Inflammation: Medicine's burning question
newyorker.com
Inflammation: Medicine's burning question
1–10 of 160 posts
Re: Inflammation: Medicine's burning question
#2It's great to read things like this... I wish my GP would do the same.
I recently had a really high cholesterol reading (both total cholesterol and LDL). Everything else (blood pressure, blood glucose etc) seems fine. I'm 38, fit and healthy and nothing that suspect in my family history. I found the attitude of my doctor in all this quite surprising. It amounted basically to "You definitely have familial hypercholesterolemia. There is no other possible option here other than statins". No further questions about what I eat, my stress levels, lifestyle - nothing.
What disappoints me the most here is now that I feel like it's all on me to determine what my real risk levels are and what's appropriate to treat this. I don't subscribe to the mainstream NHS view still heavily pushed that eating saturated fat -> high cholesterol == unhealthy as I think it's a lot more complicated (as this article shows). I don't like being is this situation as I'm as susceptible to human bias as the next person, and I'm not a doctor, however almost all of the high quality, science based writing I've read indicates that the mainstream healthcare system's view on cholesterol is wrong.
Re: Inflammation: Medicine's burning question
#3It's great to read things like this... I wish my GP would do the same. I recently had a really high cholesterol reading (both total cholesterol and LDL). Everything else (blood pressure, blood glucose etc) seems fine. I'm 38, fit and healthy and nothing that suspect in my family history. I found the attitude of my doctor in all this quite surprising. It amounted basically to "You definitely have familial hypercholest…
> almost all of the high quality, science based writing I've read indicates that the mainstream healthcare system's view on cholesterol is wrong.
My understanding is that a doctor's first job is to be risk averse. That's why they shy away from bleeding edge research and knowledge, and choose instead to rely on proven ways.
Their job isn't so much to be right as it is to not be wrong. If that means keeping you suboptimally alive, but still healthy, then so be it. Better than try to optimize and risk worsening your state.
Re: Inflammation: Medicine's burning question
#4It's great to read things like this... I wish my GP would do the same. I recently had a really high cholesterol reading (both total cholesterol and LDL). Everything else (blood pressure, blood glucose etc) seems fine. I'm 38, fit and healthy and nothing that suspect in my family history. I found the attitude of my doctor in all this quite surprising. It amounted basically to "You definitely have familial hypercholest…
> almost all of the high quality, science based writing I've read indicates that the mainstream healthcare system's view on cholesterol is wrong. My understanding is that a doctor's first job is to be risk averse. That's why they shy away from bleeding edge research and knowledge, and choose instead to rely on proven ways. Their job isn't so much to be right as it is to not be wrong . If that means keeping you subopt…
The problem is, there is no research stating that lowering dietary cholesterol leads to lowered blood levels and the reversal of fatty liver disease.
There is research stating that fatty liver disease exists due to long term over-production of cholesterol in the liver, caused by low dietary cholesterol, and increasing dietary cholesterol can lead to the reversal of fatty liver disease; and such research isn't really cutting edge, much of it is around a decade old now.
The FDA has reversed course on this, and is no longer hammering its anti-cholesterol drum.
Re: Inflammation: Medicine's burning question
#5It's great to read things like this... I wish my GP would do the same. I recently had a really high cholesterol reading (both total cholesterol and LDL). Everything else (blood pressure, blood glucose etc) seems fine. I'm 38, fit and healthy and nothing that suspect in my family history. I found the attitude of my doctor in all this quite surprising. It amounted basically to "You definitely have familial hypercholest…
The NICE evidence, which your NHS GP should be following, is here: http://www.nice.org.uk/guidance/cg181/evidence
The NICE guidance, which your NHS GP should be following, is here: http://www.nice.org.uk/guidance/cg181
Your GP should have used more information than just your non-HDL results; they should have given you a standardised risk assessment call QRISK2.
http://www.nhs.uk/news/2014/02February/Pages/NICE-publishes-...
That risk assessment needs to know your age, sex, BMI, ethnicity, family history, your blood pressure, your blood cholesterol levels, and whether you have history of diabetes, high blood pressure, atrial fibrillation, or rheumatoid arthritis.
