High cholesterol

[guru]

Just back from docs and, although it fluctuates at each 4 month visit, my cholesterol is still in the high zone after a year of diet change and exercise. Not high enough risk for statins to be prescribed but I asked the doctor about plant sterols I saw in Boots and he said give it a go.

 

So off I went and bought the Blackmores and it’s 650mg twice a day so 1.3g. I’ve been researching more (after seeing the doctor duh) and it says you need 2g for any reduction. Boots uk has high strength 1000mg for twice a day so 2g but not Boots Th. I asked the Pharmacist if I can take 3 Blackmore capsules to get close to 2g but she says no as the label says take only 2 for a reason.

 

Other research tells me I am only going to be getting 300mg from a healthy diet and the maximum a vegetarian would ever likely get is 600mg from their diet which I’m not so still short of 2g.
 
My triglycerides are also high so I though I might give fish oil capsules a go but I’ve read that they can raise ldl cholesterol which is what I’m trying to lower with these plant sterols.

 

Any thoughts on a strategy and if I can ignore Blackmore’s advice and take 3 a day? Thx

 

[ukrules]

7 minutes ago, guru said:

Any thoughts on a strategy and if I can ignore Blackmore’s advice and take 3 a day?

I would ignore it if it's generally accepted that this dosage is normal elsewhere.

 

They do things a little differently in Thailand.

 

For example, when given a course of Amoxicillin antibiotics inside Thailand, you take 4 capsules, that's 2 capsules twice a day. In the UK it's 3 capsules per day - never 4 and you take one every 8 hours. That's quite a difference there for the exact same drug.

 

These are enforced like laws but in reality it's just a guideline.

 

[Why Me]

6 minutes ago, guru said:

Not high enough risk for statins to be prescribed

Interesting, I thought statins were the go-to drug even for borderline high cholesterol. Which was my case and I've been taking 10mg/day for years with pretty good results, no discernible side effects and it's cheap.

 

Maybe the gold standard has changed. I'll be curious what Sheryl says.

[beachproperty]

There is a new drug call Vascepa (its a refined fish oil with epa only) in the USA. Its the safest drug for heart disease. Although the courts said in is not a drug because its "obvious".  Not sure if its available in Thailand

[xylophone]

1 hour ago, guru said:

Any thoughts on a strategy and if I can ignore Blackmore’s advice and take 3 a day? Thx

I'm not a fan of Statins, so I take a phytosterol complex which contains beta-sitosterol, campesterol and stigmasterol in a combination tablet from iHerb called "Mega strength Beta Sitosterol" (one twice daily, although it says one tablet three times daily).

 

Just yesterday I had my HDL and LDL levels tested and they were the best they've ever been and I put it down to these plant sterols, which I initially tried in order to assist with a prostate problem, and that also seems to work.

 

There's been quite a lot of research done on plant sterols with regard to cholesterol levels and the results were favourable, and that's why it has been used in butter/margarine type products, drinks and yoghurt products as well.

 

It wouldn't hurt to give it a try and I certainly haven't had any adverse effects from taking it for a couple of years now, and some.

[ExpatOilWorker]

Do you mind sharing your actual cholesterol numbers?

 

I am at 240/60 (Total/HDL), so also a bit high, but 4:1 ratio is still kind of OK.

[ChouDoufu]

2 hours ago, guru said:

I asked the Pharmacist if I can take 3 Blackmore capsules to get close to 2g but she says no as the label says take only 2 for a reason.

 

what reason, other than that's what was printed on the store brand labels?  real trained pharmacist?

boots carries (on the interwebs) 650mg and 1000mg strength versions.  for reasons.

 

both come with warning "Consumption of more than 3000 mg per day of added Plant Sterols should be avoided."

 

i've been using simvastatin for two decades with no side effects.  various brands, in thailand took bestatin, 15-30 mg/day depending on results of latest test.

[xylophone]

26 minutes ago, ExpatOilWorker said:

Do you mind sharing your actual cholesterol numbers?

 

I am at 240/60 (Total/HDL), so also a bit high, but 4:1 ratio is still kind of OK.

No problems with sharing my cholesterol numbers with you....... 

 

My cholesterol figures were split between HDL, LDL, and triglycerides without giving a total, which appears to be the latest way to measure them.

 

My HDL cholesterol was 42 mg/dL.

LDL cholesterol was 110 mg/dL.

And my triglycerides which have traditionally been extraordinarily high have come back to 217 mg/dL, which is not surprising given the amount of chocolate and sweet things I consume, and I discussed this with the heart specialist and he said that this level would not be a worry, however did advise to try and cut back on the chocolate a little (sad to say).

 

PS. Just noticed on the sheet that total cholesterol is 195mg/dL with an SI Unit of 5.

[Amusements]

Apparently Almonds are good for lowering cholesterol, followed by walnuts and cashew nuts. 

