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Cholesterol Way Too High ?


miodo2009

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Out of the blue I got the message that my sugar (126), cholesterol (304) and Triglyceride (758) are way too high. The doctor prescribed me Bezalip 200 mg and Aspent 81mg.

I've been told that I have to take medicines for this condition for the rest of my life and I'm still quite a young fellow in my fifties.

Is there an alternative to these medicines or are these medicines my best option ?

Edited by miodo2009
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Have you done anything to research the medication, options, or changes you can make to possibly alleviate the conditions? For example "Aspent" is aspirin. THere is a lot of information available, including medical protocol options, and it would behoove you to take advantage of the internet.

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Out of the blue I got the message that my sugar (126), cholesterol (304) and Triglyceride (758) are way too high.

What is your LDL (bad cholesterol) reading and your (HDL) good cholesterol reading?

Low HDL to high trygliceride ratio is important to know.

The doctor prescribed me Bezalip 200 mg and Aspent 81mg.

I've been told that I have to take medicines for this condition for the rest of my life and I'm still quite a young fellow in my fifties.

Is there an alternative to these medicines or are these medicines my best option ?

Doctors first jump to medicine. Always the case.

Youl could try modifying your diet first, and if it doesn't work, then go to meds.

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Out of the blue I got the message that my sugar (126), cholesterol (304) and Triglyceride (758) are way too high.

What is your LDL (bad cholesterol) reading and your (HDL) good cholesterol reading?

Low HDL to high trygliceride ratio is important to know.

The doctor prescribed me Bezalip 200 mg and Aspent 81mg.

I've been told that I have to take medicines for this condition for the rest of my life and I'm still quite a young fellow in my fifties.

Is there an alternative to these medicines or are these medicines my best option ?

Doctors first jump to medicine. Always the case.

Youl could try modifying your diet first, and if it doesn't work, then go to meds.

My HDL (ggod cholesterol) is 30, so too low. For a reason unknown to me they didn't measure LDL-C.

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Assuming these lab values are reliable and were done in a fasting state, you actually have 2 conditions:

1) Mild type 2 diabetes. There does not seem to have been any treatment prescribed for this; it should be handled first by dietary and lifestyle changes along with blood test called Hb AC1 every few months to make sure these are doing the trick. Fortunately the diet and lifestyle changes needed are similar to those required for your second problem:

2) Hyperlipedemia - as one poster remarked, total cholesterol levels are less important than the HDL and LDL levels. However regardless of what those are, with triglycerides that high, you clearly have a problem and a fairly substantial one at that. Diet and exercise may help but medication may also be necessary. There are a variety of medications which can be used, the one you were put on is in a group called fibric acid derivatives. There are also different types of hyperlipedmias some of which respond more to diet than others. More detailed blood tests than what you seem to have had done are ion order to determine exactly what type of hyperlipidemia you have and the best course of treatment. A possible alternative drug would be nicotinic acid (niacin, one the B vitamins) in high dose sustained release form. Also, fish oil supplements and increased food intake of Omega 3 fats is helpful.

The combination of elevated lipids and mild diabetes puts you at above average risk of heart disease and you should have a good cardiovascular evaluation including a stress test. Also, from what you report of the treatment you were given -- especially the lack of counseling on diet and lifestyle and the lack of attention to the diabetes -- I think you would be well advised to consult an internists specializing in these conditions, preferably one trained in the west and thus socialized to involving the patient in treatment decisions and providing clear explanations and options. There are plenty of same to be found in Bangkok. Look for someone with board certification in Internal Medicine and/or endocrinology in a western country and a special interest in "metabolic syndrome" . Depending on your weight and waist circumference and the HDL/LDL breakdown you may met the diagnostic criteria for this.

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Thanks Sheryl and others for excellent and useful information.

Although the test was being done by a hospital with a certain standing, I will let another lab do the same test again. Till then, I won't take any medication. Actually, the possible side effects scare me off a bit.

Still wondering, are there people with a more or less alike condition ? How are they dealing with it, using regular or alternative medication ?

