Coming Off Statins - Update - October 17, 2017 blood work

[sos007]

It has now been a full year since I not only stopped my statin medication (Crestor 30 mg/day) but all cardiac medicines completely. The process of weaning took 10 months from January of 2016 to October of 2016. My bypass surgery was March of 2015.

During the weaning period, I exercised daily and converted to a plant-based diet, along with fish, twice per week and still had some dairy (primarily goat-dairy). I also continue to eat egg-whites regularly for protein. I also still consume olive oil which is contrary to Dr. Esselstyn's recommendations. I lost 40 lbs during that time and my weight has remained the same for the last 12 months - 155 lbs.

When I initially stopped the statins, my cholesterol jumped dramatically. The last blood test with statins was September 6, 2016 and the first without statins was November 29, 2016,

Upon cessation of the statin and all other medications, the following metrics changed as follows:

Unit of measure = mmol/l

Total Cholesterol: From 3.86 to 5.57

Non-HDL: from 2.12 to 3.67

LDL: from 1.81 to 3.29

HDL: from 1.74 to 1.90 (that's good)

Triglycerides: from 0.69 to 0.83 (both values are good)

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My family doctor called the same night and said "what are you thinking?!".

I told him I'm thinking this is the 'rebound effect' to which he replied "what's that?". I had to explain that with many medications, once you stop them - the condition they were suppressing, rebounds temporarily to higher levels.

He agreed to not insist on changes pending a confirming blood test in January 2017, 6 weeks later.

At the January test, all of my cholesterol levels improved again, as did my triglycerides which returned to the same value as when I was on statins, and my HDL (good cholesterol) remained elevated at a good level at 1.87. However the improvement in the 'critical' LDL, and non-HDL cholesterol values (as well as total cholesterol) were minor, and I was still way above the last statin-dependent levels.

My family doctor and I agreed that since I began trending down again, I would remain off of statins, while continuing to monitor.

I have continued to measure my blood lipid profiles regularly (every 6 to 12 weeks) and each time, the values improved - which kept my family doctor happy. My cardiologist though (I saw him in May 2017) insists that I should still be taking a statin to protect myself from another cardiac event. Given my extensive research and confidence in my strategy, I declined his request to re-start the statins.

One year plus a day, after completely stopping statins, these are my current cholesterol values:

Total Cholesterol: 4.8

Non-HDL: 2.53

LDL: 2.32

HDL: 2.27

Triglycerides: 0.47

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All of these values are the best ever for me when not taking medication. They are also all in the optimal range for people without known CVD. For those WITH known CVD, like me, my LDL is supposed to be kept below 1.81. However, the Non-HDL value (an alternative target bio-marker) is in fact below the 2.6 level, or lower, recommended for those with known CVD. Therefore I have met the traditional bio-marker targets of the medical establishment.

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So do I declare victory? Sort of.

I declare victory in meeting the medical establishment's values, however, as anybody who has followed my posts knows, I have been using many other more advanced bio-markers to provide me with a more complete picture of my cardiovascular health, including among other things ApoB and ApoA1.

So far I have achieved or am very close to achieving the optimal levels for these more advanced bio-markers as well.

However, there is one bio-marker that is still of concern - Lp(a) - theoretically a genetically pre-determined level of lipoprotein-type that shows a person's pre-disposition for plaque accumulation.

I have measured it twice so far - fisrt in February of 2017 and again last month. The first measure was 764 mg/l, well above the 300 mg/l considered very dangerous. As noted, the medical community does not really measure this bio-marker and believes that it doesn't matter because it cannot be reduced by either medication, or through diet and exercise. They therefore focus on LDL cholesterol instead.

My research says that Lp(a) is probably the most important risk-metric and lowering it would be ideal for reducing CVD risk as well as the risk of heart attack and stroke.

After reading Linus Pauling's views on cardio-vascular disease, I initiated the following vitamin regimen, 3 weeks prior to my recent, October 2017, blood test:

2,000 mg Vitamin C, and 2,000 mg Lysine.

I also increased my Niacin dosage from 500 mg to 600 mg daily (well-below the 1,000 to 3,000 mg recommendations of the medical establishment). For those who do not remember a previous post I made on Niacin, it was the preferred treatment for lowering LDL cholesterol prior to the introduction of statins.

I also take many other vitamins but I didn't change their dosage from the previous blood test.

The impact? My Lp(a) result decreased to 650 mg/l, representing a 15% reduction! This is still well-above the sub-300 mg/l levels that imply low risk.

Could this be normal variance for this bio-marker measure? Quite possibly. Therefore, I have now modified my Linus Pauling-inspired vitamin regimen to:

5,000 mg Vitamin C, 5,000 mg Lysine and have added 2,000 mg of Proline.

My next blood test is scheduled for January 9th, 2018. At that time, I will also have another advanced blood test done called NMR Lipoprofile (Nuclear Magnetic Resonance (NMR) Spectroscopy). This test provides the most state of the art breakdown of LDL sub-fractions as well as particle number, and traditional cholesterol measures. I will do it concurrently with the standard lipid panel at a different lab in order to compare results.