[guru]

On 12/18/2020 at 6:30 PM, ChouDoufu said:

 

what reason, other than that's what was printed on the store brand labels?  real trained pharmacist?

boots carries (on the interwebs) 650mg and 1000mg strength versions.  for reasons.

 

both come with warning "Consumption of more than 3000 mg per day of added Plant Sterols should be avoided."

 

i've been using simvastatin for two decades with no side effects.  various brands, in thailand took bestatin, 15-30 mg/day depending on results of latest test.

Yes it was the Boots trained pharmacist I asked. I did point out the high strength 2 per day 1000mg Boots UK ones on my phone but she said Blackmores have written 2x 650mg a day for a reason saying perhaps there’s others ingredients in there which would be too much at 3 per day. On the side of the bottle the only active ingredient mentioned is plant sterols. I guess she was covering her back and if you are a vegetarian you could be hitting 2000mg with 2 of these capsules and your usual diet. I have started taking 3 a day = 1950mg + a non vegetarian diet giving around an extra 300mg so I hope its ok as still below 3000mg. Docs again in 4 months and re-tune from there I guess. 

[DavisH]

On 12/18/2020 at 6:37 PM, xylophone said:

No problems with sharing my cholesterol numbers with you....... 

 

My cholesterol figures were split between HDL, LDL, and triglycerides without giving a total, which appears to be the latest way to measure them.

 

My HDL cholesterol was 42 mg/dL.

LDL cholesterol was 110 mg/dL.

And my triglycerides which have traditionally been extraordinarily high have come back to 217 mg/dL, which is not surprising given the amount of chocolate and sweet things I consume, and I discussed this with the heart specialist and he said that this level would not be a worry, however did advise to try and cut back on the chocolate a little (sad to say).

 

PS. Just noticed on the sheet that total cholesterol is 195mg/dL with an SI Unit of 5.

Do you exercise at all? My cholesterol levers are on the high side too. However, after my first set of measurements a couple of years ago, I started exercising and lost weight (but during this time I developed a kidney stone that decided it would take months to pass (came out eventually). Anyway, me triglycerides went from 160 to below 80 (and a later measurement was even lower). I've put weight back on now, but still do running (<deleted> diet hehe). So maybe try exercise if you don't already. Ok, I better get out and run now! It's that time.

[guru]

2 hours ago, DavisH said:

Do you exercise at all? My cholesterol levers are on the high side too. However, after my first set of measurements a couple of years ago, I started exercising and lost weight (but during this time I developed a kidney stone that decided it would take months to pass (came out eventually). Anyway, me triglycerides went from 160 to below 80 (and a later measurement was even lower). I've put weight back on now, but still do running (<deleted> diet hehe). So maybe try exercise if you don't already. Ok, I better get out and run now! It's that time.

I do exercise but I admit that I could do more. My triglycerides have been in the normal window for the last 3 visits but my ldl cholesterol is the stubborn one and hasn’t got in to the normal window all year. Hdl cholesterol always normal. 

[xylophone]

14 hours ago, DavisH said:

Do you exercise at all? My cholesterol levers are on the high side too. However, after my first set of measurements a couple of years ago, I started exercising and lost weight (but during this time I developed a kidney stone that decided it would take months to pass (came out eventually). Anyway, me triglycerides went from 160 to below 80 (and a later measurement was even lower). I've put weight back on now, but still do running (<deleted> diet hehe). So maybe try exercise if you don't already. Ok, I better get out and run now! It's that time.

Thought about exercise but at 73 have had many broken bones and muscle injuries through sport, running and so on can be a pain!

 

Was very fit as a young man, but now a sedentary life and learning to relax.

 

Thanks for your post and advice.

[Sheryl]

21 hours ago, guru said:

I do exercise but I admit that I could do more. My triglycerides have been in the normal window for the last 3 visits but my ldl cholesterol is the stubborn one and hasn’t got in to the normal window all year. Hdl cholesterol always normal. 

 

note that if your triglycerides are low, indirect measures of LDL (which is what they usually do) is inaccurate.

 

You might like to get a direct LDL done.

 

What is your cholesterol ration (total cholesterol: HDL)?

 

 

[guru]

2 hours ago, Sheryl said:

 

note that if your triglycerides are low, indirect measures of LDL (which is what they usually do) is inaccurate.

 

You might like to get a direct LDL done.

 

What is your cholesterol ration (total cholesterol: HDL)?

 

 

Total choles:HDL 4.7 (0-4.6)

triglycerides 130.7 (0-150)

LDL choles 172.4 (0-130)

HDL choles 52.2 (>40)

 

How do I know if this is an indirect or direct measure of LDL? 

[Sheryl]

12 hours ago, guru said:

Total choles:HDL 4.7 (0-4.6)

triglycerides 130.7 (0-150)

LDL choles 172.4 (0-130)

HDL choles 52.2 (>40)

 

How do I know if this is an indirect or direct measure of LDL? 

Most are.

 

But your triglycerides are not unusually low so probably not an issue.

