What tests should be done, before comm... - Cholesterol Support

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What tests should be done, before commencing statins please?


Hi All

I understand that before starting statins these tests should be done

- Liver markers

- Kidney markers

- CK test

- Full lipid profile

Anything else please?

Thank you


24 Replies

Is you cholesterol level very high? from my own experience it is your cholesterol level that makes the drs decide to put you on statins.

Alpsholiday in reply to karmel

Hi karmel

My total cholesterol at the time the statins were prescribed 4 1/2 years ago, was 3.6

It's always between 3 - 3.6, and has been for 30 years, since I went vegan.

I attribute that to the vegan diet, which, as you know, has no cholesterol.

So, the liver just makes what it needs.

My problem is genetic atherosclerosis, which statins do not address at all.

So, the statins should never have been prescribed for me.

Taking them, was the biggest mistake of my life.



karmel in reply to Alpsholiday

I don't understand why you were ever prescribed statins if your cholesterol level was under 5.🙃

Alpsholiday in reply to karmel

Hi karmel

From my 'heart scare day in May 16 till Oct 16, I was with the Nurse led Cardiac team - and they said they were all very surprised at my super high Calcium score of 1315. As I had none of the usual lifestyle factors.

My BMI was 21, lifetime cyclist, never smoked, no alcohol or drugs etc.

So, they suggested genetic atherosclerosis, for which statins do not help at all.

And the lipid profile was unremarkable with total cholesterol at 3.6, so they decided that statins were not indicated.

However, when I went to another cardiac team in Nov 2016 to prepare me for CABG, I was told (no discussion at all) that I was now on a statin.

I queried this, saying my total cholesterol was 3.6 - but all I got was a shrug of shoulders!

My profile explains a bit more




Athletic activities increase sheer stress in the arteries. Sheer stress causes microtears in the endothelium. This triggers inflammation and the body's immune response to repair damage - hence plaque accumulation and calcification. This is not a genetic condition, this is a lifestyle condition.

To repair the damage caused by inflammation the preferred repair process involves collagen. In order for the body to synthesize collagen, it requires vitamin C. The more collagen required, the more vitamin C required.

Humans are the only animals on the planet that don't naturally synthesize their own vitamin C. We must ingest it. Dietary vitamin C is fine for most people assuming they eat a balanced and nutrient-rich diet. However, athletes cannot consume enough vitamin C through diet to synthesize sufficient collagen.

You must take large amounts of vitamin C. However, you cannot do so with pills or powders because you will metabolize it within 2 hours.

The best solution is liposomal vitamin C. I take 2,000 mg daily, but the human body can easily tolerate 15,000 mg per day, or more, depending on their needs and whether they have an enzyme called G6PD which among other things, helps process vitamin C. You can have a blood test to see if you have G6PD.

Source: cedars-sinai.org/health-lib....

If you have this enzyme then there's no upper limit on your vitamin C consumption:

Copy and paste this url to your web browser: (www2.lbl.gov/Science-Articl...)

I live in North America and use this product daily: livonlabs.com/liposome-scie...

If you live outside of North America, you can search here for a local supply of liposomal vitamin C:


Read my pinned post which if viewing on a computer is to the right, or if viewing on a mobile device, is below. My pinned post is titled:

'How I Conquered Heart Disease and What I Have Learned in the Process'

This week was my 6-year anniversary following triple bypass surgery and 2 angioplasty procedures that implanted 4 stents into my coronary arteries. After struggling with the side-effects of the cocktail of pharmaceuticals for 9 months, including statins, I aggressively changed by diet and lifestyle and weaned myself off of all medications, in the ensuring 9 months. I continued to take a baby aspirin for about 3 more years, but then discovered Pycnogenol which is a nutraceutical and much safer. Read this research:


I have been drug free for 5 years now, with no cardiovascular events, and all of my blood metrics are normal to optimal.

ApoB and ApoA1, as well as triglycerides are the only lipoprotein metrics you should pay attention to. LDL-C and total cholesterol metrics are of no consequence. Sugar and simple carbohydrates should be avoided at all times. Proteins, legumes, and complex carbohydrates are optimal for your diet. An all-vegetarian or all-vegan diet does not provide the right balance of nutrients, including critical amino-acids, as well as the food variety required for the gut microbiome to function optimally. The gut microbiome is connected to the brain via the vagus nerve and as such, hormonal balance requires a varied diet to feed our gut bacteria. We were born omnivores.

youtu.be/B9RruLkAUm8 Your gut and your brain.

ncbi.nlm.nih.gov/pmc/articl... ApoB/ApoA1 ratio study.

