Here's Something That Will Knock Your Hat In The Creek

[sarkin]

Coach Polly, I was in a total dream state in high school biology. I think I was probably in a dream state through college, too. It's never too late. Looking back on it, I can't fathom why I wasn't fascinated by Life On Earth!

We each have to follow our own curiosity. And if we're lucky, it takes unexpected turns along the way ;)

Sara

[tex]

But then there are trans fats . . . and where there are trans fats there are usually highly processed foods, and that means high carbs too.

I just have one more thought to add to Mary Beth's excellent post, regarding the trans fats:

While it's true that virtually all, (maybe 100% of them, for all I know), of the "man-made" trans fats are bad news for health, that doesn't mean that all trans fats are bad. There is such a thing as natural trans fats, which seem to be beneficial to our health. Guess where they are found. Yep - they're found in the grass-fed beef and butter that she mentioned. How about that?

http://www.tendergrassfedmeat.com/2010/ ... nd-butter/

Lest someone think that the site at the link above is worthless, because they're trying to sell a book, here's a mainstream source:

http://www.sciencedaily.com/releases/20 ... 152140.htm

Tex

[Gloria]

I need to get to bed because I'm leaving early in the morning, but...

Tex, weren't you originally taking the statin to reduce the risk of stroke? Are there studies showing a reduction of strokes for those with lower cholesterol? I'm also taking Simvastatin, primarily because I'm concerned about having a stroke.

My mother didn't have Alzheimer's (as far as I could tell), but she had similar symptoms because she had a stroke. So which is worse? If the stroke affects your short term memory then it's similar to Alzheimer's. The main difference is that Alzheimer's patients conditions deteriorate; stroke victims generally stay the same or get better.

Gloria

[Zizzle]

My mother's father died of Alzheimer's. Her mother died of congestive heart failure and circulatory problems in her 90s. My mom had 2 sub-acute subdural hematomas (brain bleeds in the skull) last year at age 65. She is otherwise healthy, and they never found a cause of the bleed, except shrinking of the brain (normal as you age) and the resulting strain on the veins around the skull. This year they discovered chronic gastritis due to H.Pylori infection. Now that that grueling treatment is over, she's being put on Lipitor for high cholesterol (240? with high LDL). She and her mom took it a few years ago and did not tolerate it well. They discontinued it. But now her doc is saying the cholesterol is a problem that must be dealt with.

I'm a statin critic and have been trying to get my in-laws to stop taking them. But they refuse and instead suffer with muscle aches and "brain fog." My MIL swears she thinks she's getting dementia at the young age of 64. Could statins be a CAUSE of the alzheimer's epidemic we are seeing? I blame trans fats for the cholesterol woes of my parents and grandparents - they are the margarine and shortening generation. I hope new guidelines and trends towards using natural fats have a long-term health impact for my generation. Then again, we need a tidal wave of change to undo the damage done by sugars and processed foods.

[ant]

Just to chime in.....my mother has been on statins since a triple heart bypass about 14 years ago. She is now rapidly progressing with dementia (very little short term memory left). At 90, I wonder is her dementia "natural" or worsened by the statins?

Best, ant

[tex]

Tex, weren't you originally taking the statin to reduce the risk of stroke? Are there studies showing a reduction of strokes for those with lower cholesterol? I'm also taking Simvastatin, primarily because I'm concerned about having a stroke.

While epidemiological studies indicate that elevated cholesterol levels are linked with increased ischemic stroke risk, I'm not aware of any research that proves that lowering cholesterol levels will lower the stroke risk. There is reasonably clear evidence, however, that statins do indeed lower the risk of ischemic stroke, independent of any cholesterol effect, (just as they lower the risk of any adverse cardiovascular event, independent of any connection with cholesterol. In fact, I'll go so far as to suggest that statins lower the risk of adverse cardiovascular events, despite their propensity to lower cholesterol.

