bautieri

Seems like we haven't had a nutrition thread in some time so lets blow the dust off that topic.

Last week I went in to see my doctor for a yearly physical and (due to my strong family history of heart disease) blood work to test my Cholesterol and blood sugar. I got the results yesterday and it was a mix of good and bad.

First the good news: I'm down 21lbs since starting biking, presently at 224lbs. My blood sugar is at 82 which I assume is a good thing, total cholesterol is 157 which is supposedly good. LDL is 102 down from 130 two years ago. Resting heart rate of 57 bpm.

Now the bad: HDL is still low coming in at a staggering 19. Triglycerides are 182, and my risk ratio is 8.26.

Enclosed with the letter was a note stating that the doctor would like me to make another appointment to talk with her about medication. I assume she will yell at me then prescribe medication. Personally I don't want to go on medication at this point in my life. Turning to my fellow Clydes, does anyone have suggestions on how to raise HDL and lower Triglycerides? I would like to be able to show some progress on these numbers by my next appointment in exactly one month. From what I've read online it appears to be somewhat hereditary and if thats the case I'm screwed. Males in my family (both sides) tend to punch out shortly after 60 due to heart disease. Thanks in advance for any advice.

Bau

Barabus

Personally, I would go on the meds. I know doctors that take it even with normal cholesterol just as preventive. However, you state that you don't want to do so. Therefore, lose another 10% of body mass, double your exercise and eat less bad carbs (for the tri's)!

Neil_B

My HDL was 28, and I was told to take niacin, a B vitamin, in large doses. I got to 4 pills a day and started to break out in hives, so I went off the stuff. I exercised heavily, most of it cardio. My next blood test showed an improvement, and I was advised to continue taking niacin, since 'it's working.' Pardon me for thinking exercise had something to do with it. It might work for you to.

And don't buy into that "my parents had it, so I will too" mindset. Yes, it could happen. But why live life waiting for the other shoe to drop?

lil brown bat

Hi bautieri,

First off, you have my support and encouragement for not wanting to automatically go the medication route. The current state of pharmaceuticals is a real mixed blessing. On the one hand, there really are some wonderful drugs out there that make it possible to manage conditions that were previously unmanageable. On the other hand, at least in the United States, it's all too obviously big business, and pricey drugs are heavily promoted as the first resort for so many conditions. Glaxo, Phizer and the like would really prefer it if you bought their product rather than managed your condition some other way. I'm a Celebrex-and-other-pharmaceutical-free person with rheumatoid arthritis, so sometimes, it can be done.

On the other hand, if we're being honest, it can't be done by everyone -- or even when it can, it's not the right path for everyone. Drug therapy is the appropriate course in some cases, hopefully in conjunction with other supportive therapies and/or lifestyle changes. So when you talk to your doctor, ask for her advice about drug therapy (or not) in conjunction with other strategies, and see if she feels the drugs are still necessary.

What increases HDL? Here's a decent article from about.com (it also talks about drug therapies to raise HDL). In short: aerobic exercise, weight loss, not smoking, cutting out trans fats, increased monounsaturated fats, fiber, 1-2 alcoholic beverages a day, and foods with omega-3 fatty acids. What doesn't help: a very low fat diet or a diet with lots of animal fats. Whole grains and olive oil, red wine and plenty of exercise -- give it a try and see if it helps!

flip18436572

Good luck with the doctor. I think a lot of it can be changed by diet and exercise, but that is only my opinion and I am not a doctor or nurse. Just some of the reports and studies I have read and people that I have talked to about their dietary changes and their blood work changes afterwards.

CACycling

My wife, who has always exercised more than I, eaten better than I, kept near her ideal weight MUCH better than I, has problems with cholesterol. When first diagnosed, she cut out more of the little animal fat she ate, switched to oatmeal for breakfast and tried the non-pharm suppliments. A year of that didn't budge her numbers so she finally gave in and went on meds and they worked. Sometimes your predisposition will trump your best efforts.

Wogster

Many doctors are more drug pusher then doctor these days, it's faster to write a prescription and bill your insurance for the office visit, then it is to stop and talk to you for 5 minutes and go over all the options.

High cholesterol, even when it appears hereditary, is sometimes diet related. Where do you learn how to eat? From your parents, so if they have bad eating habits, then often you do too. Your doctor should refer you to a nutritionist/dietitian, to look at diet, your biking, so your getting some exercise, maybe you need other exercise options as well, considering the cost of drugs, paying a nutritionist for a few visits, might save you or your insurance company a lot of money if you have a drug plan. Check with your insurance company, some will cover drugless options, some will cover it, only if referred by your doctor, some will not at all.

You have 2 options, one is to try a nutritionist/dietitian for six months and see if you can get it under control, the other is to take the drug for six months while trying to get it under control. If your over 35, that may be better, we don't want you checking out trying to climb the hill from hell.....

rideorglide

Bau,
All I can say right now, is you are not alone on this.

