45 and 275 @ 6'4"

[Alex2507]

Did someone say jelly-roll?

Mmmmm....

I pigged out pretty good yesterday to break my fast for bloodwork and that's good because my doctor's office just called to ask me to come in because my levels were abnormal and concerning. He's going to try to push Lipitor on me again. I'm going to ask to see what my trend has been over the last 3 years with glucose, blood pressure, triglycerides, LDL and HDL before I agree to take meds. I feel that if I'm moving in the right direction big pharma can take a hike.

 

[Rickster71]

Hey, I sent you an email.



.

 

[Adam]

...my doctor's office just called to ask me to come in because my levels were abnormal and concerning.

Hopefully they were just concerned because they seemed abnormally healthy. Seriously - I hope it's okay.

 

[Alex2507]

Here's the skinny. My cholesterol is still high but I have been demoted from High Risk to just Moderate Risk. Normally he would have recommended some sort of medication that grows tits on men but I guess since I already got them ...

The doc wanted to put me on some sort of med but after asking him what kind of results he expected to see in a particular time frame I pointed out that I had matched that goal (10% drop in 3 months) and more with just diet that has no side effects and is sustainable.

I forgot what the blood pressure numbers were but they went from just staring to be high to normal and my weight dropped 16 lbs since 01-11-12. That's about 2 lbs a week since then and my scale evidently adds +1% so ... hmmm ... now that I think about it I was 283 lbs 3 years ago after quitting smoking.

The Numbers​

....................................3 Years Ago........................Now

Glucose................................111...............................82 (outstanding)

Total Cholesterol....................279..............................254 (right direction)

LDL .........(unmeasurable due to high triglycerides).........181 (right direction)

HDL....................................32.................................29 (wrong direction)

Triglycerides........................364................................122 (this is great)


So ... there's a way to get past this. I asked what I could do to get my HDL up and he said exercise. Pffff ...

 

[Rickster71]

I asked what I could do to get my HDL up and he said exercise. Pffff ...

What?!
Are you sure this guy is a real doctor?
Crazy talk...I'd get a second opinion.

 

[Swerd]

Your total cholesterol is still very high. Generally I've heard that total cholesterol above 240 is considered high risk. 200-240 is borderline, and 200 or lower is desirable. Medication with a statin drug, such as lipitor (generic lipitor is now available and costs less) in most cases does lower total cholesterol.

I have been on lipitor (20 mg each day) for about 3 years and it has dropped my total cholesterol from about 190-200 to 120-130. A lot of people have taken lipitor for some time now and most have no side effects - its a pretty safe drug. It is also clearly effective. Not only does it lower total cholesterol, but it leads to less heart attack and cardiovascular disease.

Your glucose and triglycerides have really dropped. One of the benefits of the low carb diets, such as you are doing, is that you switch over from burning carbohydrates for energy to burning fat. For most people this significantly lowers triglyceride and cholesterol levels, but there is a wide variation among individuals.

Science is looking for ways to increase HDL levels but so far nothing is both safe and effective. The level of HDL expression seems to be genetically determined. Stay tuned, this is an active field of research.

So does your doc say you need to go on lipitor? If there are no other risk factors such as high blood pressure, maybe you can talk him into waiting while you continue on your diet. He may want to check your blood again in a few more months and see if the trend continues to be good.

 

[Alex2507]

What?!
Are you sure this guy is a real doctor?
Crazy talk...I'd get a second opinion.

I've got an extended route to the red Box that cuts through Slater Park. It would afford me a chance to 'old lady' jog about a mile on grass. I walked it once and even walking on grass feels different on my knees. I don't know ... sh!t, that gym about a 5 minute walk away from here has a good size pool. Maybe it's time to break out the Speedos a little earlier this year.

Your total cholesterol is still very high. Generally I've heard that total cholesterol above 240 is considered high risk. 200-240 is borderline, and 200 or lower is desirable. Medication with a statin drug, such as lipitor (generic lipitor is now available and costs less) in most cases does lower total cholesterol.

I've got it in black and white from the blood lab that moderate risk is >240 and high risk is >260mg/dL.

I have been on lipitor (20 mg each day) for about 3 years and it has dropped my total cholesterol from about 190-200 to 120-130. A lot of people have taken lipitor for some time now and most have no side effects - its a pretty safe drug. It is also clearly effective. Not only does it lower total cholesterol, but it leads to less heart attack and cardiovascular disease.