There's nothing a drug can do that an optimal diet and lifestyle (exercise) cannot achieve. Keep in mind that the older you get, the more you should limit extreme exercise such as marathons and half-marathons. The sheer stress they create damages your enthothelium much more rapidly as you age. If you're a runner, a 20-minute daily run is sufficient.

In any case, as an athlete your issue is sheer stress, not a genetic pre-disposition:


Good luck and message me privately if you have any questions.

Alpsholiday in reply to sos007

Hi sos007

All I was asking for was which tests should be done before statins are prescribed.

And you've gone way off the topic.

However, to play fair, I started reading your input, but stopped when you said that, in my case, atherosclerosis is a lifestyle condition (cycling) and not genetic.

This is absolutely incorrect for these reasons -

1 - I've had scans of the carotid, arms and legs to determine if the atherosclerosis was all over - but these tests revealed 0% Calcium, so no atherosclerosis in the rest of the body at all. Just the cardiac arteries. How do you explain that?

2 - My 17 AV cycling group of 10 are of all ages from 35 - 74 - all lifelong cyclists - our common factor is that we can all ride at 17AV

And, 3 (lifelong cyclists) are older than me and they have all checked their cardiac atherosclerosis, after hearing about my superhigh Calcium reading of 1315, and all 3 of them have 0% Cardiac calcium readings - how do you explain that?

3 - Aerobic Exercise to your Max actually clears out the arteries and is recommended for all ages. How do you counter that?

If you have any tips for The Question I have posted, get back.

Thank you


Manolete in reply to Alpsholiday

Hi AlpsCan I ask you what is riding 17AV?👍

Alpsholiday in reply to Manolete

Hi Manolete

17 AV is the Average speed of the bike ride.

From 16-45 I was able to ride at 25 AV, then of course, slightly slower each year. Pros can ride at 30+ easily.

At age 66 I was able to ride with a 17 AV group.

I know an 81 year old who can ride at 16 AV!

Get on your bike!


Manolete in reply to Alpsholiday

Thanks for the update I presume that is in miles per hour?

Alpsholiday in reply to Manolete

Yes MPH.

Manolete in reply to Alpsholiday

Woaw that is fast

sos007Ambassador in reply to Alpsholiday

If you re-read my response, I attempted to speak in general terms about athletes and perhaps had a poor choice of phrasing in my inference toward the end between athletes in general terms, and you as an athlete. I cannot possibly know why or how you got CAD based on the very limited information provided.

I'm not here for debates or to prove people right or wrong. I simply provide information that many may not previously have considered.

I presented information that I believe would potentially help you place circumstances into perspective.

Every person is a unique individual when it comes to diet, lifestyle, stress and sleep habits, all of which, in whole or in part, can have a material impact to plaque accumulation in the arteries.

Coronary arteries are different than those in other parts of the body because of the bending, bifurcation and blood flow turbulence that happens in the proximal areas of the heart.

The fact that a group of individuals share your activity is insufficient to draw comparisons to your situation as several of the variables I noted above could make a material difference. Genetics are not irrelevant, but they determine the risk factor in the minority of the population. So in general terms, dietary and lifestyle choices, stress and sleep are more relevant for the majority.

I'm not debating that aerobic exercise is good for the body - I simply pointed out that there are many people who live what they believe to be healthy lives due to active exercise and end up getting atherosclerosis. My explanation based on sheer-stress provides another plausible explanation for you to consider.

Rather than take my comments as some type of challenge you should consider all of the information that I presented to help you gain some insights.

The use of statins is a highly debated subject.

Doctors look at LDL-C levels in a lipid profile to determine the need for statins - so there's your standard medical-industry answer.

However, there are many, both within and without the medical industry, who dispute the need to use statins. Half of people who get heart attacks have normal cholesterol values.

My initial response included a suggestion as to what other blood tests would be better markers for determining CAD risk.

The total cholesterol metric is a virtually worthless biomarker.

Good luck.

Alpsholiday in reply to sos007

Hi sos007

Thanks for all your many points, which I have read.

However, do get back if you have any answers for my Post Query, which is what tests should be done before statins are prescribed.

Thank you


sos007Ambassador in reply to Alpsholiday

Not sure what you missed from my first 2 responses.The standard test is a lipid panel which measures LDL-C and all other standard cholesterol metrics.