Tom Stormcrowe

Tuna and fish oils

Jarnett

I know how you feel, my doctor has told me to lose weight and put me on Cholesterol med's as well. I have been on niacin for about 3 months and my HDL is at 23 up from the 18 I started at. Niacin and exercise, will help your levels. If you do start taking niacin, take it at night with a baby aspirin, it will help keep the itching down. Good luck.

bautieri

Thank you all for the information. Looks like I need to step the riding up and consume more omega 3s.

Jarnett

Niacin does that? See, this is why I don't like medication. You trade one aliment for another. I think I am going to take lil brown bat and wogsterca's advice and attempt to convince the doctor that I want to see a nutritionist rather than take the medicine. If anything else she gets to make another appointment in 6 months to check my progress so it'll be win win for her should the diet and exercise not get it under control.

Thanks,

Bau

George

+1 and to get your HDL up, work out more.

Neil_B

Niacin is a B vitamin. It needs to be taken in large doses. Some possible side effects include flushing, itching, nervousness, etc. B vitamins are a primary additive to Red Bull and other such 'energy' beverages; imagine slamming one Red Bull after another, and you get the idea. I had a rare side effect of breaking out in hives, so my dosage was reduced to a very low level. Many people use it without problems.

geraldatwork

Intersting thread. I am 59 and up until about a year ago had low HDL all my life. When I was first tested about 25 years ago my HDL was in the upper 20's. It has stayed around that range the entire time going from a low of about 25 to occasionally breaking the 30 barrier. My total cholesterol is usually around 175-200 so I never really did anything. About a year ago my total went up to 208 which isn't really that bad but combined with the low HDL the doctor decided to put me on a generic statin. Throughout the years I have tried different things to raise the HDL, one at a time. I tried Fish Oil (2 grms p/day), Niacin (1.5 gms p/day), increasing excersize, even drinking a glass or two of red wine each night. Nothing raised the HDL. So I decided to try everything at once, except the red wine. I also added one grape seed extract capsule to the formula. Amazingly about 6 months ago my HDL went up to 38 and just last week went up to 47 with my total cholesterol going to about 140 something, don't exactly remember. I call it my "make my HDL an offer it can't refuse plan" By trying everything that might raise my HDL all at once on a daily basis (I only take 500 mg of Niacin now) it is making a difference. My doctor said it is the biggest increase in HDL he has ever seen in his 30 years of practicing internal medicine. So this is what I take/do.
Ride my bike at least 4 hours a week.
500 mg of Niacin (not buffered as that doesn't work as well)
100 mg of grape seed extract
2 grams of fish oil

I also in the last year have greatly increased my eating of various nuts which has the type of fats that works in a similiar way to fish oil. For some reason all of the stuff I take with the addition of excersize seems to work.

evblazer

Do you mean work out as in weight type exercises or just cardio? I'm approaching HDL issue land and fish makes me break out (fish oil makes me feel kinda ill too) plus I'm not allowed to do weights or any isokenetic/metric exercises so hopefully slow cardio is good too?

Actually took a while to get my cardiologist way back when to agree to let me ride, even though I had already been doing it a bit. Still I have to keep my HR low,avoid pushing myself and keep the cadence up which makes it have less effect for time spent then most people could get.

Tom Stormcrowe

Try cold pressed Flax Seed oil then....also a great source of Omega3 fatty acids and not fish based Make sure it's cold prssed though since the heated process changes the Omega 3 levels.

Spinz

1+ on the Flax Seed oil. Also consider Red Yeast Rice and muskadine grape seed as cholesterol lowering adjuncts.

Nothing is as effective as Niacin for lowering cholesterol. However flushing is the most common side effect.

Flushing can be reduced by taking an 81 mg asa and slow release Nician.

In the end it will be more cost effective to take the meds your MD recommends,exercise and eat a low fat diet. Lp

onastrat

My doc said to try niacin, the anti flush kind.

texascarl

Oats help me keep the LDL low, exercise + fish oil (3 a day) + Slo-Niacin to raise HDL (not as low as yours, but too low to suit me). There's a lot of useful info at this Dr's blog: https://heartscanblog.blogspot.com/


Luck to all of us!

maxwell.bruce

I had the same problem. My thoughts/approach:

I tried slow-release niacin, but had liver enzyme increases -- some think that the substrate for the vitamin (waxy matrix?) may have a detrimental effect.
I relented briefly and went on Lipitor and Zetia. My total cholesterol plummeted from 191 to 66. Very worrisome, plus I've heard about muscular/cardiovascular adverse effects. Went back off it after a month.
I started taking psyllium fiber mixed with 16 oz water each am, and with dinner. Good for elimination, certainly, but said to have a salutary effect on cholesterol, as well.
On the theory that the slightly increased cholesterol was due to an inflammatory process, went on 1g/day of Carlson's fish oil. I take it every am with food.
Total cholesterol went from 191 to 160, HDL from 9 to 40.
Now, I still have elevated triglycerides. That, combined with slightly elevated ALT (liver enzyme), indicate NAFLD (non-alchoholic fatty liver disease). The only cure? Lose weight, especially abdominal. Which reduces all kinds of other risk, of course, including cancer, diabetes and heart disease. Tris have been going down right along with my weight (225 down to 207, heading to 185, I hope!).
My 2c.