Sunday, October 20, 2024

blood work

Blood work was a total disappointment, as I can't out run my genes.  Despite totally clean eating and exercise, 90% vegan for weeks, low added sugar, and zero animal fat for over a week...

Total cholesterol - 215

LDL - 158

HDL - 42

TriG - 152

Glucose - 91 

Worst LDL - HDL ratio I've recorded at 5.12.  TriG also high.  Oddly, I still get the full state benefit incentive since I just need 3 of 4, the only one I missed was TriG which needed to be under 150, just missed.  Now I need a decent BP reading.  But that is all total BS anyway.

Obviously, the conventional wisdom isn't working.  Mediterranean diet, mostly vegan, low carb.   Can't imagine how bad my values must be when I'm not eating well.  

I've signed up with Quest Diagnostics so I can get tested anytime I want.  I'm going to try some different things that have worked in the past.   Niacin.  High fiber oat bran cereal.  Reduce coffee intake.  Should have done all that before this test.  Damn.   

Nothing else particularly remarkable, but my PSA is up from 1.8, and 1.6 the last tests to 2.6.  Bears watching I suppose.

I did read a meta study involving 12 million people in S Korea that showed the best total cholesterol for longevity was between 200-239, so who knows?  I'm going to still ask my Dr for a CT coronary angiogram scan.  


22 comments:

  1. Try a Chat GPT AI search on CVD related deaths and their links with cholesterol.
    The first search shows the correlatons of mortality/CVD with hi LDL and total cholesterol. And the benefits of High HDL.
    The 2nd is interesting, as well as a link with high values of Tri there is the very interesting correlation with the risks of poor values in the Tri and Sugar index.
    *********
    A meta-analysis published in the *Journal of the American Medical Association* (JAMA) examined the association between baseline low-density lipoprotein cholesterol (LDL-C) levels and total and cardiovascular mortality after LDL-C lowering¹. The study found that higher baseline LDL-C levels were associated with increased mortality and cardiovascular events. This suggests that lowering LDL-C can significantly reduce the risk of cardiovascular-related deaths.

    Another meta-analysis published in *BMC Cardiovascular Disorders* reviewed the lipid profiles and prognosis in patients with coronary heart disease (CHD). It found that higher levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were associated with an increased risk of major adverse cardiovascular events (MACE) and all-cause mortality². Conversely, higher levels of high-density lipoprotein cholesterol (HDL-C) were linked to a reduced risk of cardiac death².

    The second search shows the link with Trglycerides.
    ***************
    Elevated triglyceride (TG) levels have been linked to increased mortality rates. Here are some key findings from recent studies:

    1. **All-Cause Mortality**: Higher triglyceride levels are associated with an increased risk of all-cause mortality. A study found that for every 1 mg/dL increase in TG, there was a significant rise in the risk of all-cause mortality (HR: 1.08, 95% CI: 1.02, 1.15)².

    2. **Cardiovascular Mortality**: The relationship between TG levels and cardiovascular mortality is less consistent. Some studies suggest a link, while others do not find a significant association².

    3. **Triglyceride-Glucose Index (TyG Index)**: This index, which combines triglyceride and glucose levels, has been shown to be a strong predictor of mortality. Higher TyG index values are associated with increased all-cause mortality, particularly in patients with conditions like severe aortic stenosis¹.


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    1. File this under:
      'no shit sherlock'

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    2. Then there is this... https://meddocsonline.org/annals-of-epidemiology-and-public-health/the-LDL-paradox-higher-LDL-cholesterol-is-associated-with-greater-longevity.pdf

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    3. Interesting. I’ll do some sleuthing later. Check out ULTA for lab tests they are the cheapest I’ve found by far. They keep their costs down by not accepting insurance. They primarily use quest labs. https://www.ultalabtests.com/?gad_source=1&gbraid=0AAAAADqIuEbbFKnitXqRsWioRx13Fywht&gclid=Cj0KCQjw99e4BhDiARIsAISE7P9wODnsHDsI81rQh0dB2AgowQJpxJ08Ga3_K6Jiasg995Ua6mwiPp4aAgXpEALw_wcB

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  2. Interesting study. But Korean population may not translate as they have much less CVD and much more stomach and liver cancers. Also they didn’t correlate statins in this study - old people lower mortality for 200 to 240ish - how many were on statins? Statins save lives not just by lowering lipids they pin plaques in place so they don’t break off and cause heart attacks. I also question the significance of the young people in this data set as they were tracked for only 10 years. So all cause mortality for a group of 20 something’s might not be relevant. Accidental death is typically highest cause of mortality in this group how would cholesterol affect that? This is the type of study that provides interesting data to run follow up studies on but is far from conclusive. They do say this “ Individuals with higher TC levels were older and had higher levels of fasting glucose, systolic blood pressure, and BMI (Table 1). People with TC ≥240 mg/dL tended to be non-drinkers and were more likely to have comorbid heart disease, stroke, or cancer. ” So this explains the U at the highest TC levels maybe too far gone for statins to help. The next TC group down might get benefits from statins and likely a bunch of them were on statins. So inconclusive. This was 2019 should be follow ups by now. Keep looking and post more if you find them.