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Out of the blue I got the message that my sugar (126), cholesterol (304) and Triglyceride (758) are way too high.

What is your LDL (bad cholesterol) reading and your (HDL) good cholesterol reading?

Low HDL to high trygliceride ratio is important to know.

The doctor prescribed me Bezalip 200 mg and Aspent 81mg.

I've been told that I have to take medicines for this condition for the rest of my life and I'm still quite a young fellow in my fifties.

Is there an alternative to these medicines or are these medicines my best option ?

Doctors first jump to medicine. Always the case.

Youl could try modifying your diet first, and if it doesn't work, then go to meds.

Hi Miodo2009

Your lipid profile are way too high as you have mentioned. You probably suffer from dizziness or light headache as well??

How is your blood pressure? what is your weight and BMI?Do you smoke? If you do smoke, have high BMI, and high blood pressure(over 140/90)then it is very risky for stroke and heart attack.

Sorry did not mean to scare you but those numbers are really high and you should take immediate action which is definitely medication plus life style modification. Once your cholesterol drop, you may consult your doctor to reduce the dosage of medication you take.

If you doubt about the lab results, you may get it done ASAP and tell them to do direct test on LDL because your triglyceride is too high so they could not calculate LDL-C. ( Google LDL calculation)

Most of doctors would prefer statin group over other lipid lowering agents unless coontraindication/allergy off course.

For alternative treatment, Plant sternal, B3, Fish oil are good. Becareful with B3 though, it can cause hepatitis as well. You may need doctor/health care professional advise on starting dose to minimize the adverse reaction.

Avoid high saturated fat products,Ssea food, eggs, high cholesterol food,fried food. Steamed, BBQ, Griiled, Boiled food are good. Lots of vegetable and whole grain meals are helpful to lower your cholesterol.

Avoid too much sweat fruit due to high blood sugar. You may want to read about DASH diet which is recommendation for high blood pressure but it is excellent advise for high cholesterol too.

Reduce your weight if you are over weight,regular aerobic excercise will help you burn the sugar and cholesterol as well as lower your blood pressure.

When you are on Statin, liver function test should be checked every few mounths.

Lots of people on statin for years with no problem. Do not wait.

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Nutrition, nutrition, and nutrition.

As someone mentioned earlier, your LDL/HDL ratio is important. As for your triglycerides and sugar levels, I wouldnt worry about it. You can easily get that lowered through nutrition.

It might seem like im preaching to the choir here but eat tons of vegetables, limit fruit, eat chicken, fish and limit rice, pasta, breads. Rice and noodles will be hard here in Thailand but it can be done.

Absolutely no processed junk, no fast food, no soft drinks ie. Pepsi, sprite which contain HFCS.

And lastly exercise. If you dont exercise then start off slow and work your way up.

Good luck.

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Actually, my life style isn't that bad : I don't smoke or drink and do exercises everyday, except Sundays.... And although I don't pay too much attention to my diet, I guess it wasn't that bad either. My blood pressure seemed to be alright the time I went to see the doctor.

The reason why I went to see a doctor was dizziness, which I had since about 2-3 weeks after having encountered motion sickness during a journey in the curved mountains of one of Indonesia's islands.

Thanks again.

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I had cholesterol more in the 400 's and when I was 50 I eventually went to a GP who managed to make me understand I had to address the problem. He gave me a choice of either diet or medication upon my insistence, since he didn't believe I could change my diet ; truth is I was very unaware for years of dietary principles. It was very demanding as to ANIMAL FAT , I had to all but forget about : milk, yoghurt, cheese , butter , cream ; eggs; fatty meats ( I now have little meat, I cut off ALL of the fat in servings of meat , and if i have fried chicken , from somebody's kitchen, I carefully peel off the juicy, crusty skin, which is frustrating). Have olive oil ; avoid palm oil.

Any processed cake or whatever is full of the wrong kind of fats ; you'll have to learn about this , check the small letters on packages.

sugar you don't burn becomes fat .

omega 3 is at a premium for us .But some fish oil in whatever form won't be enough to do the trick .

