High Total Cholesterol (over 300)

#5

You don’t say how old you are, but there are tests that will tell you whether you have a big problem. CAC is in order, and calculate the density like this (if you search this site for The Arrow you will find the entire post, I’m tech challenged or would give it to you here):

In order to calculate what I call your true risk, you’ll need your Agatston score, which is the score you’ll be given with your test. You’ll need the plaque volume, which is usually included in the printout you get. You’ll need the thickness of the CT slice they took of your heart. This is included in about a third to a half of the reports I’ve seen from various centers. It will be either 3mm or 2.5mm.
You can tell which it is by the time it took you to get the CAC scan. If it took ~ 45 seconds to one minute, then you were scanned by an EBT machine and your slice thickness is 3mm. If your scan took 35 minutes to an hour, then you had a helical scanner and your slice thickness is 2.5mm.
Once you have that in hand along with your scan, you’re ready to roll. Here are the steps.

  1. divide the volume score by the slice thickness
  2. take that number and divide it into the total calcium score
  3. look up that number on the chart below (Table 2 in the JAMA paper).
    Let’s take a look at a scan that a friend of mine sent me.
    616xauto
    I happen to know this scan was done on an EBT scan, so the slice thickness is 3mm.
    The total calcium score (the Agatston score) is 476.65. We can see that the volume score in the middle column above 401.73.
    Dividing the volume score by the slice thickness (401.73/3) gives us 133.91.
    Dividing that number into the calcium score of 476.65 (476.65/133.91) gives us 3.56.
    When we look up 3.56 on the table below, we find this person to be in the 4th quartile (he/she falls into the 3.19-4.0 range), which means he/she has low risk, despite his/her high Agatston score.
    616xauto
    I just had a friend come to me panicked about a calcium score he had received of 3,000, which is the highest I’ve ever seen. When I ran his calculations for him, I feared the worst, but he came in at 3.30, which puts him in the 4th quartile.
    Before he came to me, he had already undergone a thorough workup by his cardiologist, which included a stress echo. Which is the first thing that needs to be done in the face of a huge calcium score. His was perfect.

There are ways to measure soft plaque too, but I saw this video and it’s within my budget so give it a try:

Good Luck,

#6

What is your LDL and HDL?

#7

Can’t believe you suggest two handymen come and fix the electrical wiring in someone’s house rather than a licensed electrician. For someone who doesn’t know anything about it. Or tell them to try and fix the wiring themselves by some perceived voodoo calculation (as who except an expert knows whether it’s voodoo or not).

(Eades and Brewer, neither of those two are cardiologists).

I suspect a fire will start in the house of whoever accepts that offer. But some people appreciate voodoo. About as useful to the non-expert.

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#8

No, I acknowledge that one way to go is to take as much statin, eze, bem, PCSk9, as possible. It’s expensive and there are side effects, for some people they are horrible. You need a doctor that will go along and help. It’s one way to go. I don’t go that way. And I appreciate the help from people that don’t go that way.

I have irrigation systems and an addition to the house and a shop and outbuildings and I wire them all myself too. No problems yet.

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#9

If your lifestyle stats and diet really are as good as you say then my hunch would be that your high cholesterol would most likely be genetic (familial hypercholesterolemia). However, if this is the case you have probably had a very high cholesterol level all your life. Have you never had it tested before?

It would probably be a good idea to have a more extensive lipid panel done too which measures triglycerides, ApoB and Lp(a) which would give you a better idea of how dangerous your high cholesterol might be. Those tests are really cheap through Marek Health if you can’t get it done by the VA.

Good luck and there are lots of people on here who are very knowledgeable on all things cholesterol related and they have helped me immensely. You’ve already had replies from some of them.

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#10

See this thread: Blood test results - would appreciate help deciphering

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#11

I suggest that all cholesterol measures on their own don’t give you enough information.

You need to evaluate every marker you can with respect to your risk of heart attack or coronary disease.
Some key ones follow…

Coronary artery calcium

Unsourced from my notes - Coronary artery calcium (CAC) scans are created by using computed tomography (CT) scans, which are a type of X-ray scan, to detect the presence and quantity of coronary artery calcification (the warning signs of atherosclerosis). A CAC test reveals both the location and quantity of calcium located in three of the main coronary arteries. The scan provides a score which represents your risk. The lower the better! This score will change over time, and is known to increase with age, so it is important to record it regularly (in a manner that balances the downsides of the X-ray radiation — ask your doctor what’s best for you). Atherosclerosis is a disease of ageing, and that means your risk is increasing over time. If you are aged 50 or above and have never had one — work with your doctor to get one performed.