I'm aware of a study with simvistatin that significantly reduced overall mortality but they excluded people with high triglycerides. A later study with pravastatin without the exclusion of the high triglycerides group showed a 33% drop in overall mortality in a group that had not had a previous heart attack (like me, thank Christ). The Oslo study had interesting results regarding diet based cholesterol moderation but they picked people with cholesterol #'s over 300 and had an aggressive anti smoking component. Cardiovascular mortality was affected but overall mortality was not. I'm sure you know better than anybody how difficult it is to decipher the results of studies. I think I remember reading about studies done with aspirin showing a reduction of the numbers of heart attacks but not a reduction of fatal heart attacks. For some reason I find that funny ... well at least until I have a heart attack. Then it will be a most serious matter.

Your glucose and triglycerides have really dropped. One of the benefits of the low carb diets, such as you are doing, is that you switch over from burning carbohydrates for energy to burning fat. For most people this significantly lowers triglyceride and cholesterol levels, but there is a wide variation among individuals.

My understanding is that high triglycerides which result from hyperinsulimia is a really good predictor of heart attacks.

Science is looking for ways to increase HDL levels but so far nothing is both safe and effective. The level of HDL expression seems to be genetically determined. Stay tuned, this is an active field of research.

The Mayo Clinic has some suggestions, all of which I'm on top of other than exercise but my doc agrees with you about it being genetic.

So does your doc say you need to go on lipitor? If there are no other risk factors such as high blood pressure, maybe you can talk him into waiting while you continue on your diet. He may want to check your blood again in a few more months and see if the trend continues to be good.

You're right on the money. I was emailing Rick about this and for a minute thought I had already covered that. In a normal situation my numbers require meds but my reducing the production of HMG CoA reductase through insulin control seems like just as good a plan as doing it through the use of statins. You see, if you eat all your vegetables and take a multi vitimin ... ... kidding.

My thought on why my HDL dropped from 3 years ago is that it had actually dropped below 29 and 3 months ago when I started this diet it has actually come up to 29. That would remain consistent with the improvements in all the other areas. I've got 3 months to make this Dr. Barry Sears really shine. The weight loss was encouraging in it's own right but this is a whole new ball game. I am able to make these numbers do what I want ... unfortunately it means no cookies ... well, reduced cookies anyways.

 

[Swerd]

All in all, that's a pretty good report. Not a home run, but a big step in the right direction. Keep up the good work.

You get extra credit for using terms like simvistatin, pravastatin, and HMG CoA reductase. Ten extra points if you can tell me what HMG CoA is an abbreviation for. No credit if you use wikipedia.

I wouldn't attach too much importance to an apparent drop in HDL levels from 32 to 29. The assay for HDL isn't so precise. I don't know for certain, but the biochemical method for determining HDL in human serum is probably somewhat sloppy. It might easily vary if you repeated the assay 10 times with the same serum sample. There is also another kind of variability. If you had blood drawn 10 times over a month or two, always after fasting for ~12 hours, the resulting numbers could still bounce around because your physiological state is not identical each time.

So the HDL assay may have a precision no better than ±10%. If so, 32 ± 10% and 29 ± 10% are essentially the same number.

 

[Alex2507]

Ten extra points if you can tell me what HMG CoA is an abbreviation for.

Knowing that is way above my pay grade.

So the HDL assay may have a precision no better than ±10%. If so, 32 ± 10% and 29 ± 10% are essentially the same number.

Interesting. The doc said that 10% drop was significant but now I really want to know what the precision of that assay is. It bugs me.

I found the following on this page but got the feeling that when they said 13% it was more complicated than 13%.

NCEP analytic performance goals for HDL-C (26)(27).

In developing guidelines for analytical performance, the expert panel considered the requisite analytical performance needed for reliable medical decisions in relation to biological variation and the capabilities of routine laboratories [for a more detailed explanation of the goal setting process, see Refs. (26)(27)]. The current primary goal is that total error (bias + 1.96CV) be within 13% of the true value. The total error term, combining the contributions of imprecision (random error) and inaccuracy or bias (systematic error), represents the maximum tolerable error in measurement of a single specimen to 95% tolerance limits, i.e., in 19 of every 20 measurements. The underlying specifications for imprecision and bias consistent with the total error goal are informative. Imprecision, in proportional units or CV, should be ≤4%. At low HDL-C values, this proportional target becomes difficult to achieve, e.g., at 250 mg/L the proportional goal would be 10 mg/L; therefore, the precision guideline shifts to an absolute or standard deviation target of 17 mg/L for HDL-C values <420 mg/L. The bias should be <5% from the true value, determined by the accepted RM. Thus, in this example the total error target of 13% is equal to 5% plus 1.96 times 4%.

 

[Swerd]

Interesting. The doc said that 10% drop was significant but now I really want to know what the precision of that assay is. It bugs me.

I found the following on this page but got the feeling that when they said 13% it was more complicated than 13%.

