25

Well, the only reason I’m suggesting otherwise (because I think you’re correct), is because of studies of Lp(a). If you have something wrong with you, people with higher Lp(a) tend to have worse outcomes. Now, Lp(a) is different from LDL, but maybe something could be said for more LDL = “better” repair, which means more atherosclerosis.

I can’t figure out how you’d ever test this, though.

(You've tried everything else; why not try bacon?) #26

That’s the problem with so many questions in health and nutrition. :cry:

(Denise) #27

not just questions either, it’s the lack of interest so many people show in nutrition, and because of that they’re health can be failing. I was with a gal lastnight helping her figure out what the pills she has piled up from her doctor as she’s sick, and all they do is give another pill which is probably to try and “fix” the previous pill’s side-effects :worried: Of course all she can do is talk to her doctor, I told her she needs to ask the questions she’s asking me, to her doctor instead :frowning:

(B Creighton) #28

Welcome Stefana. Taking medications is always a personal choice. My personal belief is that medicines can be OK on a temp basis for pain, infections, etc, but I think our society has become far too dependent on them to manage chronic “disease.” I too plan not to take any medications on a chronic basis. A few years back I got up to about hypertensive levels, where BP medicines get considered. Rather than just rely on that, I decided to try to lose weight and change my health, which is how I fell into keto, low carb, and this forum. People here have been very inspiriing and helpful, especially for my wife.

Anyway, your labs are great from a 1970s perspective when LDL of 300 was the upper limit of normal, and before statins were invented. Trigs normally go down on low carb, which I believe all doctors would say is good. The only thing they are triggered on is the LDL of 220 as now that is considered “higher” than normal. I personally wouldn’t worry about a LDL particle test. I believe that is a red herring. For two years now I have ordered an oxLDL test, but this year Labcorp stopped offering it, and I had to get it elsewhere on my own… it was 47… about half of last year. I believe the quality of my LDL is much more important to heart disease than the quantity… you can read about studies etc on my thread in this forum here: Discussion of dietary cholesterol and cardiovascular disease
I believe the number of LDL particles is only important to the extent that means there is more LDL to potentially become oxidized on a bad/SAD diet. So, my answer was to correct my diet… and my blood pressure dropped 40+ points from before I began, my varicose vein pain has gone away as well as some of the spider veins in my foot. I would have no objections to a CAC test… maybe that would relieve their concerns, and it would give you a good baseline to measure against future possible issues. I kinda wish I had one as I believe I have reversed some CAD, but don’t have much objective evidence to prove that.

(Stefana) #29

Thank you for your response!
And yes I agree this forum is full of encouraging and well educated people, I’m happy to have found it :hugs:

(Denise) #30

Can anyone tell me why a doctor would give a patient a statin when their total cholesterol is 179?

Their trigs are 59

Hdl 91

so I get .64 ratio

She’s 81 and even her NP told her she should take the statins, 2 kinds, because her numbers too high for “bad cholesterol” as they put it. I saw the printed out reports from the doctor, so no confusion possible. Denise