Health Problems

Noodleface · May 15, 2019

Yes

I see that I could get XR tabs too, might bring that up.

Srathor · May 15, 2019

Talk to doc about long release Metformin. That helps.

Noodleface · May 15, 2019

Yeah I just looked into that. Next time I'm there I'll mention it

LiquidDeath · May 16, 2019

So I went to get my yearly physical today with a new doctor since I'm moving two towns over next month and wanted a new doc close by. When it comes to the diet portion she mentions that her digital records show that previously I had borderline high cholesterol and asks about my diet. I explain that I've pretty much always been right near that 200 total cholesterol mark and that diet really never had an effect, but that I had been alternating low carb and keto for the last three years after following the general consensus low fat, heart healthy diet for most of the rest of my adult life. She proceeds to tell me that I should watch out for that because most low carb and keto diets rely too much on animal fat and protein and those things are PROVEN to raise cholesterol levels. Instead of getting into the weeds with her about how much research I've done on these subjects and how diet science hasn't proven that at all, I decide to take a different route and say "Thanks, I'll take that into consideration. On that subject, all my research shows that total cholesterol may not show the whole picture for health so I was wondering if you could order the test for measuring my LDL particles to see if they are the fluffy good kind or the dense bad kind." Her answer was "Yes, I can do that, but no current medical guidelines take into account particle size in their diagnosis or prescription. We only look at total cholesterol."

It is my firm belief that GPs should be researching and recommending solutions to the most common issues we face these days, and diet and exercise should be at the top of that list. I really wish I could find a GP that gave enough of a fuck to stay current on those subjects. I was really tempted to ask her if she thought I should just follow the food pyramid for optimal health, but didn't want to blatantly antagonize her.

Khane · May 16, 2019

I always just answer that question with a simple "Oh just eating better and getting more exercise". And if they press me on how I'm eating better I just hit them with the ol' "Oh less fast food and pizza, more home cooked meals from scratch".

ver_21 · May 16, 2019

LiquidDeath said:
So I went to get my yearly physical today with a new doctor since I'm moving two towns over next month and wanted a new doc close by. When it comes to the diet portion she mentions that her digital records show that previously I had borderline high cholesterol and asks about my diet. I explain that I've pretty much always been right near that 200 total cholesterol mark and that diet really never had an effect, but that I had been alternating low carb and keto for the last three years after following the general consensus low fat, heart healthy diet for most of the rest of my adult life. She proceeds to tell me that I should watch out for that because most low carb and keto diets rely too much on animal fat and protein and those things are PROVEN to raise cholesterol levels. Instead of getting into the weeds with her about how much research I've done on these subjects and how diet science hasn't proven that at all, I decide to take a different route and say "Thanks, I'll take that into consideration. On that subject, all my research shows that total cholesterol may not show the whole picture for health so I was wondering if you could order the test for measuring my LDL particles to see if they are the fluffy good kind or the dense bad kind." Her answer was "Yes, I can do that, but no current medical guidelines take into account particle size in their diagnosis or prescription. We only look at total cholesterol."

It is my firm belief that GPs should be researching and recommending solutions to the most common issues we face these days, and diet and exercise should be at the top of that list. I really wish I could find a GP that gave enough of a fuck to stay current on those subjects. I was really tempted to ask her if she thought I should just follow the food pyramid for optimal health, but didn't want to blatantly antagonize her.

Some docs don't want you to ask questions or think too hard/critically. I try to find docs with some patience and curiosity and will to challenge insurance companies.

Speaking from 10 years experience of dealing with early onset heart disease, I would say family history is a huge factor. Then, diet and exercise are great, but they will not achieve enough cholesterol reduction for all individuals.

Lipid panel should be an annual thing with every physical. If you have hypercholesterolemia, you should do a lipid panel every 6 months. You should also be seeing a cardiologist and/or lipid specialist. LDL/HDL/VLDL and Triglycerides are just monitoring the imbalance. The best tests for seeing heart disease are calcium score and CT angiogram. There is a carotid artery plaque check too, iirc.