So I finally managed to have my cholesterol down to the 200's .

And my GP carried on a bit since I had become real skinny , the thing made me anorexic for a while . I went up to the 250's and he says that's all right for a man of 56 (average readings are for younger people).He 'd much rather I took some pills I think , since I appear to manufacture my own bad cholesterol from inside , I'd say the result of bad former diet.

I repeat, this diet is quite a job and is socially difficult ; it's very much like quitting the ciggy .Seems to me starting from 300 you can make it with more ease than me .

At the moment I have another condition which makes

cholesterol secondary ; I have reasons to believe smoking, drinking , and too much cheese on top of the butter didn't help me stay in top shape .

As to sugar my father in law was in the hospital in Chiang Maï with lots of diabetes, and my ex wife, who had to monitor her own during preggie so knew about it , had to do the readings of the analysis for him over the phone, since she said they didn 't do it right at the hospital ; she later gave him a little prick- your- finger- yourself gizmo to monitor his sugar.

A friend of mine with a serious case of II diabetes and medical background told me I should be careful with sugar for my son with this heredity" so that if he gets it later it will be milder "; I gather that after a certain level insulin is in order , so you're right to inquire about your analysis readings .

Edited by souvenirdeparis
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Today I went to another hospital, also with a certain standing to do the same blood tests as a few days ago, see my original post. Most results were more or less the same, except for the Triglyceride, which was decreased from 758 on Friday to 528 today.. I did the same fastening process for both tests, so that can't be an influence. 528 is still too high, but a difference of 230 in 3 days is quite a lot, or not ?

I'm also writing this because I have to decide whether or not I should take medicines. I'm not against regular medicines, but with my rather sensitive body I'm afraid my liver will get damaged, if I have to take these medicines for the rest of my life. So, is it really such a bad idea to start with a good diet first ? I much prefer this above taking medicines. But I know from experience most doctors only see medicines as the golden way, some of them maybe even don't know enough about alternative ways to solve this diabetes-cholesterol problem.

So again, with these results : Sugar 126, Cholesterol 304, Triglyceride 528 (Today), HDL,30 is it preposterous to even think about a healthy diet first before starting to take medicines ?

Edited by miodo2009
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I also have high cholesterol (212). I'm quite thin, exercise a lot, work outdoors every day, nearly 60 yrs.

A lot of the advice within this post appears on the mark. I steer clear of pills as much as possible. My mom sent me some cholesterol pills, I took one, it messed up my BM for a day - tossed the rest of the pills in the wastecan. also recommend avoiding sugar and too-sweet fruits (watermelon comes to mind), and take the skin off chicken, and avoid pastries and sodas. Residing in Thailand makes things somewhat difficult, when trying to stick with a healthy diet. Dearth of avocados, 100% fruit juices a rarity, same for 100% vege juices. In my town, there's just one place which has carrot juice (20 baht). It's funny, when I first came to Thailand, between 10 and 20 years ago, a person could get V-8 juice in any mom and pop store. Now you can't, but instead, everything except water has loads of sugar or fermented sugar. The trend in Thai food and available drinks is away from what's healthy, and steadily downhill toward debilitating items. It's particularly important for anyone who's watching over kids. Get them started on relatively healthy eating/drinking habits. I know it's not easy, as there is such immense pressure from corporations to compel children to eat/drink the worst stuff.

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I also have high cholesterol (212). I'm quite thin, exercise a lot, work outdoors every day, nearly 60 yrs.

A lot of the advice within this post appears on the mark. I steer clear of pills as much as possible. My mom sent me some cholesterol pills, I took one, it messed up my BM for a day - tossed the rest of the pills in the wastecan. also recommend avoiding sugar and too-sweet fruits (watermelon comes to mind), and take the skin off chicken, and avoid pastries and sodas. Residing in Thailand makes things somewhat difficult, when trying to stick with a healthy diet. Dearth of avocados, 100% fruit juices a rarity, same for 100% vege juices. In my town, there's just one place which has carrot juice (20 baht). It's funny, when I first came to Thailand, between 10 and 20 years ago, a person could get V-8 juice in any mom and pop store. Now you can't, but instead, everything except water has loads of sugar or fermented sugar. The trend in Thai food and available drinks is away from what's healthy, and steadily downhill toward debilitating items. It's particularly important for anyone who's watching over kids. Get them started on relatively healthy eating/drinking habits. I know it's not easy, as there is such immense pressure from corporations to compel children to eat/drink the worst stuff.

