Cholesterol - any doctor here ?

[Wheeze]

No, my test was an arterial flow reduction NOT a narrowing. Very different things. Oh, and I smashed the Bruce protocol!!

[Gambatte]

Hello all,
thanks for contributing to the thread and apologies for being absent for a while.
Here more info:
My BMI is 21, I'm 177cm and 66kg, weight never (!!) been outside the 65-67kg range since mid teen 30yr ago. I've had low body fat all my life. I've been on Mediterranean diet all my life (easier when you are born in Italy and grew up there with Italian parents, my mum is/was a nurse and always been super health conscious and educational.)
My "diet" includes huge amount of veg (yes, very huge), especially raw veg, infinitillions of tomatoes, whole grains, much fresh fruit, tons of olive oil, very little butter fat salt sugar red meat, extremely little cured meat, zero "ready meals". Nobody eats more veg, or less processed, than I do.
Been running / triathlon kind of constantly for 30yr.

Here some weak points: my dad's brother died of heart attack, my dad's father also had one (diagnosed years later), my Mum also has naturally high cholesterol (was 280, now 200 with statins). Family history for heart condition is extremely telling, no surprise is the first thing the cardiologist always ask.
I learnt that, to a very large extent, cholesterol is simply produced by the liver, so with a "wrongly tuned" liver could cause high cholesterol, even with good nutrition and exercise and perfect BMI. Just bad luck.

Spoke with a cardiologist. She didn't like the fact that I had the test just after lunch (cheese, cholesterol -wise the worst aliment) and suggested to get one on empty. But most Dr say unlike other values cholesterol is not really bothered by when you ate last, so not sure what to make...
My ECG was perfect. So is heart rate. But pressure 80-140 is high. She said statin NOT justified right now, but keep monitoring cholesterol AND pressure.

Here next steps, as suggested by the cardiologist: take cholesterol test again, on 12hr fasting, and in any case check it regularly, at least once a year. Check thicknesses of the arteries (a simple eco blabla Doppler test), take some cholesterol reducing supplement (looks like a medicine but it's not, can't remember the name, can be bought even on Amazon). Diet and lifestyle I'm afraid no room for improvement there, they are already perfect.

No sure how much any of you guys is interested, but I like this forum very much, you folks are super supportive, I'll update here...

[Mike T]

No, my test was an arterial flow reduction NOT a narrowing. Very different things. Oh, and I smashed the Bruce protocol!!

Flow reduction due to what? Sorry, I don't understand.

[Mike T]

Hello all,
thanks for contributing to the thread and apologies for being absent for a while.
Here more info:
My BMI is 21, I'm 177cm and 66kg, weight never (!!) been outside the 65-67kg range since mid teen 30yr ago. I've had low body fat all my life. I've been on Mediterranean diet all my life (easier when you are born in Italy and grew up there with Italian parents, my mum is/was a nurse and always been super health conscious and educational.)
My "diet" includes huge amount of veg (yes, very huge), especially raw veg, infinitillions of tomatoes, whole grains, much fresh fruit, tons of olive oil, very little butter fat salt sugar red meat, extremely little cured meat, zero "ready meals". Nobody eats more veg, or less processed, than I do.
Been running / triathlon kind of constantly for 30yr.

Here some weak points: my dad's brother died of heart attack, my dad's father also had one (diagnosed years later), my Mum also has naturally high cholesterol (was 280, now 200 with statins). Family history for heart condition is extremely telling, no surprise is the first thing the cardiologist always ask.
I learnt that, to a very large extent, cholesterol is simply produced by the liver, so with a "wrongly tuned" liver could cause high cholesterol, even with good nutrition and exercise and perfect BMI. Just bad luck.

Spoke with a cardiologist. She didn't like the fact that I had the test just after lunch (cheese, cholesterol -wise the worst aliment) and suggested to get one on empty. But most Dr say unlike other values cholesterol is not really bothered by when you ate last, so not sure what to make...
My ECG was perfect. So is heart rate. But pressure 80-140 is high. She said statin NOT justified right now, but keep monitoring cholesterol AND pressure.

Here next steps, as suggested by the cardiologist: take cholesterol test again, on 12hr fasting, and in any case check it regularly, at least once a year. Check thicknesses of the arteries (a simple eco blabla Doppler test), take some cholesterol reducing supplement (looks like a medicine but it's not, can't remember the name, can be bought even on Amazon). Diet and lifestyle I'm afraid no room for improvement there, they are already perfect.

No sure how much any of you guys is interested, but I like this forum very much, you folks are super supportive, I'll update here...

Your risk of a vascular event looks pretty low to me! I cannot believe a statin is indicated - but doctors feel almost obliged to "do something", especially if their remuneration encourages activity.

PS: White pasta? White bread?

[Gambatte]

Your risk of a vascular event looks pretty low to me! I cannot believe a statin is indicated - but doctors feel almost obliged to "do something", especially if their remuneration encourages activity.

PS: White pasta? White bread?

In my case exercise, nutrition and weight are good, been good all my life.
But family history, pressure, and cholesterol are not good. So "some" risk is definitely there.

Mike, thanks but maybe you misread: the Dr said as things stand today I do NOT need statins.

I love pasta, switching now to wholegrain. Bread, been making my own for many years, always wholegrain. But trading white for wholegrain has only a very small improvement for cholesterol.

[Wheeze]

Good plan Gambatte. Just keep an eye on it for now but genetic cause looks odds on favourite.
Mike. I had a CT coronary angiogram with the data processed by Heartflow which us a NICE approved CFD (computational flow dynamics) assessment of arterial flow. My cardiologist tells me that the 30% flow restriction (which is asymptomatic) leaves me at risk of sudden cardiac death under high stress....hence his instruction to stop racing.

[Mike T]

Good plan Gambatte. Just keep an eye on it for now but genetic cause looks odds on favourite.
Mike. I had a CT coronary angiogram with the data processed by Heartflow which us a NICE approved CFD (computational flow dynamics) assessment of arterial flow. My cardiologist tells me that the 30% flow restriction (which is asymptomatic) leaves me at risk of sudden cardiac death under high stress....hence his instruction to stop racing.

But what is causing flow restriction if it is not narrowing?

[Mike T]

In my case exercise, nutrition and weight are good, been good all my life.
But family history, pressure, and cholesterol are not good. So "some" risk is definitely there.

Mike, thanks but maybe you misread: the Dr said as things stand today I do NOT need statins.

I love pasta, switching now to wholegrain. Bread, been making my own for many years, always wholegrain. But trading white for wholegrain has only a very small improvement for cholesterol.

Unless you have an event a statin would not be of benefit, even if your cholesterol does not come down. I know you are not on one now. The benefits of whole grain foods are way beyond cholesterol reduction - more fibre and other goodies, lower glycemic index, better glucose control etc. Spelt wholemeal pasta is delicious - and I recently started cooking the pasta in the sauce rather than in water - so much tastier.

[Gambatte]

Mike,
I'm lost with the logic. What does one do (ok, other than diet, lifestyle, etc) to lower cholesterol BEFORE an event occur, to make it less likely that it will actually occur?
OK statin is not my thingz, but still, the question stands.

[Wheeze]

I understand your concern Gambatte. It seems like you are already leading a lifestyle that should result in normal lipid profile.If I were you, try the minor adjustments already suggested and do a fasting lipid check in 3 months. See how you are then.
In my case, the abnormal lipid profile was genetic. Statins halved my cholesterol level in 3 months...I had kept to same diet. My profile now remains stubbornly normal.