At any rate, in view of the evidence, I have to conclude that statins do indeed lower the risk of ischemic stroke, but IMO, this has nothing to do with lowering cholesterol. Consider this quote from a very recently-published research report:

According to the prevailing paradigm, high LDL cholesterol is said to promote atherosclerosis growth, which explains why it is a risk factor for cardiovascular disease. There is much contradictory evidence, however.30–,33 It is true that high t-C is a risk factor for coronary heart disease, but mainly in young and middle-aged men. If high t-C or LDL-C were the most important cause of cardiovascular disease, it should be a risk factor in both sexes, in all populations, and in all age groups. But in many populations, including women,24 Canadian and Russian men,34,,35 Maoris,36 patients with diabetes,37,,38 and patients with the nephrotic syndrome;39 the association between t-C and mortality is absent24,34,36–,39 or inverse;35 or increasing t-C is associated with low coronary and total mortality.40 Most strikingly, in most cohort studies of old people, high LDL-C or t-C does not predict coronary heart disease28,40–,50 (Table 1) or all-cause mortality28,40,42,44,48,51–,58 (Table 2); in several of these studies the association between t-C and mortality was inverse,48,53,,58 or high t-C was associated with longevity.51,,54 These associations have mostly been considered as a minor aberration from the LDL-receptor hypothesis, although by far the highest mortality and the greatest part of all cardiovascular disease are seen in old people.

Of course, in the above quote, t-C stands for total cholesterol, and the red emphasis is mine.

http://qjmed.oxfordjournals.org/content ... eytype=ref

The following study was done over 16 years ago:

Conclusions. —Our findings do not support the hypothesis that hypercholesterolemia or low HDL-C are important risk factors for all-cause mortality, coronary heart disease mortality, or hospitalization for myocardial infarction or unstable angina in this cohort of persons older than 70 years.

http://jama.ama-assn.org/content/272/17/1335.abstract

The title of another study is:

Cholesterol and other lipids predict coronary heart disease and ischaemic stroke in the elderly, but only in those below 70 years.

Again, I added the red emphasis.

http://www.ncbi.nlm.nih.gov/pubmed/11689222

The following study involved only women, aged 60 and over, and it yielded extremely illuminating results:

92 women aged 60 years and over (mean 82.2, SD 8.6) living in a nursing home and free from overt cancer were followed-up for 5 years. 53 died during this period; necropsy revealed cancer in only 1 patient. Serum total cholesterol at entry ranged from 4.0 to 8.8 mmol/l (mean 6.3, SD 1.1). Cox's proportional hazards analysis showed a J-shaped relation between serum cholesterol and mortality. Mortality was lowest at serum cholesterol 7.0 mmol/l, 5.2 times higher than the minimum at serum cholesterol 4.0 mmol/l, and only 1.8 times higher when cholesterol concentration was 8.8 mmol/l. This relation held true irrespective of age, even when blood pressure, body weight, history of myocardial infarction, creatinine clearance, and plasma proteins were taken into account. The relation between low cholesterol values and increased mortality was independent of the incidence of cancer.

http://www.ncbi.nlm.nih.gov/pubmed/2564950

Consider this phrase from the above quote:

Mortality was lowest at serum cholesterol 7.0 mmol/l, 5.2 times higher than the minimum at serum cholesterol 4.0 mmol/l, and only 1.8 times higher when cholesterol concentration was 8.8 mmol/l. This relation held true irrespective of age, even when blood pressure, body weight, history of myocardial infarction, creatinine clearance, and plasma proteins were taken into account.

If we convert the international units, (mmol/l) used in this comparison, to conventional units, (mg/dl), we can see that the researchers are saying that actual mortality in this cohort was lowest at a serum cholesterol level of 270 mg/dl. Mortality was 5.2 times higher at a serum cholesterol level of 154 mg/dl, and mortality was only 1.8 times higher, (than the minimum), at a serum cholesterol level of 340 mg/dl. Obviously, this is in stark contrast to what most doctors claim about cholesterol levels, and their relationship to mortality risk.

Again, note that I'm not saying that statins don't reduce the risk of death due to cardiovascular events. I'm merely pointing out that doctors have a completely bass-ackwards view of the role of cholesterol in overall mortality risk, for people past middle age. They treat cholesterol as if the effects were chiseled in stone, but they are not. As we age, the important parameters completely change, and we need to change our thinking to reflect that reality. If the risk of death from a cardiovascular event is the only consideration, then yes, statins are the way to go. If overall mortality risk is important, though, then it's a whole different ball game, because unfortunately, statins lower cholesterol levels, and that's counterproductive, as we get older.

IMO, statins may well be beneficial for people with high cholesterol levels, who happen to be in the middle-age category. For those of us who can remember what life was like before tv came along, statins appear to impose a negative effect on our overall mortality risk. At least, that's how I see it.

Tex

[tex]

Zizzle,

I agree with you. For her age, your mom's cholesterol is not high, it's lower than the ideal level, (about 270). Since a risk of ischemic stroke is not indicated, I would be very concerned about taking a statin, if I were in her shoes. If cholesterol is what her doc is focusing on, then obviously he is basing his recommendations on obsolete thinking.