I don't think that 212 is too high for a person of your age. That is at least what doctors in Europe would tell you. Thai docs might look at it differently but as long as the HDL-LDL ratio is okay, 212 is really nothing to worry about.

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I also have high cholesterol (212). I'm quite thin, exercise a lot, work outdoors every day, nearly 60 yrs.

A lot of the advice within this post appears on the mark. I steer clear of pills as much as possible. My mom sent me some cholesterol pills, I took one, it messed up my BM for a day - tossed the rest of the pills in the wastecan. also recommend avoiding sugar and too-sweet fruits (watermelon comes to mind), and take the skin off chicken, and avoid pastries and sodas. Residing in Thailand makes things somewhat difficult, when trying to stick with a healthy diet. Dearth of avocados, 100% fruit juices a rarity, same for 100% vege juices. In my town, there's just one place which has carrot juice (20 baht). It's funny, when I first came to Thailand, between 10 and 20 years ago, a person could get V-8 juice in any mom and pop store. Now you can't, but instead, everything except water has loads of sugar or fermented sugar. The trend in Thai food and available drinks is away from what's healthy, and steadily downhill toward debilitating items. It's particularly important for anyone who's watching over kids. Get them started on relatively healthy eating/drinking habits. I know it's not easy, as there is such immense pressure from corporations to compel children to eat/drink the worst stuff.

and add to that the sugar and salt that thais add when cooking.I agree with you cholestorel at 212 is ok.I am looking at my last test and my CHL was 254,4 above the highest limit.my tryglicerides were 167,within range,only just,of 30-170.

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I also have high cholesterol (212). I'm quite thin, exercise a lot, work outdoors every day, nearly 60 yrs.

A lot of the advice within this post appears on the mark. I steer clear of pills as much as possible. My mom sent me some cholesterol pills, I took one, it messed up my BM for a day - tossed the rest of the pills in the wastecan. also recommend avoiding sugar and too-sweet fruits (watermelon comes to mind), and take the skin off chicken, and avoid pastries and sodas. Residing in Thailand makes things somewhat difficult, when trying to stick with a healthy diet. Dearth of avocados, 100% fruit juices a rarity, same for 100% vege juices. In my town, there's just one place which has carrot juice (20 baht). It's funny, when I first came to Thailand, between 10 and 20 years ago, a person could get V-8 juice in any mom and pop store. Now you can't, but instead, everything except water has loads of sugar or fermented sugar. The trend in Thai food and available drinks is away from what's healthy, and steadily downhill toward debilitating items. It's particularly important for anyone who's watching over kids. Get them started on relatively healthy eating/drinking habits. I know it's not easy, as there is such immense pressure from corporations to compel children to eat/drink the worst stuff.

I don't think that 212 is too high for a person of your age. That is at least what doctors in Europe would tell you. Thai docs might look at it differently but as long as the HDL-LDL ratio is okay, 212 is really nothing to worry about.

?? I don't know about your "bad " cholesterol ratio, but really 212 at 60 is quite all right.

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Thanks souvenirdeparis. Could you make the effort and give me an example of your diet ?

I started having salads & tomatoes, which was new to me . For proteins I rely on fish, ie mostly salmon , the frozen sort . I have it in the micro wave, no oil. I used to have ham too . I steam cook all my vegetables, I have leek and cauliflower as much as I can .I buy frozen veggies too, potatoes, whatever, but always plain, never the sort with cream or meat or whatever dressing. olive oil on all . I'm not much of a cook and all this is a bit on the bland side .In the morning I have bread with some honey or jam , no sugar after but for fruit ; sometimes too many apples I must say. I drink coffee in the morning, de- cafeined in the afternoon, water . No booze whatever :) I often add omega 3 butter ersatz .

