Be warned! I was very hot when I wrote this in 2013. I can be intemperate at times,
and plain spoken, as for example when I refused the recommendation of an
endocrinologist given to me over the phone by his nurse. When she told me that
the doctor suggested I “try” a statin, I told her “the doctor really should be
ashamed of himself.” The next morning the doctor called me at 7:30 AM, saying I
had hung up on his nurse.
That was not
true; she hung up on me after I made that comment. Apparently,
she hadn’t told him what I’d said, leaving it to me to tell him directly. It
added fuel to the fire. He then calmly told me that the LDL value in my Lipid
Panel was high and that both the ADA and the AHA guided that my LDL should be below
100mg/dl. I told him that I didn’t care what the ADA and the AHA guidelines
said. I then went into a bit of a harangue about Ancel Keys, and suggested the
doctor really should “go back to school.” That did it! He declared, “You need
to find a new doctor.
I don’t apologize for what I said. I had high
hopes that I would find an endo who was enlightened. I haven’t seen an endo in
25 years, seeing only an internist/cardiologist. I failed to find one this time,
but it was entirely my fault.
Of course, I could have accepted the prescription
he offered and then refused to fill it. Then the doctor could simply have
written in my chart that I was “non-compliant,” like all the other “old people”
(his PA told me) who “don’t care about their health.”
That’s what she said when I asked her why other
patients didn’t follow her recommendation to eat Low Carb. She eats about 60
carbohydrate grams a day. I eat about 15, for glucose control. I am a long-term
Type 2 diabetic.
Anyway, in reaching my latest level of
self-assurance (arrogance?) about optimal blood lipid levels, I had a fresh
recollection of Chapter 41, “Blood Lipids,” in “Perfect Health Diet” (Scribner,
2012), a very good book by Paul and Shou-Ching Jaminet (both PHDs). It is only
“background” material for most Type 2s, and they do get “into the weeds” a bit,
but I like their approach to healing – finding the root causes rather than treating the symptoms.
Chapter 41 has the following sub-sections: “Optimal
HDL Levels,” “How to Raise HDL Levels,” “The Immune Functions of LDL,” “Optimal
Blood Lipid Levels,” and “Troubleshooting Blood Lipids.”
From page 366, here’s what the Jaminets have to
say about the optimal blood lipid (cholesterol) levels: “The ideal serum lipid
profile that produces the best health and minimizes mortality – looks like
this:
·
Total Cholesterol
level between
200 and 260 milligrams per deciliter
·
LDL Cholesterol
level above 100
milligrams per deciliter
·
HDL Cholesterol
level above 60
milligrams per deciliter
·
Triglyceride level around 50 to 60
milligrams per deciliter”
How did my lipid profile compare to the Jaminet’s
ideal? Here’s the endo’s lab report for my serum lipid profile:
·
Total Cholesterol
level = 245
·
LDL Cholesterol
level = 176
·
HDL Cholesterol
level = 58
·
Triglyceride level
= 54
Okay, my LDL (176) was high – the highest
it has ever been (since 1992,
when lab reports first starting calculating LDLs). And my Total Cholesterol (245),
was the highest ever, going
back 40 years to 1974. I am
comforted, however, by the knowledge that my TG/HDL ratio was 0.93, which is
<1.0 and therefore “ideal.” Altogether, though, as the endo told me, my
lipid profile did not fit the ADA and AHA guidelines. I wonder what the Jaminets
would have said?
And for the record, my latest (April 2019) lipid
panel was: TC = 186; HDL = 80; TC/HDL ratio = 2.3; LDL = 92; non-HDL 106 and
triglycerides (TG) = 56. TG/HDL ratio = 0.70. And that was BY DIET ALONE. I
DO NOT TAKE STATINS.
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