Hello eveyone!

We have been hard at work on getting my husband healthier as he is having his knee replaced March 8th. He started low carbing (again) Jan 1st. Here are some of his numbers and dates. I can see improvements quickly, but it's still scary too! He is on 4- 6 fish oils (lovaza), 2 coconut oils 1000mg each, 2 co-enzyme Q-10's 100 mg each, plus 6000IU Vit. D 3 daily. He is eating very strict Atkin's now and has cut out his wine. Someone please advise us here. He also has added Niacin 500mg once a day (flush free.) It seems he is improving, right???? Please tell me all about the VAP. The doctor here ordered the test, but told him "good luck getting that interpreted." They had never heard of the test and it was very complicated to get the results interpreted. I sure don't think he needs a cardiologist to tell him to go on a low fat diet again! THAT IS WHAT HAPPENED! He got gout and some bad lipids last year and got off of Atkin's last June - from pressure from the medical world. He is feeling better now, and we hope he can recover well after his knee replacement!

THANKS IN ADVANCE!

10/1/2009
Chol. total 315
Trig. 401
HDL 43
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1/27/2010
Chol. total 252
Trig. 254
HDL 33

LDL Calc. 168
LDL/HDL ratio 5.1
fasting glucose 105
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2/10/2010

Chol. total 254
HDL 33
LDL 180
Trig. 191
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VAP profile
LDL - 180 range<130
VLDL 41 <30
Non HDL Chol (LDL + VLDL) 221 <160
apoB100 - calc 144 <109
LDL-R (Real) C 146 <100
IDL Chol 29 <20
Lp (a) chol 4.0 <10
Remnant Lipo (IDL + VLDL3) 51 <30
HDL - 2 (most protective) 5L >10
HDL-3 (less protective) 29L >30
VLDL (small remnant) 22H <10
LDL1 Pattern A 29.0
LDL2 Pattern A 4.1
LDL3 Pattern B 72.6
LDL4 Pattern B 40
LDL Density pattern B

A1c 5.7
Vit. D 36.8 range 32 - 100
Creatine Kinase, Total Serum 85 range 24 - 204

You might as well flush the toilet twice a day for all the good that will do. You have to get the kind that makes you flush, unfortunately. Dr. Davis recommends Slo-Niacin.

You don't need prescription fish oil. OTC is fine. I get Carlson's Lemon fish oil because it is very concentrated. A tablespoon is a good big dose of omega3. Jarrow makes it too and I think their price is better. Iherb.com is a great place to get it.

I'd wait until he's been on low carb for at least 3 months before ordering a VAP or NMR. When I had mine done the company that did it (paid out of my own pocket) provided a lot of info about how to read it. Lots I also picked up reading on Dr. Davis's blog: heartscanblog.blogspot.com

From what I can see, your husband's results look pretty bad. High triglycerides (too many carbs, booze doesn't help). Pattern B cholesterol is bad, he's got quite a lot of it. His VLDL is high... that's bad. His A1c is high, he's probably pre-diabetic or even diabetic.

D3 is lowish. Depending on the lab used for that, he could be even lower than that number. He should be at least 60-70 ng/ml. It'll help his heart if he's that high too.

I think Dr. Davis would have a field day with your husband's reports. You guys might want to look into joining his Track-your-plaque program. You'll get lots more specific advice than I can possibly give you.

The gout, diabetes, high triglycerides all scream the same thing... metabolic disorder brought on by too much fructose. He probably has fatty liver disease too. Are his liver enzymes raised?

On Nancy's recommendation:
http://www.trackyourplaque.com/

Join Angie!!

I kept trying to join and they kept declining my card when the card is fine. I am going to go and read the benefits of joining. I have wondered many times if he was diabetic. Wonder why the doctor harps on statins instead of the potential damage diabetes would do. I can't even imagine what his A1c was prior to low carbing. On one of his past lab sheets, his fasting glucose was 149....did they say anything??? NO!!!!! I am going to go and try to join again. I am so glad I found this place!

Doing the math, so since Oct, he has reduced his risk (dividing HDL into TG) from higher than 9 to 5.78? I realize it isn't good still, but isn't there a good chance he will continue to improve at this rate??? I am afraid they are going to really try to push the statins on him at Duke, especially when he goes in for the pre-op physical. Would the statins benefit him at all in reducing his LDL? Since he had this kind of number reduction in less than six weeks on Atkins and then dropped another 50 TG points in 2 weeks on the supplements, and is now able to ride a recumbent bike, is it possible his risk would be tremendously better in the next month? (I know - a lot of questions!)

I am still trying to join the Track Your Plaque. I entered something wrong I think the first time and now, it flagged my card in their system I think. I will join but in the meantime, have I found an internal medicine doctor at Duke that believes in low carb and have emailed him for a consultation. I am very excited about that!

http://lowcarbdoctors.blogspot.com/...dicine%20Clinic

Do cholesterol drugs do any good?

There's a difference between treating a disease and treating a number.

Thanks Nancy! That has become our motto regarding statins!

Angie,

I didn't see any comment about his blood pressure/ heart rate. Does he not have those symptoms?

No high blood pressure or pulse rate. No elevated liver enzymes. He really doesn't appear to have anything wrong!

I am thrilled to hear that he doesn't have hypertension, etc. You caught it early.

Gout is caused by uric acid crystals. Excess uric acid comes from carbohydrates and particularly fructose. The malic acid in (any brand) apple cider vinegar will dissolve the crystals. It should be consumed with food, as the acidity aids digestion or alternatively, requires extra buffers on an empty stomach. It can be used in recipes lots of ways to avoid drinking it.