(At the moment I have to throw in some eggs , butter, chees, yoghurt, if you look up the thread on chemos you'll understand why ;I haven't had cholesterol readings for 9 months since I can't worry about them now (had checks every 6 months before) but this diet worked for me for several years).

By all accounts, the pills for cholesterol are safe . It's easy to lack minerals etc with a hard diet . Try the diet for a few months then check again. Seems to me your cholesterol is not urgent, adress the sugar first.

Edited by souvenirdeparis
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Today I went to another hospital, also with a certain standing to do the same blood tests as a few days ago, see my original post. Most results were more or less the same, except for the Triglyceride, which was decreased from 758 on Friday to 528 today.. I did the same fastening process for both tests, so that can't be an influence. 528 is still too high, but a difference of 230 in 3 days is quite a lot, or not ?

I'm also writing this because I have to decide whether or not I should take medicines. I'm not against regular medicines, but with my rather sensitive body I'm afraid my liver will get damaged, if I have to take these medicines for the rest of my life. So, is it really such a bad idea to start with a good diet first ? I much prefer this above taking medicines. But I know from experience most doctors only see medicines as the golden way, some of them maybe even don't know enough about alternative ways to solve this diabetes-cholesterol problem.

So again, with these results : Sugar 126, Cholesterol 304, Triglyceride 528 (Today), HDL,30 is it preposterous to even think about a healthy diet first before starting to take medicines ?

What is preposterous is to focus on treatment without first having determined what type of dyslipidemia you have. There are many different types and the treatment options differ accordingly. You need to consult an internist who specializes in these disorders. I cannot stress that enough. When you do, s/he will order the appropriate additional lab tests and arrive at a definitive diagnosis at which point the treatment options can be discussed. Depending on which type of lipid disorder you have, a trial of diet + exercise + fish oil may be appropriate and may or may not make it possible for you to avoid taking lipid-lowering agents. But the type must first be ascertained. Some types are more likely to respond to diet and exercise than others, and some types carry a higher risk of cardiovascular disease than others.

As mentioned earlier you also need to be screened for possible ischemic heart disease. This is very important, and the state of your coronary vessels as well as the exact type of lipid disorder you have would be important factors in deciding whether or not to immediately start taking a lipid lowering drug or to first give diet + exercise alone a trial. (You need to modify diet and exercise in any event, even if taking a lipid-lowering drug, especially since you have mild diabetes). The fish oil is I think a no-brainer, especially with your HDL low.So the chouice is between diet + exercise + fish oi alone or same plus a lipid lowering drug. Of course, you can share with the doctor your preference for avoiding medication if possible. For that, select a doctor who trained in the West as they will have been socialized in the practice of involving patients in the decision making process, doctors who have trained and worked only in Thailand usually are not so comfortable with that approach.

Caution is in order when getting advice from others based on what worked for them as they may have a different type of lipid disorder than you do. While we do not yet know exactly what type of lipid disorder you have, we do know that it is one where triglycerides are elevated. Statins are not as effective in this instance as they are in situations where only cholesterol is elevated. A fibrate drug, such as you were prescribed, may be more effective. Niacin may also be an option.

Please, see an appropriate specialist and find out exactly what type of lipid disorder you have so that ou can then make an informed choice about how to proceed.

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Thanks souvenirdeparis. Could you make the effort and give me an example of your diet ?

I started having salads & tomatoes, which was new to me . For proteins I rely on fish, ie mostly salmon , the frozen sort . I have it in the micro wave, no oil. I used to have ham too . I steam cook all my vegetables, I have leek and cauliflower as much as I can .I buy frozen veggies too, potatoes, whatever, but always plain, never the sort with cream or meat or whatever dressing. olive oil on all . I'm not much of a cook and all this is a bit on the bland side .In the morning I have bread with some honey or jam , no sugar after but for fruit ; sometimes too many apples I must say. I drink coffee in the morning, de- cafeined in the afternoon, water . No booze whatever :) I often add omega 3 butter ersatz .