Test your ApoB (“A-PO-B”)

Unsourced from my notes - Stop using your LDL-C as your primary risk assessment tool (The “LDL” value too commonly called the “bad” cholesterol), and start tracking your ApoB. ApoB is a particular type of molecule attached to the types of lipoproteins carried by your LDL (and VLDL) that are the most likely to enter the arterial wall and lead to plaque formation. You need to know how many of these atherogenic particles you have present in a given volume of you blood — this drives your risk. Your ApoB value is influenced by diet and lifestyle and can be controlled with pharmaceutical intervention and possibly through certain forms of supplementation.

Do you have elevated Lpa (”L-P-little-A”)?

Unsourced from my notes - Lipoprotein-a is a particle which carries cholesterol, fats and proteins and is made by your body, and how much of it you make is inherited. Elevated levels of Lpa increase your risk of a heart attack or stroke as they are known to cause atherosclerosis. You certainly need to know if you carry the genetic risk factor, and the earlier the better (i.e. get this test done as early as possible)! Levels of Lpa don’t change much over one’s lifetime, so testing it once is enough in most cases! Know your Lpa status, and better know your risk, and whether or not you should modify your diet, lifestyle and treatment options.

Track your inflammation with C-Reactive Protein (CRP)

Unsourced from my notes - At its roots, atherosclerosis is known to be intimately connected with inflammation. In fact, it is often damage to the arterial wall that attracts the formation of plaque in the first place. This damage occurs over time, and is known to be increasingly likely with high blood pressure and high blood glucose levels. CRP is a very common and relatively low cost blood test that can be easily ordered up by your doctor, and should be tested annually at the very least. High levels of CRP are indicative of increased risk of cardiovascular disease, and once again can be influenced by changes in diet and exercise. If you have the option, go for the high-sensitivity CRP (hsCRP) test if possible!

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#12

As you said, you’re eating a diet high in saturated fats. Too much of those fats will raise your LDL, even if you are getting them from a “natural” food.

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#13

300 total probably means every number is bad.

You’re doing the right things (except eating a lot of saturated fat - natural or otherwise). You could probably eat more carbs too - beans and vegetables are great for you.

By all means get the more detailed data everyone is asking for, then you have two choices:

  1. Take a statin for 6-10 weeks AND eat less saturated fat. Re-check. Get in line as quickly as possible.
  2. Try diet for a 6-10 weeks, check, then decide to add on statins.

I would choose number 1. See what’s possible, then scale back if you can.

I have very similar characteristics to you and my cholesterol is sky high. It’s genetic - my cousin’s is as well. Eating less saturated fat does very little, eating less sugar does nothing (I don’t eat that much of either and do eat lots of fiber).

Statins change the numbers dramatically. Adding Ezetimibe changes them even more.

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#14

I prefer Bempedoic Acid and Ezetemibe over a statin. Same or better effects with fewer side effects. 10 mg of Crestor and 10 mg of Ezetemibe have a better effect than 80 mg of Crestor alone. Best to order Bempedoic Acid from India. The VA can give you Crestor and Ezetemibe.

Also, Lipitor (not Crestor) is affected by grapefruit juice. So, be aware of that.

Bempedoic Acid, Ezetemibe and Crestor can be used together for optimal effect on cholesterol and inflammation. That’s what I do, except I use Lipitor (5 mg).

These are my results on the triple therapy. Before and after.

Screenshot_2024-12-15-13-30-04-86_f541918c7893c52dbd1ee5d319333948
Screenshot_2024-12-15-13-30-04-86_f541918c7893c52dbd1ee5d3193339481080×208 57.7 KB

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#15

The single best little cheat sheet I’ve seen for the layperson I can share with friends and family, so thank you

#16

If I had a 300 cholesterol levels, I would be getting re-tested to verify the result, while changing my diet, and using pharmacological interventions immediately. If I remember correctly, a 300 level would qualify someone for the newest, expensive medications with most insurance providers.

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#17

Also, Crestor is affected by grapefruit juice. So, be aware of that.

I think there is a low risk of Crestor = rosuvastatin being affected by GFJ.

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#18

Yes. Lipitor is affected by grapefruit, not Crestor. Sorry for mixing them up. I usually refer to them by Atorvastatin and Rosuvastatin. Atorvastatin is affected by grapefruit. Rosuvastatin is not.

I use Atorvastatin as Rosuvastatin is murder on my muscles.

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#19

Where to purchase Bempedoic Acid and Ezetemibe?

#20

I use these two Indian vendors for Bempedoic Acid and Ezetemibe (together in one pill)

image

Both are good and provide high quality medicine. They also have WhatsApp available.

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#21

Thanks for the quick reply.

Pat

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#22

What brands do you think are good for these medications? Generally Good Indian Pharma Companies

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#23

I use the Brillo EZ from Sun Pharma. Based on my results, I am quite happy with this brand! I haven’t tried others.

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#24

And what’s your monthly dosage?

Thanks.