Statins work for some people and cause miserable side effects for others (muscle pain, fatigue, irritability). Most other common cholesterol drugs have limited effectiveness and annoying side effects. If you try everything and don't get acceptable results, a good doc can put together a case for PCSK9 inhibitors. They are injectables that almost work too well at reducing cholesterol. Good news If you suffer a heart attack, you can make an immediate case for PCSK9 inhibitors. Besides that, you can pray to the gods of gene therapy or arterial blockage drano.

LiquidDeath · May 17, 2019

Got my test results back.

CHOLESTEROL	223 mg/dL	<200 mg/dL
TRIGLYCERIDE	45 mg/dL	<150 mg/dL
HDL	62 mg/dL	40 - 59 mg/dL
LDL CALCULATED	152 mg/dL	<100 mg/dL
NON-HDL CHOLESTEROL	161 mg/dL	<130 mg/dL

This is the note the doctor put on them:

"Your LDL is high as expected from previous. I would just suggest trying to increase dietary fiber and reduce animal fats as discussed. Everything else looks good!"

The kicker to all this is that my LDL:HDL ratio is 2.5. Men with a ratio under 3.4 have half the average risk of heart disease than men over it, and a fourth of the risk of men with a ratio 5 or greater. In fact, my HDL is almost 29% of my total cholesterol which would mean I'm on the very high side of the population. All of this to say that these numbers seem to indicate I am perfectly healthy and should probably be advised to continue doing whatever diet and exercise routine that got me here in the first place.

This is shit I expect a GP to know, especially since obesity, diabetes, and heart disease are the biggest health issues facing people in the US at this time.

Khane · May 17, 2019

According to that chart it is high. Not saying the "guidelines" are gospel or anything but you are over the "desired maximum" on everything except triglyceride.

LiquidDeath · May 17, 2019

Khane said:
According to that chart it is high. Not saying the "guidelines" are gospel or anything but you are over the "desired maximum" on everything except triglyceride.

I get that, and it is why I've done so much research on these things.

Noodleface · May 17, 2019

I think your doctor is just trying to look out for you and comparing lab results. I don't think she set the guidelines on that lab report.

Frenzied Wombat · May 17, 2019

LiquidDeath said:
So I went to get my yearly physical today with a new doctor since I'm moving two towns over next month and wanted a new doc close by. When it comes to the diet portion she mentions that her digital records show that previously I had borderline high cholesterol and asks about my diet. I explain that I've pretty much always been right near that 200 total cholesterol mark and that diet really never had an effect, but that I had been alternating low carb and keto for the last three years after following the general consensus low fat, heart healthy diet for most of the rest of my adult life. She proceeds to tell me that I should watch out for that because most low carb and keto diets rely too much on animal fat and protein and those things are PROVEN to raise cholesterol levels. Instead of getting into the weeds with her about how much research I've done on these subjects and how diet science hasn't proven that at all, I decide to take a different route and say "Thanks, I'll take that into consideration. On that subject, all my research shows that total cholesterol may not show the whole picture for health so I was wondering if you could order the test for measuring my LDL particles to see if they are the fluffy good kind or the dense bad kind." Her answer was "Yes, I can do that, but no current medical guidelines take into account particle size in their diagnosis or prescription. We only look at total cholesterol."

It is my firm belief that GPs should be researching and recommending solutions to the most common issues we face these days, and diet and exercise should be at the top of that list. I really wish I could find a GP that gave enough of a fuck to stay current on those subjects. I was really tempted to ask her if she thought I should just follow the food pyramid for optimal health, but didn't want to blatantly antagonize her.

When I was found to have high cholesterol, my doc sent me for some sort of chest catscan that looks for calcium. When the test came back negative, he said that despite my high cholesterol, I had no need for a statin.

Khane · May 17, 2019

LiquidDeath said:
I get that, and it is why I've done so much research on these things.

I'm with you that "fat makes you fat" is bunk science. And generally speaking "nutritional science" is bunk for the most part anyway. You can find studies to support any theory on healthy eating you have. I've done keto diets on and off my entire adult life with great success and never had test results come back as anything other than in the "healthy" range.