The preferred blood test for atherogenic lipoproteins is ApoB/ApoA1 as well as triglycerides.

ALT and HbA1C, as well as CRP (c-reactive protein) are also valuable.

ALT is part of liver panel which will include AST as well.

These are the rest of the liver function tests: mayoclinic.org/tests-proced...

GFR and ACR are kidney function tests.

My total Cholesterol was, and is, significantly higher than yours was and is. In my opinion, a Triglyceride result is more important than a total Cholesterol result.

Is it possible that you had undiagnosed prediabetes for many years? If so, that would certainly lead to a cardiovascular issue.

As for you being prescribed & advised to take statins when your total Cholesterol was so low, I think it was irresponsible. The statins could have certainly, in my opinion, contributed to your muscle issues.

Vit C can be very helpful for inflammation/infection, and for cardiovascular issues. I've been taking Vit C for decades, in divided doses, throughout the day.

Hi Londinium

I remember your replies to my very first post on HU 2 years ago.

Thanks for contributing.

Never been pre-diabetic ever with my weight always at about 62k.

Yes, absolutely agree with you 100% that those statins should never have been started.

The aches are still there now, 4 years after stopping them.

I've tried 1g of Vit C a day for a few weeks, but no impact on the aches.



I understand about your weight etc. But slim and athletic people can have a blood sugar or insulin problem that can go undiagnosed for years.

In order to accurately assess whether you were ever prediabetic, you have to view past lab results e.g. Triglycerides, to see if it was in the lower part, or upper part, of the lab ref. range.

So the question is, have you done that? Have you looked back at those past Triglycerides to see at which end of the lab ref. range they were in the years leading up to your cardiovascular CABG problems?


Off on my bike now

Will reply late evening



Hi londinium

These are my 6 Medichecks triglycerides results since Feb 19.

Range is 0-1.7. On a vegan diet for 31 years now.

In date order - 0.93, 0.77, 0.96, 0.78, 1.16, 0.93.

I don't have any pre- CABG results, but my diet hasn't changed for 30 years, so I Figure they would be similar?

My fasting bloods have always been in the low range for diabetes.



I don't understand lab results without lab ref. ranges alongside them. But you'll be able to see, for yourself, if your Triglyceride is toward the upper end of the lab ref. range or toward the lower end. I'd also say to check Hba1c, and maybe other tests too.

I'm surprised you don't have Triglycerides lab results from the cholesterol/lipid tests that must've been carried out prior to, and around the time of, your cardiovascular issues?

Did you have xanthoma/xanthelasma on your face or body? Did you have a white circle, Corneal Arcus, in your eyes?

What type of calcium supplement were you using? Did you have vaccines as an adult prior to your cardiovascular issues? What fats and oils were you using? What Vit D3 level did you maintain in the years prior to cardiovascular issues? These are all things to consider.

And, out of personal interest, which K2 brand/product has your wife been purchasing and what daily dose have you been using?

Hi Londinium

Thanks for your points

1- All the triglycerides have the range 0 - 1.7.

2- My wife recommended Nu U Vit K2/Mk2 - 200iu

3 - Diabetes checks all normal

4 - No xanthoma

5 - Not heard of 'white circles'

5 - H+B Calcium with Vit D

6 - 10 ug Vit D for very many years, now 16 ug - with lab results of 70 or so



Your Vit D3 intake seems low, as does your D3 level of 70 nmol. Some medics recommend maintaining D3 levels of around 100-150 nmol, whilst others recommend even higher.

If I were going to use a Calcium supplement, I'd probably not choose Calcium Carbonate, as it's been suggested to possibly cause/worsen arterial issues.

I’m always interested in the Statin research because I cannot take them . Like Hamlet who could never make up his mind ‘“to be or not to be’” I feel the stress lies in whether I should be taking them or not. I was fit with all tests coming back normal but still needed a triple bypass which I still question whether it was hereditary or not. What my family has passed down is the inability to cope with stress . Yes sport is good for you (I play tennis) but what I find does the damage is repetition. I find I’m ok playing normally but if I have a lesson whereby I have to repeat back hands for a time it’s then that the old joints start to moan. That’s why I question running especially on hard roads .

Hi polypuss

Keep up the exercise, in any form that you can handle

Yes you're right about running

I've met many a runner who can't do it any more as their knees are shot - but they can ride a bike ok!

You prob had genetic cardiac atherosclerosis, like me - hence the 3CABG



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