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  3. You would benefit from statins. A low calcium score doesn’t change that. The most dangerous plaque is those that haven’t calcified enough to get pinned in place and you can’t see that plaque with a coronary CT scan. They figured that out with the statins paradox- statins were lowering heart attacks and saving lives but increased coronary scans calcium score. Basically changes the composition of existing more dangerous plaque that isn’t visible by the scan and pins it in place. So this is where a doctor might resist the test - false sense of confidence and the patient won’t take statins anyway so counter productive.

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    1. Coronary computed tomography angiography (CCTA) with dye is better than Calcium coronary CT scan. I'll ask my Dr for it.

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    2. Ok but what will you do with the results? Say if it put you in the 15 percent chance of having a coronary in the next 10 years would you take statins? Doubt if it would be higher than that.

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    3. Statins have undoubtedly kept my parents alive. My brother was put on a max dose of Lipitor, his LDL fell from 202 to 48, total 283 to 120. Then he started showing elevated liver markers. They have since backed off his dose.

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    4. Whether it’s true or not tell your Doc that the scan is needed for you to make a lipids decision. Then he will probably order it. Another study this one more recent and 50 to 89 year cohort. Similar results. Looks real. Ratio is key. https://bmjopen.bmj.com/content/14/3/e077949.long

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    5. I meant statins decision

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    6. Wow huge change your brothers lipids with statins. Did the zio monitor show anything concerning?

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    7. Some meta studies show statins contribution to longevity is minimal. "Eight trials randomizing 65 383 adults (66.3% men) were identified. The mean age ranged from 55 to 69 years old and the mean length of follow-up ranged from 2 to 6 years. Only 1 of 8 studies showed that statins decreased all-cause mortality." https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2773065

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    8. But the point of that trial was to determine how long it takes for statins to provide a benefit- benefit being avoiding a major cardiovascular event. Just because they didn’t follow long enough to see lower mortality doesn’t mean that event didn’t really suck. Can take you from a world class athlete to barely being able to walk upstairs. Basically they want to know who not to treat so if your life expectancy is less than 2.5 years no benefit expected. “ These findings suggest that statin medications for the primary prevention of cardiovascular events may reduce cardiac events for some adults aged 50 to 75 years with a life expectancy of at least 2.5 years”

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    9. Assuming all Americans over age 50 match the criteria in the article (relatively healthy non diabetic, etc) 600,000 major cardiovascular events would be prevented in 2.5 years if all adults were on statins. This number is low as there are a lot of unhealthy adults.

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  4. You would benefit more from a baseline echo cardio gram and stress exercise test. I just finished one went 16.5 minutes on the Bruce Protocol which translates to a VO2 max of 60. The cardiologist said “ Please inform the stress echo was normal. No evidence of inducible ischemia or heart blockage. Excellent exercise tolerance, and impressive that he exercised for over 16 minutes”. The last grade I got halfway through was 20 percent and 5.5 MPH. Echo showed adaptation typical of aerobic athletes heart chambers at the top end of normal ranges for size and an enlarged IVC. At exhaustion they immediately have you lie down on the table and get images of your heart pumping under severe stress to check for normal wall movements. To get one of these bad boys you have to complain of chest pain with or after exercise or have an abnormal EKG - which I have but it is from an “athletic heart”. Also they will try to stop you at 133 BPM unless you get the doctor to approve you going to failure. For you 133 would be meaningless. So you have to have that conversation ahead of time and make sure their staff knows of it, in case the doctor forgot to tell them. I had three nurses basically trying to get me to stop as opposed to what they do for a VO2 max test where they cheer you on. Do it. Beat my 16.5. You can do it.

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    1. Make it a stress echo test. (Echo before and immediately after maximum exertion on a treadmill)

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    2. "three nurses basically trying to get me to stop". ... LOL that's hilarious

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  5. On the subject of no shit sherlock (lol), that`s the way GPT spits out answers for completeness. The point is the TyG index. You were worried about your Tri number. You could try calculating this metric.
    I have never heard of anyone receving feedback on this measure from a doctor, it appears to be a work in progress. Nevertheless it seems pertinant for the western tendancy towards metabolic syndrome and the effect of combined risk factors.

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    1. As an indicator of my innately poor V02 max, I have a high max HR and when not in shape it doesn't take much to elevate. After a hard tempo set where HR goes to mod 180s, I can fully recover to 120 in several minutes when sitting down. Soon as I stand up, walk a little ways, and do a little stretching, I'm right back up to 140-150.

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    2. I don’t think your VO2 max is poor. I bet you would score pretty well on the Bruce protocol. When you trained for 5K’s you were pretty good - id estimate median in a competitive masters field (not local fun runs). Your 800 mm a few years back was impressive. Your heart has adapted to your training so you have a sprinters heart. Watch the interviews with the elite sprinters after a 100 they are gasping for air but the 800 meter guys catch their breath almost immediately. Anaerobic endergy production puts you in oxygen debt. It takes 16 times as much O2 to produce energy and it is replaced when the effort is over. You have the capacity to go deep into anaerobic debt and the payback is painful.

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