I could take the easy way out and say "no better than ±10%" is just about the same as 13% like they said. Or I could read that damn paper. You actually found a review article that does address the question, how precise is this assay? Because I had to open my big mouth, I guess I should read it. Damn!

I hope I can understand it, or at least nod my head intelligently (i.e. fake it) as I stumble through their precision numbers.

The bottom line doesn't change. The decision on whether to medicate or not is based on the total cholesterol and LDL cholesterol numbers. So the precision or lack of precision of the HDL-C number doesn't matter.

HMG CoA = hydroxy-methyl-glutaryl coenzyme A

The enzyme that turns HMG CoA into mevalonic acid is blocked by the statin drugs like lipitor.

HMG-CoA reductase - Wikipedia, the free encyclopedia

 

[STRONGBADF1]

HMG CoA = hydroxy-methyl-glutaryl coenzyme A

I was just off a bit...

 

[adwilk]

I was just off a bit...

Yeah, I'm just confused now.. I keep checking back to see if Alex is skinny and healthy yet so we can make fun of how fat he used to be... Its gonna happen... I can't wait.

 

[STRONGBADF1]

I'm thinking of calling him "Twiggy".

 

[Alex2507]

I could take the easy way out and say "no better than ±10%" is just about the same as 13% like they said. Or I could read that damn paper. You actually found a review article that does address the question, how precise is this assay? Because I had to open my big mouth, I guess I should read it. Damn!

I hope I can understand it, or at least nod my head intelligently (i.e. fake it) as I stumble through their precision numbers.

The bottom line doesn't change. The decision on whether to medicate or not is based on the total cholesterol and LDL cholesterol numbers. So the precision or lack of precision of the HDL-C number doesn't matter.

HMG CoA = hydroxy-methyl-glutaryl coenzyme A

The enzyme that turns HMG CoA into mevalonic acid is blocked by the statin drugs like lipitor.

HMG-CoA reductase - Wikipedia, the free encyclopedia

I know you're good at reading that stuff. It was sheer luck that I was able to skim the article long enough to find that part but you're right, it doesn't really matter. However the doc did want to put me on meds. He only agreed to give me 3 more months on this diet after I sort of presented my argument for not going on them. Now I can't remember if I said this earlier in the thread or to Rick in an email but when pressed he said that on meds he would have expected a 10% decrease in either the total or LDL, I forget. I was able to show that I had already done that with about 3 months of dieting so being allowed to further control cholesterol production via reduced insulin levels made as much sense as getting on meds.

The only draw back is that if I go much past 5 hours without food I tend to not care about diets and cholesterol. I just got back from the grocery store (Whole Paycheck lol) and while I was in there it was killing me not to buy dessert, hard salami, cheese and bread. I was hungry and ate a decent sized Zone friendly chili just as soon as I got in but the thought of how much I would enjoy the aforementioned combo is making me weak. I better go eat some low fat cottage cheese, fruit and almonds.

Life sucks, what more is there to say?

 

[psbfan9]

I'm sure you know this already. Avocados, some sea food (shrimp) and more fiber will all help raise the hdl levels. You seem to have a dislike for cereal, but it can be filling, sweet, and have a good amount of fiber without tasting like wood chips.

Read the list of ingredients, read the label again, then read the f@#$%ng label once more. Low fat will mean more sodium or more sugar, less sodium will mean more fat. Don't be fooled by labels. Know what's really in the product despite what it says on the label. They're selling a product and know all the 'buzz' words to get you to fall for the marketing. Uncured meat, and meat without nitrates and nitrites will help. Instead of buying deli turkey/meat, get a whole turkey or chicken and roast it yourself. It's cheaper and you have control over what goes on it.

I've seen my dad go through this. Heart disease, cancer, diabetes. It f@#$!ng sucks to watch. He's 83 and still fighting.

Seriously, go walk. If your knee's hurt, go to the gym that's 5 minutes away and walk in the pool. It will become like an addiction once you start doing it and making it a regular routine.

You deserve to be healthy.

 

[Alex2507]

I'm sure you know this already. Avocados, some sea food (shrimp) and more fiber will all help raise the hdl levels. You seem to have a dislike for cereal, but it can be filling, sweet, and have a good amount of fiber without tasting like wood chips.

The only reason I don't do avocados is because the amount of fat that I'm interested in for one meal gets met with about 2 tbls and then keeping the rest of the avocado usable is a chore. Olive oil and almonds are my go to fat sources. All three are listed as favorable fat sources though. I'm taking a fish oil supplement and am always up for seafood but it's odd that you mention shrimp because when it comes to seafood that is one of the higher ranked cholesterol containing sources (IIRC)... not that I'm concerned with dietary cholesterol. And cereal, no redeeming qualities whatsoever. Beyond it's unappetizing nature to me it is simply a carb source and I get that covered in the AM with some honey in tea and a piece of fruit. I might consider cereal though if it did taste like wood chips but it's got some weird flavor that I imagine would be mix of Adam's shorts and socks ... pass.