But basing your belief entirely on the ratio doesn't seem like good practice. You could have ldl at 1000 mg/dL and hdl at 500 mg/dL and still be at a ratio of 2:1 but your cholesterol would be off the fucking charts.

LiquidDeath · May 17, 2019

Khane said:
I'm with you that "fat makes you fat" is bunk science. And generally speaking "nutritional science" is bunk for the most part anyway. You can find studies to support any theory on healthy eating you have. I've done keto diets on and off my entire adult life with great success and never had test results come back as anything other than in the "healthy" range.

But basing your belief entirely on the ratio doesn't seem like good practice. You could have ldl at 1000 mg/dL and hdl at 500 mg/dL and still be at a ratio of 2:1 but your cholesterol would be off the fucking charts.

That's true. I think my main hang-up on this is that I don't want to be the better researched, more knowledgeable party in the room when I'm talking to a doctor about my health. Especially when it is an issue that GPs should be crushing. The fact that these recommendations and levels they've been spouting for decades have led to even worse outcomes and they are still making the same recommendations makes me not want to listen to their recommendations at all.

Noodleface · May 17, 2019

Is there something I can read about this? Published?

Khane · May 17, 2019

There is more than you could ever want to read from both sides of the argument.

EDIT: By the way if you're thinking about trying it you would need to talk to a specialist first. Diabetics are at risk of going into Ketoacidosis which could kill you. So you probably want to steer clear of low carb diets.

LiquidDeath · May 17, 2019

Khane said:
There is more than you could ever want to read from both sides of the argument.

EDIT: By the way if you're thinking about trying it you would need to talk to a specialist first. Diabetics are at risk of going into Ketoacidosis which could kill you. So you probably want to steer clear of low carb diets.

I'll add to this that Type 1 diabetics should certainly stay away from it, but there is lots of research being done that shows keto diets can help Type 2 diabetics control their condition and reduce or eliminate their dependence on insulin. It is a complete lifestyle change, though.

**DO NOT TAKE ANY STEPS TOWARDS THIS WITHOUT SPEAKING TO A KNOWLEDGEABLE MEDICAL PROFESSIONAL**

That being said, I'd look up Dr. Dominic D'Agostino for more information. He is at the cutting edge of using keto nutrition to solve current medical problems.

Dr. Dominic D'Agostino on KetoNutrition: From Science to Application - Blog | Virta Health

Reversing Type 2 Diabetes with Nutritional Ketosis - Blog | Virta Health

Captain Suave · May 17, 2019

Khane said:
generally speaking "nutritional science" is bunk for the most part anyway

When I started fixing my diet a few years ago I went from zero eggs per month to 14/week for six months. My cholesterol dropped like a rock. Now every six months research waffles between their being the perfect food or heart attacks on a plate.

If I've learned anything from my lifetime anecdote of dieting, it's that what you eat barely matters as long as you stay lean and in good aerobic health.

alavaz · May 17, 2019

My cholesterol has been between 190-230 for the last 10 years and my doctor hasn't really mentioned it much. I've had some issues with PVCs and rapid heartbeats over the years too so I've had full workups from cardiologists 3 times over the past 10 years and they always say my heart looks perfectly healthy.

Noodleface · May 17, 2019

Khane said:
There is more than you could ever want to read from both sides of the argument.

EDIT: By the way if you're thinking about trying it you would need to talk to a specialist first. Diabetics are at risk of going into Ketoacidosis which could kill you. So you probably want to steer clear of low carb diets.

No, not thinking about trying it. I have a pretty strict diet (BUT THE B URGER KING CALLS ME SO OFTEN) and just keep my numbers in check. I've considered a keto diet but being low sugar feels fucking awful.

Borzak · May 17, 2019

Laid down to sleep at 2pm. Woke up and the clock said 7. Light coming in the window. Walked inside and asked if they ate super. yeah, 12 hours ago. It was 7am. So I slept for 17 hours. The good news is my hands feel a little better. Kind of a long nap.

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