 

Your LDL is in the high range, not borderline high but high.  And your ratio while OK is far from great, it is preferred to be below 3.5

 

If you cannot get it down by other means might need to consider medication. Make sure the diet changes you have made are the right ones, Thai doctors tend to give outdated recommendations. Avoiding processed carbs and consuming  a lot of  fiber are at least as important as reducing staurated fat intake if nto more so.

[guru]

1 hour ago, Sheryl said:

Most are.

 

But your triglycerides are not unusually low so probably not an issue.

 

Your LDL is in the high range, not borderline high but high.  And your ratio while OK is far from great, it is preferred to be below 3.5

 

If you cannot get it down by other means might need to consider medication. Make sure the diet changes you have made are the right ones, Thai doctors tend to give outdated recommendations. Avoiding processed carbs and consuming  a lot of  fiber are at least as important as reducing staurated fat intake if nto more so.

Thank you Sheryl, I will certainly do that.

 
Any thoughts on these plant sterols to help me a long? I’m a little nervous as my research suggests that although they can lower my LDL cholesterol , the plant sterols themselves could accumulate themselves in my arteries leading to heart problems ? 
 

Also, if I can’t sort it out myself, could statins be a temporary solution to lowering my ldl choles, a kick start if you like, whilst I adjust my diet, health and lifestyle? 

At the moment, the doc plugged my numbers into his computer software and it churned out a 2% risk of a heart event and said try and sort it out yourself first before I prescribe statins. 
 

 

 

 

[Sheryl]

4 minutes ago, guru said:

Thank you Sheryl, I will certainly do that.

 
Any thoughts on these plant sterols to help me a long? I’m a little nervous as my research suggests that although they can lower my LDL cholesterol , the plant sterols themselves could accumulate themselves in my arteries leading to heart problems ? 
 

Also, if I can’t sort it out myself, could statins be a temporary solution to lowering my ldl choles, a kick start if you like, whilst I adjust my diet, health and lifestyle? 
 

 

1. I have never heard this and it is difficult to imagine how it would be possible. What plant sterols c an do is interfere with absorption of fat soluble vitamins like A and D.

 

This is a good write up  https://www.bda.uk.com/resource/food-facts-plant-stanols-and-sterols.html

 

2. It is difficult to get off stains once you start as there is a rebound effect. Note that statins are nto the only drugs that lower LDL. Niaspan (immediate-release high dose niacin) for example.

[Lazy Sod]

Slightly off topic, but it might help someone. I’ve no option but to take statins as my LDL is 230. Was suffering side effects, especially aches, but this local brand of CoQ10 has made a big difference. 
 

[xylophone]

22 minutes ago, Lazy Sod said:

Slightly off topic, but it might help someone. I’ve no option but to take statins as my LDL is 230. Was suffering side effects, especially aches, but this local brand of CoQ10 has made a big difference. 
 

I also take CoQ10 on a daily basis and get mine from iHerb or Healthpost (NZ).

[cooked]

1 hour ago, xylophone said:

I also take CoQ10 on a daily basis and get mine from iHerb or Healthpost (NZ).

Statins interrupt your body's natural production of Coq10 (amongst other things) which is why it may help. Why not just eat turmeric and garlic?

[xylophone]

2 minutes ago, cooked said:

Statins interrupt your body's natural production of Coq10 (amongst other things) which is why it may help. Why not just eat turmeric and garlic?

Have taken CoQ10 for years and don't take statins, so all is well.

[guru]

6 hours ago, Sheryl said:

 

1. I have never heard this and it is difficult to imagine how it would be possible. What plant sterols c an do is interfere with absorption of fat soluble vitamins like A and D.

 

This is a good write up  https://www.bda.uk.com/resource/food-facts-plant-stanols-and-sterols.html

 

2. It is difficult to get off stains once you start as there is a rebound effect. Note that statins are nto the only drugs that lower LDL. Niaspan (immediate-release high dose niacin) for example.

Thanks Sheryl. I will go with the Bda link you provided but the information I read which had me worried was from this link:

https://www.healthline.com/nutrition/phytosterols-good-or-bad#risks

 

“Numerous human studies link high phytosterol intake with an increased risk of heart disease (9Trusted Source, 10Trusted Source, 11Trusted Source).

Additionally, among people with heart disease in a large Scandinavian study, those with the most phytosterols were most likely to get another heart attack (12Trusted Source).

In another study in men with heart disease, those with the highest risk of heart attack were at three times greater risk if they had high concentrations of phytosterols in the blood (13Trusted Source).

What’s more, studies in rats and mice show that phytosterols increase plaque buildup in the arteries, cause strokes, and shorten lifespan (14Trusted Source, 15Trusted Source).

Even though many health authorities like the American Heart Association still recommend phytosterols to improve heart health, others disagree.

For example, Germany’s Drug Commission, France’s Food Standards Agency (ANSES) and the UK’s National Institute for Health and Care Excellence (NICE) all discourage the use of phytosterols for heart disease prevention (1Trusted Source, 16).”