Monday, May 13, 2019

Retrospective #87: Optimal Blood Lipid Levels

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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