Could statins be a CAUSE of the alzheimer's epidemic we are seeing?

I doubt that it is a primary cause, but I would be very surprised if it were not shown to be a contributing cause, somewhere down the line.

Tex

[Mags]

Tex--

I may be missing something here, but I thought that total cholesterol levels had been abandoned in favor of HDL/LDL ratios a long time ago. Instead, it appears that they are still trying to sell that same old song-and-dance scare so they can sell more drugs!

Both my father and my stepfather take statin drugs. One of them needs to, one of them does not.

My dad is diabetic, with a high blood pressure, bad ratios, and has a family history full of strokes and heart attacks. In his case, the benefits outway the risks. He is 65 years old.

My stepdad has no diseases, he kind of watches what he eats, gets very little exercise, and has a total level of 260, but good ratios. He has a family history of people living to be 100 years old. He carries maybe an extra 20 pounds and is 61 years old. Why is he on a statin?

I just don't get it.

Mags

[tex]

I may be missing something here, but I thought that total cholesterol levels had been abandoned in favor of HDL/LDL ratios a long time ago.

If you will look at my first reference above, (oxfordjournals), you'll see that even that ratio, (at least the part that LDL plays), doesn't really hold up to close scrutiny, either. It's valid for younger and middle-aged men, but not for older men, nor for anyone else in the population mix.

My stepdad has no diseases, he kind of watches what he eats, gets very little exercise, and has a total level of 260, but good ratios. He has a family history of people living to be 100 years old. He carries maybe an extra 20 pounds and is 61 years old. Why is he on a statin?

He's probably on a statin because he trusts his doctor, but unfortunately, his doctor is confused. With your stepdad's genes, he doesn't need to be on a statin, IMO, (remembering that my opinion is worth zilch, in the medical world).

Tex

[sarkin]

Mags,

I have a theory about theories here. At first they knew about cholesterol... then they understood more about HDL/LDL ratios. Now they are realizing that there's also VLDL... and triglycerides are a factor in relation to cholesterol, not just in themselves. And C-reactive protein (CRP - let's not leave out any TLAs*!), and hs-CRP. And homocysteine. Even knowing all these vital statistic about a particular patient doesn't predict very reliable how much gunk is actually clogging up the arteries - not quite. (I am in a phase where I think everything is gunked up by gluten, but luckily, I'm not anyone's doctor.) That could mean either that there are more factors in play that haven't been looked at yet, or that no one yet has decoded the complex interactions - which might not be the same in everybody... since one size does not fit all, no matter how they try to jam our feet in those glass slippers... OR there could be another explanation I haven't thought of. (I wish more people would ponder the sentence "there could be an explanation I haven't thought of" more often.)

In fairness to medical professionals, they have to practice medicine according to the best understanding they can get their hands on. Apples fell out of trees before one fell on Isaac Newton's head and clonked him some news about gravity. The research galumphs along, but it's hard to be sure what that means exactly for what any one of us should do. But if you're a doctor with a patient in your office, you can't wait till the science gets clear to make a choice. It always takes me time to convince a new doctor that I don't want a prescription every appointment. I think many patients do, and are concerned if there's no immediate action. It can be hard to wait and see...

On the other hand, as you point out, making a decision to put someone on a drug (for life, for all practical purposes) based on total cholesterol alone is definitely old school.

I see Tex has responded while I'm typing here and given you much better specifics on the statins issue. And - I don't know how we should weigh the current research against established practice, generally. We can't change diet or treatment everytime a new publication comes out, but we can hope our providers are doing their best to stay up to speed, and do our best ourselves. Ironically, we may be better off, as MCers, with a relatively small population and a lot of shared knowledge right here. For sharing info on more common diagnoses, there are almost too many choices, many of them flat-out contradictory.

I guess I'm saying - again - glad to be here, and thank goodness for one another,

Sara

*three-letter acronym... it bothers me that it could also stand for two-letter acronym ;)

[Mags]

Tex--

Thanks for the info--I was scanning and missed it. You are right about my stepdad, of course. I've been meaning to get after him about it.

Sara--

Thanks as well. You might be interested in a book called Overdosed America; the author's name escapes me at this time, but he is a Robert Wood Johnson Fellow. His research on statins follow's Tex's to a "T" (ha!), but there is a lot of interesting info in there about how drug research is done and just how the FDA works nowadays..

Love,

Mags

[sarkin]

Mags - that sounds like my kind of book. I should probably save it for a serene moment ;)

Thanks!

Sara