(At the moment I have to throw in some eggs , butter, chees, yoghurt, if you look up the thread on chemos you'll understand why ;I haven't had cholesterol readings for 9 months since I can't worry about them now (had checks every 6 months before) but this diet worked for me for several years).

By all accounts, the pills for cholesterol are safe . It's easy to lack minerals etc with a hard diet . Try the diet for a few months then check again. Seems to me your cholesterol is not urgent, adress the sugar first.

Your diet doesn't sound too bad, souvenirdeparis. Is low-fat yoghurt not an option ?

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Today I went to another hospital, also with a certain standing to do the same blood tests as a few days ago, see my original post. Most results were more or less the same, except for the Triglyceride, which was decreased from 758 on Friday to 528 today.. I did the same fastening process for both tests, so that can't be an influence. 528 is still too high, but a difference of 230 in 3 days is quite a lot, or not ?

I'm also writing this because I have to decide whether or not I should take medicines. I'm not against regular medicines, but with my rather sensitive body I'm afraid my liver will get damaged, if I have to take these medicines for the rest of my life. So, is it really such a bad idea to start with a good diet first ? I much prefer this above taking medicines. But I know from experience most doctors only see medicines as the golden way, some of them maybe even don't know enough about alternative ways to solve this diabetes-cholesterol problem.

So again, with these results : Sugar 126, Cholesterol 304, Triglyceride 528 (Today), HDL,30 is it preposterous to even think about a healthy diet first before starting to take medicines ?

What is preposterous is to focus on treatment without first having determined what type of dyslipidemia you have. There are many different types and the treatment options differ accordingly. You need to consult an internist who specializes in these disorders. I cannot stress that enough. When you do, s/he will order the appropriate additional lab tests and arrive at a definitive diagnosis at which point the treatment options can be discussed. Depending on which type of lipid disorder you have, a trial of diet + exercise + fish oil may be appropriate and may or may not make it possible for you to avoid taking lipid-lowering agents. But the type must first be ascertained. Some types are more likely to respond to diet and exercise than others, and some types carry a higher risk of cardiovascular disease than others.

As mentioned earlier you also need to be screened for possible ischemic heart disease. This is very important, and the state of your coronary vessels as well as the exact type of lipid disorder you have would be important factors in deciding whether or not to immediately start taking a lipid lowering drug or to first give diet + exercise alone a trial. (You need to modify diet and exercise in any event, even if taking a lipid-lowering drug, especially since you have mild diabetes). The fish oil is I think a no-brainer, especially with your HDL low.So the chouice is between diet + exercise + fish oi alone or same plus a lipid lowering drug. Of course, you can share with the doctor your preference for avoiding medication if possible. For that, select a doctor who trained in the West as they will have been socialized in the practice of involving patients in the decision making process, doctors who have trained and worked only in Thailand usually are not so comfortable with that approach.

Caution is in order when getting advice from others based on what worked for them as they may have a different type of lipid disorder than you do. While we do not yet know exactly what type of lipid disorder you have, we do know that it is one where triglycerides are elevated. Statins are not as effective in this instance as they are in situations where only cholesterol is elevated. A fibrate drug, such as you were prescribed, may be more effective. Niacin may also be an option.

Please, see an appropriate specialist and find out exactly what type of lipid disorder you have so that ou can then make an informed choice about how to proceed.

I went to a Thai endocrinologist and showed her both of my lab tests. She supported the idea of first giving a diet a try for 3 months. I'm now busy trying to find that diet.

She didn't let do any additional lab/blood tests. Sheryl : what are these specific tests so I can ask for them ?

She also told me once you get started with these medicines you have to take them all your life. This surprises me : if I take medicines and at the same time start with a healthy diet, why not try and see after let's say 6 months if the healthy diet alone can do the trick ?

Another question : is it true that one can be less strict about one's diet when taking these lipid lowering agents ?

I started with fish oil which contains EPA 180 mg and DHA 120 mg,one capsule per day. Is this appropriate for my condition ?