Niacin does help. The straight nicotinic acid form is most effective. It causes flushing, itching, and sweating which moves toxins out through the skin. Start at 100 mg. and work up slowly as flushing reaction subsides. There is no reason to rush it. It isn't dangerous, but it is uncomfortable. I also took slo-niacin at bed time (500mg.) and slept through any minor reaction. I improved my lipid profile even on the DASH diet, forcing down whole grains and 3 fruits per day. Fish oil, salmon oil, flaxseed meal and/or oil, olives and extra virgin olive oil, coconut oil and nuts (walnut, almond) all help. <Medeteranian recipes> Fiber (from psyllium, ground flaxseeds, cruciferous veggies, etc.) also helps (colon clean). He should take B-complex 3x per day to aid metabolism as well as lecithin once a day to emulsify fats (exchange healthy fats). Even eating high protein, the b-complex vitamins can be insufficient. They're cheap and non-toxic... you can afford yellow urine until the lipids improve.

You mentioned something about a high blood glucose. I assume that was a fasting measurement? The elevated uric acid and caffeine both contribute to insulin resistance. I use hibiscus flower tea with added citrulline malate 2x per day to improve my Nitric Oxide. I switched to water-processed decaf coffee (it actually tastes better than my old coffee). Those steps were the end of all of my "metabolic syndrome" symptoms. I had the high blood pressure and rapid heart rate as guidance, but perhaps he would benefit? He has the gout to guide him, and perhaps he could tinker with a glucose monitor and see better what's going on. You do have a couple of hints with those issues to indicate the underlying problem.

My only other thought on your post is the coconut oil taken in tablet form. I use coconut oil for cooking. It is delicious. I mix it with unsweetened cocoa powder and stevia to make a chocolate paste that I add to plain yogurt and it turns into chocolate chips. I use coconut oil instead of butter on steamed veggies. The Nutiva 54 oz. (1532 g.) costs about $22 online. Much cheaper and yummier than tablets.

The lipid profiles are ONLY risk factors. You don't need to fix them overnight, it seems like a slow process - kind of like losing two lbs. a week seems slow after years of gaining one lb. a month. He will be years younger in just a few months.

One thing to be aware of is that niacin raises your blood glucose so if that's an issue I would be very cautious about using it.

Thanks for that advice!!!

He is on the 750 slow-niacin now as part of Dr. Davis recommendation (the great cardiologist from trackyourplaque.com) Also, the flax, the coconut oil, EVOO, cruciferous veges. Today, again by Cadheart, he suggested we drop the coconut oil. Not sure what advice to take. If Dr. Davis doesn't correct him (and they say he will if it's wrong) then I am unsure about it???

He hasn't flushed on the slo niacin that he is aware of.

Also - he is taking Metformin 2x daily as well as I read it helps to lower TG's also. Can't hardly get him to eat b/c the Metformin reduces his appetite a lot. Plus, he is on iron for this month before his surgery, so stomach achy from that.

Don't know if I can force any more pills on him 3x a day at this point. He takes so many (2 gout, 4 fish oils, 2 co-enzyme Q-10s, Niacin, 2 celebrex, prednisone, Metformins, 3 irons, 2 coconut oil, stool softeners......) Poor fella!

Ortho wanted him to add Percocet (the pain is horrendous and he can't come down stairs at all now) and he refused. I am like "What's a few more pills?"

Seems he has been diabetic for a while. I have his records from 3 years ago. His fasting glucose consistently over 110. Scary!!! What if I hadn't been looking??? So yes, he is monitoring now! Hope this can be reversed.

Oh man, prednisone is awful stuff. That can make him diabetic right there. Has he been on it long?

Nine months! Hasn't really helped his pain in my opinion....but the possibility exists it could be worse I suppose! He agreed to start using the vicodin and also admitted he used the wine to cope. Dr. Davis also said the wine DID NOT CAUSE his problem. He wrote:

Dr. Davis

Master Contributor

Posted: 2/14/2010 8:33:05 AM

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Welcome, ReelKeel. Wow! I think CADHEART and Lindy made all the crucial points. Your husband is demonstrating what is actually a very common pattern in people who have overindulged in carbohydrates and have a genetic sensitivity to carbohydrates: high triglycerides (the first "domino"), which leads to low HDL, drop in healthy large HDL, small LDL (severe ), an--no question--pre-diabetes. The important issue here is eliminate wheat, cornstarch, sugars, and other unnecessary carbohydrates. This is not Atkins, as we do not say "eat all the bacon, cheese, and sausage you can," which causes colon cancer, increases uric acid, and causes other health problems. Also, as Lindy points out, lipoproteins alone do not constitute near-term risk; the presence of heart disease does this. So a heart scan and/or a stress test are in order. This should be common sense on the part of his doctor; if he doesn't get this, then it's time to find someone who does, as well as knows how to tie his shoes.

He also said in an email he has had this for a long time. He has been on and off the prednisone for years but yes, he did used to overindulge in carbs....as in donuts, blizzards, fries daily! He is now happy on th TYP diet plan!

Well, I love Dr. Davis and think he's mostly on the right track, but he's obviously at least several weeks out of date on bacon and sausage causing colon cancer. He is a reformed vegetarian and that takes some time to get out of that mentality. Go take a look at the first page in the Media section right now. New reports that red meat DOES NOT cause cancer, the old reports were faulty and their faults were covered up.

I just ran across this comment from Peter from Hyperlipid and I think it's pretty good.



That last bit is crucial: " TYP is undoubtedly a work in progress"

It very much is. Dr. D. changed his stance on meat and fat dramatically over the last couple years although IMHO he has a way to go yet, he still seems to have some of that ex-vegetarian squeamishness.