Read the list of ingredients, read the label again, then read the f@#$%ng label once more. Low fat will mean more sodium or more sugar, less sodium will mean more fat. Don't be fooled by labels. Know what's really in the product despite what it says on the label. They're selling a product and know all the 'buzz' words to get you to fall for the marketing. Uncured meat, and meat without nitrates and nitrites will help. Instead of buying deli turkey/meat, get a whole turkey or chicken and roast it yourself. It's cheaper and you have control over what goes on it.

Actually there's a local deli that sells this natural deli turkey that has nothing in it. Whole Foods sells a similar product for 50% more but neither have any saltiness or much flavor for that matter. Not flavor like Boar's Head would have. Aside from chicken breast the only chicken I buy is those whole rotisserie chickens from the grocery store for about 8 bucks. It's my fast food. The dark meat and tasty crispy skin on certain parts bumps that out of the preferred protein sources category but it's better than the alternatives in the fast food arena.

I've seen my dad go through this. Heart disease, cancer, diabetes. It f@#$!ng sucks to watch. He's 83 and still fighting.

This I'm sorry to hear. I had an old lady say to me that getting old is not for sissies.

Seriously, go walk. If your knee's hurt, go to the gym that's 5 minutes away and walk in the pool. It will become like an addiction once you start doing it and making it a regular routine.

I'm already doing the walking and my knees have gotten better with it. I'm not like in a wheel chair fat or nothin'. My knees use to be tight during the walk, then after the walk and now not at all. I'm going to up the distance by going through a park and doing an old lady jog on the grassy detour to my local red box. I thought about the pool thing but that's just another monthly payment and the next thing you know my g/f would want a membership and right after that neither of us would be going. That's just history that wants to repeat on me. I'd be better off paying an additional 50 bucks on some credit card debt and walking/jogging to the redbox. That's a destination that I'm not likely to stop going to.

Looking back on the thread I realized that I've only lost about 5 lbs in the last 5 weeks. Although better than a kick in the @ss that could be improved upon. I mean I'm thrilled to be under 260 and all but I've still got clothes from when I was like 235 or so. What's another 25 lbs?

 

[djreef]

OK Alex, looks like you need real help.

You need to cut carbs. AS deeply as you can. When I go on a 'cut' I drop to a totall of 75gms per day @2200kcals. With my training schedule I can drop 3-5lbs per week of mostly fat down to 205. Look, stop trying to reinvent the wheel. We meatheads figured this stuff out 60 years ago. The concept is simple.

One of the killer things about lo-carb diets is you blood lipid panel and glucose tolerance cleans up in a fairly short amount of time. I'm not talking Adkins, but something that weans you away from unhealthy meat sources (hot dogs, bacon, sausage) and guides you towards healthier ones (fish, chicken, eggs).

The problem is your body no longer is working in an efficient manner. The key to increasing the efficiency is to use your body for what God give it to you for. Find something activity wise that you like doing. You're tall, join a basketball league, or find an empty and just shoot buckets, tennis, cycle - whatever. That way it doesn't seem like work. I'll catch up when I get back from softball practice.

DJ

 

[Adam]

The key to increasing the efficiency is to use your body for what God give it to you for. Find something activity wise that you like doing.

Apparently, there's some religious debate about that last part...

 

[Rickster71]

OK Alex, looks like you need real help.

You need to cut carbs. AS deeply as you can. When I go on a 'cut' I drop to a totall of 75gms per day @2200kcals. With my training schedule I can drop 3-5lbs per week of mostly fat down to 205. Look, stop trying to reinvent the wheel. We meatheads figured this stuff out 60 years ago. The concept is simple.

One of the killer things about lo-carb diets is you blood lipid panel and glucose tolerance cleans up in a fairly short amount of time. I'm not talking Adkins, but something that weans you away from unhealthy meat sources (hot dogs, bacon, sausage)

DJ

Oh too bad...
You had him, right up to the point you mentioned Bacon and Sausage

 

[Alex2507]

We meatheads figured this stuff out 60 years ago.

... but I'm an airhead.

75g of carbs for a day? That's like two french fries!

I just got through reading a 270 page book that has an additional 40 page bibliography written by a PH.D. I'm gonna stick with that but good luck with any plan you're on that works for you. I'm far from well versed on any of this but that doesn't seem like enough carbs and it seems like too rapid a weight loss.