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If anybody is interested in the results of my other advanced bio markers, including ApoB and ApoA1- you may send me a private message and I'll provide you with the results.

For the record, the only carbohydrates I consume are complex carbohydrates, I completely avoid simple carbohydrates except for 2 teaspoons of honey per day.

In terms of fat - I consume olive oil and the fat generated by nuts, as well as the fat found in salmon and other cold-water fish. I have not indulged in any other animal fats as many others do on the low-carb, high-fat diets. Among the dairy I consume, I use full-fat organic goat milk, as well as 0% and 2% fat, plain Greek yogurt.

[pryor147]

Hi great post, I have made very simular changes to diet. strict for now and see the benifits later. No Meat No Dairy No pastries No Bread, Pasta or rice so just veg, salads seeds nuts porridge rolled oats.

In two days reduced insulin by at least 50%, glucose reading stable 5 - 8 no lows or highs as previous week. Taking some vitamins and just ordered SERAPEPTANE. Next blood works on in JAN 18

[sos007 Ambassador in reply to pryor147]

Good for you. Just keep in mind dietary changes must be permanent to be effective.

[Penel]

Good to hear you are having such success with your dietary changes.

[Spareribs]

Very interesting post thank you, don't forget to supplement B12 esp on a plant-based diet & my favourite Vitamin D

[sos007 Ambassador in reply to Spareribs]

Already taking both among others. Thanks.

[Spareribs in reply to sos007]

good to hear

[Sparky3333]

Wonderful:))) Ive also dropped all my heart medications recently, however I'm still be a bit slack on the exercise front. Wonderful to read such a thoughtful and inspiring post!!!

[sos007 Ambassador in reply to Sparky3333]

Thank you, and congratulations to you as well! Exercise is not a luxury, so get up and go!

[bobaxford]

Another very interesting post on your progress. Please continue to keep us all informed.

Just as an aside I am still following the Esselstyn recommendations but contacted him via email recently as I am conflicted about changes I have made to my diet too and wondered if his views have changed since he wrote his book.

This was his reply

“ I am concerned that you are eating of fish, chicken,and olive oil, all of which injure the endothelial lining of your arteries. Remember the only reason that heart disease develops is after decades of injuring the endothelium, It is no longer capable of making sufficient nitric oxide to prevent you from forming arterial blockages and plaque. Reintroducing the endotheliuml injuring foods is obviously contra indicated.“

So I am still somewhat conflicted about these foods and the possible effect on atherosclerosis progression.

[sos007 Ambassador in reply to bobaxford]

Well Bob - I think my experience certainly paints a different picture. I have been monitoring my endothelium function in a clinical setting and my FMD% (Flow-Mediated Dilation) score has continued to improve. In August 2016, over one year ago, it was at 6.8% which indicates medium risk and compromised endothelium function. This was not a surprise since I have CVD. What I didn't know was my score prior to my surgery. I would venture to guess it would have been less than 5% which would indicate a high risk of developing CVD.

I have since measured it twice since then, in January of 2017 my score improved dramatically to 7.9% which still left me in the medium risk range, but clearly in the upper portion of that range. In July of this year, I measured it again and scored 8.4% - another significant improvement. I brought my wife along who is in good health and she scored 8.7%. Her score is the threshold of the 'low-risk' category. Optimally you want to be at 10% or better, but at 8.7% your endothelium is sufficiently healthy that it neither detracts from, nor adds to your life expectancy and risk of CVD.

Right now I feel pretty amazing - I'm very energized and my lung capacity seems better than ever, especially since I've adopted the Linus Pauling Therapy. Psychological? Perhaps. However, I continue with my disciplined diet and exercise regimen and am hoping Linus Pauling was right about Vitamin C's impact on CVD.

For whatever its worth, eating fish twice per week, and chicken once per week and using olive oil liberally does not appear to be hindering my cardiovascular health.

Doctors tend to stick to their theories especially if they've found success using them. Perhaps Esselstyn's dietary regimen would have had my endothelium FMD score up and over 10% by now, but I'm trending in that direction anyway, so I'm not worried about my current diet.

Nitric oxide production is enhanced by exercise and green leafy vegetables like arugula and spinach as well as broccoli. I ensure that I exercise daily and eat at least one of those vegetables daily. My diet and exercise therefore appear to more than compensate for any potential damage being done by fish, chicken and olive oil.

Keep in mind, my consumption of fish and chicken are very modest. 21 meals in a week and only 3 of them have animal protein. I get the rest of my protein from Greek Yogurt 0% or 2% fat, plain; Greek Feta (goat and sheep milk), egg whites, beans, lentils and chickpeas, and a half cup of nuts, as well as nut butter daily. I also ensure I eat bran cereal with a half cup of blueberries daily as well as dark chocolate. Dark chocolate also generates nitric oxide production.

A diet has to be sustainable to be effective, and as disciplined as I am, I can't imagine living without olive oil and feta - after all, I AM Greek - OPA!

Best of luck.

[sandybrown in reply to bobaxford]

Am I to understand, eating of fish, chicken,and olive oil is bad for my heart and my body?

[sos007 Ambassador in reply to sandybrown]

That's the view of Dr. Esselstyn. I don't agree with his view.