Edited by miodo2009
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low -fat yoghurt has no taste at all ; better have half of a normal one sometimes and the rest the day after .

I was told that once I'd start pills I' d have to keep on taking them for the rest of my life , same ; guess your body gets used to them and needs them (which is just the same said otherwise).

Doc said pills nothing to worry about, and sure, with them your diet will be less demanding .

(btw I think triglycerids have not been an issue for me, I don't remember discussing them with a doc even though I had many blood tests)

if after the diet you see it's difficult to lower rates, then you manufacture your own bad cholesterol from minimal intakes, and pills would be in order then.

btw I wasborn in Normandy , raised with the notorious diet of cuisine au beurre , cream, camembert , rillette (pate).

I found my (ex) Thaï wife was unable to understand the concept of "cholesterol/healthy diet" in spite of multiple demands (divorce was a plus health wise).She thought white rice +nam prik pla = salad + green veggies and cholesterol = pom pooy .

what about your sugar ?

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low -fat yoghurt has no taste at all ; better have half of a normal one sometimes and the rest the day after .

I was told that once I'd start pills I' d have to keep on taking them for the rest of my life , same ; guess your body gets used to them and needs them (which is just the same said otherwise).

Doc said pills nothing to worry about, and sure, with them your diet will be less demanding .

(btw I think triglycerids have not been an issue for me, I don't remember discussing them with a doc even though I had many blood tests)

if after the diet you see it's difficult to lower rates, then you manufacture your own bad cholesterol from minimal intakes, and pills would be in order then.

btw I wasborn in Normandy , raised with the notorious diet of cuisine au beurre , cream, camembert , rillette (pate).

I found my (ex) Thaï wife was unable to understand the concept of "cholesterol/healthy diet" in spite of multiple demands (divorce was a plus health wise).She thought white rice +nam prik pla = salad + green veggies and cholesterol = pom pooy .

what about your sugar ?

My sugar is also too high, so this in combination with cholesterol levels makes the situation kind of serious. But I don't think it'll cost me a lot of effort to skip the cokes, the ice creams and whatever else may be bad for my condition.

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you'll soon become an expert on nutrition and a better cook .

You'll find plenty on the net .

Take it seriously but relax and enjoy your meals.

How strange it may sound, in a way this bad news from the doctor has done me well, like a wake up call. In the past I always hoped that I would become really happy someday in the future. When I got this bad message from the doctor, and she looked quite serious, I got the feeling that I could be dead any time soon and that gives another perspective on life.

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I went to a Thai endocrinologist and showed her both of my lab tests. She supported the idea of first giving a diet a try for 3 months. I'm now busy trying to find that diet.

She didn't let do any additional lab/blood tests. Sheryl : what are these specific tests so I can ask for them ?

She also told me once you get started with these medicines you have to take them all your life. This surprises me : if I take medicines and at the same time start with a healthy diet, why not try and see after let's say 6 months if the healthy diet alone can do the trick ?

Another question : is it true that one can be less strict about one's diet when taking these lipid lowering agents ?

I started with fish oil which contains EPA 180 mg and DHA 120 mg,one capsule per day. Is this appropriate for my condition ?

I would make the fish oil at least twice a day.

Re lab tests, need to be guided by a specialist in lipid disorders but I think most would check homocysteine levels, C Reactive protein, and direct assay of LDL (the indirect estimate obtained in standard tests is not reliable when triglycerides are as high as yours). If it was not already done in the initial screening, also need to check thyroid function (TSH, T3/T4) to rule that out as a contributing cause, and you need to have HbAC1 tested to establish a baseline after which it will need to be measured periodically to assess how well controlled your diabetes is.

And as mentioned, you definitely need at least a stress test as you are at elevated risk of coronary artery disease. Given your dizziness and if no other obvious cause has been found for that, might also want a carotid Doppler (sort of ultrasound that checks out if the main arteries to your brain are narrowed by plaques, it's a noninvasive procedure), and depending on the results of the stress test further investigations of the coronary arteries (e.g. cardiac CT) may or may not be warranted.

