Kevin’s Corner on Exercise and Nutrition

There is tons of information out there on the topic of Cholesterol. How can you find out what your numbers are? Did you get all the right tests? So, what does it all mean? What are the important numbers? What can you do about it? What are your options? Sorting this all out is a nightmare.

Let me share a little of my history and then I will try to give you my opinion on what I think you should start thinking about doing about the questions above:

I found out at the age of 20 when I was in the height of training with the cross country team at the University of Maryland at College Park that my cholesterol was over 200. At the time, the test was a simple pin prick and they only gave me my total cholesterol. They couldn’t or didn’t give me my HDL and LDL counts. I basically ignored the numbers and continued with my life. I had already seen a cardiologist earlier that year. I saw the cardiologist because during my physical to be given clearance to compete and train on the Cross Country Team, the doctor heard what he thought was a slight murmur. The cardiologist ran a number of tests and said I was fine to compete. What was strange to me back then is why didn’t he want to know about my cholesterol? I thought it was probably because he was clearly fine with what he heard from listening to my heart and could see from my EKG. What I know now is cholesterol takes years and years to build up. Why would he be suspicious or worried about me having high cholesterol when I was 6 feet tall and weighed about 160 and was running close to 60 miles a week?

Fast forward 20 years. I still have a total cholesterol of just over 200 off of medication. I have tried pretty much every cholesterol medication over the last 12 years and combination of meds that is available on the market; Lipitor, Zocor, Crestor, Niaspan, and Zetia. They all worked to lower my LDL, raise my HDL to some degree and in some cases help me control my Triglycerides.

However, all of these medications caused me to have myopathy or what I like to describe is a feeling like I was one of the guys Joe Pesci and Robert De Niro worked over in the movie Goodfellas. The muscle soreness or myopathy ran the range of small little nagging injuries that I would write off to my training to full blown goodfellas syndrome. Each time I was tested for bad liver enzymes and my CTP levels they always came out normal. So, the doctor would just tell me to go off for a couple of weeks and resume the doses. Mind you, I took pretty much the smallest doses you could get. 10mg was my last dose on Crestor.

Crestor was a hoot. This is a drug where in addition to having the low grade myopathy over a course of several months that just didn’t ring out to me that it was the medication and a nagging hamstring injury that I kept excusing away to just over training, I developed a headache that never would go away. It was a 24/7 headache that lastest almost 3 months. This was the kind of heahache that you spend the day with, go to sleep with, you wake up with. I ended up seeing the following professionals; my MD, my chiropractor, a physical therapist, an allergist, an acupuncturist, a neurologist, a cardiologist, and an endocronologist. Can you imagine what my bills looked like? Thank god I had insurance through my employer. I ended up trying a repotoire of medications with no relief; every over the counter headache med you can think of, muscle relaxants, anit seizure drugs, prescription pain killers. Do you know what fixed it? I stopped taking the Crestor. Duh! About 4 weeks later the headaches went away and you know what my cardiologist suggested? Why don’t we try a lower dose or try a different med. Can you believe the nerve of this guy? Talk about when the only thing you have is a hammer, everything looks like a nail.

So, now, I have been clean and sobor off of the meds for good since October. As I sit here today, I am simply blown away with how great I feel. Knock wood, but I have not had a cold for over 4 months. my nagging hamstring injury is gone. The headache, gonesville. I am running like a gazelle. My recovery from my hard workouts is unbelievable. I am doing stuff I haven’t done for at least 10 years and I think I am actually recovering faster now than I did then. I will share what changes I made in my life later on. Trust me when I say to you that it is unbelieveably simple. but so very very hard to do. I am not going to kid you.

So, how do you become informed about Cholesterol?

One of my favorite resources on the web for getting the skinny on cholesterol and the latest research broken down into human readable format is Dr. Mirkin. Dr. Mirkin has an entire section on his site on cholesterol and Heart Health. What I love about his site is his ability to boil down into two or three paragraphs a summary of the latest research.

I also read everything WebMD has to say. They have a lot of great information for you to at least gain a deeper understanding on what cholesterol is and what mainstream medicine and sometimes alternative medicine can do for you, but definitely not all.

So, how can you find out what your numbers are and more importantly, did you get all the right tests?

Your primary care physician should be able to order a standard cholesterol test (Blood Lipid profile) The tests he/she most likely will NOT order, but you should demand that he/she does are; Lp(a), CRP, Homocysteine and wait for it….. Vitamin D. Yup, Vitamin D. The test you want is 25(OH)D. Thanks Dr. Mercola! Having a deficiency in Vitamin D could double your risk for a heart attack if you have metabolic disorders like hypertension. Check out this report from WebMD.

So, what does it all mean? What are the important numbers?
I can run down the ranges, and I will, but just remember that they probably could change in the next year. They have in the past. It would be better to get your guidance from Dr. Mirkin or WebMD.

What I will tell you is that high cholesterol is a symptom and not the problem. Of course if your arteries all clog up from your high cholesterol it has moved from a symptom to a problem.

Guidance on the numbers also depends on whether you are a man or a woman for some of the numbers. Here is what I know based on recommendations for men: You want your LDL below 130 and ideally under 100. Get your HDL over 40 and ideally over 50. I believe for woman the minimum is 50. For Triglycerides, under 150, but I think it should be more like under 100. I call this the carbohydrate fat. If you eat a lot of simple carbs, this number will be high. CRP under 1. Lp(a) under 30. Mine was over 100 for the last 6 years and probably longer, I just didn’t know. Now, it’s 21 thanks to my diet! Yeah! Homocysteine below 100. Vitamin D above 32, but ideally in the 40-50 range. This guidance will on Vitamin D will most likely change to a minimum of 40.

What can you do about it? What are your options?
Well, the guidance I can give on the numbers is it depends. Especially, if you have other risk factors like you smoke, you are overweight, you are sedintary, your diet sucks (more on that later), you are in a high stress job, you have high blood pressure, and if you have type I or type II diabetes. All of these factors weigh heavily on what you should do about your cholesterol.

If you have a lot of these factors above, please see your doctor and follow their recommendations and take the medications that they precribe, at least for the short term to try to at least put the finger in the dike. Long term, you need to see what you can do about addressing the underlying causes of your risk factors and then get off the meds. They may take care of you short term, but long term, they will eventually kill you.

If you do go the drug route, I highly recommend reading, Supplementing your Presciption by Dr. Cass. She is amazing and should be given a medal for her book. You need to read this book.

If you are like me or you can get to where I am and you exercise regularly, you are not overweight, and you don’t smoke, but you stil have high cholesterol. I think you have other options besides going the drug route. I went the Paleo Diet route with amazing results.

I will leave you with these thoughts….

Diet is everything!

Food is a drug.

Question: If someone could help you identify the foods that are making you sick, do you think you could do what is necessary to replace them with something else?

You know, for the longest time I could not answer that question with a NO. I chose the drug route. So, here I am 10 plus years later and my answer has changed to a YES. Maybe I can convince you to change your answer to a yes as well.

I hope this was helpful. I hope I can come back and pile on with my thoughts on things like Lp(a) and what I think caused it drop by 100 points for me. I can tell you more horror stories about Lipitor. I could spend a lot more time talking about healthy diets and following the science behing why diets like the Paleo Diet have it right, lower inflamation and change your Omega 6: Omega 3 ratio.

If you happen to stumble on my new blog, post a comment or question and I promise I will try to get back to you and hopefully answer your question to the best of my ability.

Take care,

Kevin