I don't know where you are located, but if in Bangkok you might consider seeing Dr. Pymitra Sritara at Praram 9 hospital, Monday, Tuesday and Thursday evenings. He is a Professor at Mahidol and the Director of the Cardiovascular and Metabolic Center at Ramatibodhi, and has published on lipid disorders. Uk trained. This link has his bio: Welcome to Praram9 Hospital

In terms of diet, it is pretty straight forward (although not necessarily easy to do!):

  • AVOID processed carbs: white rice, white bread, pasta, noodles, anything containing added sugar. This pretty well rules out all packaged foods.
  • MINIMIZE or eliminate red meats; chicken is fine but try to avoid the skin/fat; fish very good
  • INCREASE vegetable intake, salads, whole grains (make your own salad dressing, tho, or stick to oil & vinegar as the commercial ones are full of sugar. Balsamic vinegar + olive oil plus some Italian herbs males a great and healthy dressing).
  • Fresh fruits in moderation
  • Avoid fried foods in the market and at restaurants but it is fine to fry your own using olive oil, canola or other healthy oil.
  • Get in as much fiber as you can. in addition to increased salads and vegetables and whole grains (brown rice/whole wheat bread), it is a very good idea to have a daily or near daily serving of something like oatmeal or a bran cereal without added sugar (Kellogg's All Bran is very good). These taste much better if you add some cinnamon, and cinnamon itself has been demonstrated to help regulate blood sugar. Adding a small amount of fresh fruit or raisins also makes these taste nice. Use the non-sugar sweetener of your choice, many people like sucralose (Fitne and other brands).
  • Eliminate alcohol or limit it to small quantities of red wine
    Dairy: skim milk is fine, so is unsweetened yogurt. People have differing views re cheese, my take is Ok in moderation.
    Eggs are also controversial. My advice would be Ok but in moderation, say 2-3 times a week.

If you can do all the above as well as get regular exercise it is quite likely you will be able to get your diabetes under good control without need for medication and your lipids will improve altho to what extent I can't say, depends on the type of disorder.

Should it prove to be the case that you need a lipid-lowering drug in addition to dietary changes you might want to consider niacin (a B vitamin) as an alternative to fibrates and other drugs. For some reason it is often overlooked, but it is quite effective in many people. In past was considered inconvenient due to need for frequent dosing and tendency to cause a temporary flush/hot feeling, but there is a sustained release form (brand name Niaspan) which gets around that if taken at bedtime. (You still get a transient flush, but you sleep through it). Many people who dislike the idea of taking medication feel better about using a vitamin.

I can see you are taking this seriously and prepared to make changesm, which is good. look on the bright side: this is exactly what health screenings are for, to identify this sort of thing before you have a stroke or heart attack so that you can take steps to avert same.

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""use non sugar sweetener"" not :

Aspartame & Aspartame Poisoning Information Site

see "distribution" on this link , then google "aspartam silent killer".

for fish oil, I used to have lots of cans of smoked cod liver ; worth 2 euros a can ,must contain 10 times the amount in a box of pills for 7 times less expensive than one box.

(lost the taste for this right now , just like cans of sardins in olive oil; very convenient though, not easy to shop& cook healthy all the time ; buying fresh fish I can ,but at a distant shop, then must cook quickly, not easy ; and expensive .

I have coffee without sugar , only a little jam or honey in the morning.

of course sometimes I go bababobo and swallow 2/3 of a pack of whatever biscuits or a chocolate bar (§125 grams) before I get to my sense .The trick is not to buy them , which sometimes is too much for my will power .

Nobody's perfect .

for eggs, cheese , I have one or the other on days I don't have fish or chicken .

they're all : "animal fat" , so one or the other. Because you need calcium etc too.

there is low fat cheese, I'd rather have regular amsterdamer or gouda , but with smaller servings (same for yogurt) ; then again, not always easy to buy then eat just a little at a time . Don't aim at perfection , don't become allergic to animal fat :)

Edited by souvenirdeparis
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