Your GP should have most of that, and if you think they don't it's probably a good idea to let them know.
You've said that you think the "eating saturated fat leads to high blood cholesterol" thing is wrong, and that the NHS seems to push this, but you also say that your GP didn't ask you what you eat, so it seems your GP isn't pushing that hypothesis. Your GP (from what you've said) didn't say "stop eating animal fat and take this medication", your GP said "take this medication".
Re: Inflammation: Medicine's burning question
#6Earlier quoted context omitted.
> almost all of the high quality, science based writing I've read indicates that the mainstream healthcare system's view on cholesterol is wrong. My understanding is that a doctor's first job is to be risk averse. That's why they shy away from bleeding edge research and knowledge, and choose instead to rely on proven ways. Their job isn't so much to be right as it is to not be wrong . If that means keeping you subopt…
The problem is, there is no research stating that lowering dietary cholesterol leads to lowered blood levels and the reversal of fatty liver disease. There is research stating that fatty liver disease exists due to long term over-production of cholesterol in the liver, caused by low dietary cholesterol, and increasing dietary cholesterol can lead to the reversal of fatty liver disease; and such research isn't really…
> much of it is around a decade old now
Has your doctor done any research/training about cholesterol in the last 10 years?
I'm being snarky. But I think it's important to consider the lifecycle of doctor careers. If you go to a liver or cholesterol specialist, then I'm sure they will be up to date with even findings from the last year. But I wouldn't expect a GP to be up to date on what every field within medicine has decided in the last decade after years and years of back-and-forth.
It's almost like asking a computer scientist to know both the difference between Angular and React, and how to rewrite COBOL mainframe code into Lisp. The actual job of a computer scientist is writing proofs in Coq and understanding the difference between lexical and context-free grammars.
Re: Inflammation: Medicine's burning question
#7It's great to read things like this... I wish my GP would do the same. I recently had a really high cholesterol reading (both total cholesterol and LDL). Everything else (blood pressure, blood glucose etc) seems fine. I'm 38, fit and healthy and nothing that suspect in my family history. I found the attitude of my doctor in all this quite surprising. It amounted basically to "You definitely have familial hypercholest…
The NICE evidence, which your NHS GP should be following, is here: http://www.nice.org.uk/guidance/cg181/evidence The NICE guidance, which your NHS GP should be following, is here: http://www.nice.org.uk/guidance/cg181 Your GP should have used more information than just your non-HDL results; they should have given you a standardised risk assessment call QRISK2. http://www.nhs.uk/news/2014/02February/Pages/NICE-publis…
Thank you for those links!
I should have been clearer: what bugged me about my interaction with the GP was that he didn't ask about anything to do with lifestyle/diet. When I went looking on my own - everything I seemed to find from the NHS/Heart UK suggested that cutting saturated fat was essential, leading to my conclusion that this is what the mainstream medical establishment still believes.
Re: Inflammation: Medicine's burning question
#8It's great to read things like this... I wish my GP would do the same. I recently had a really high cholesterol reading (both total cholesterol and LDL). Everything else (blood pressure, blood glucose etc) seems fine. I'm 38, fit and healthy and nothing that suspect in my family history. I found the attitude of my doctor in all this quite surprising. It amounted basically to "You definitely have familial hypercholest…
Take matters into your own hands and change your diet.
Nothing beats a high anti-inflammatory whole-foods plant-based diet.
Check the research.
Re: Inflammation: Medicine's burning question
#9It's great to read things like this... I wish my GP would do the same. I recently had a really high cholesterol reading (both total cholesterol and LDL). Everything else (blood pressure, blood glucose etc) seems fine. I'm 38, fit and healthy and nothing that suspect in my family history. I found the attitude of my doctor in all this quite surprising. It amounted basically to "You definitely have familial hypercholest…
It comes down to diet. My LDL is 66 and my HDL is 75. I don't eat eggs, meat, or cheese. Basically, nothing that has cholesterol.
My numbers will probably be even better this year. I have looked at /r/keto and /r/paleo. Their cholesterol numbers aren't good.
Re: Inflammation: Medicine's burning question
#10It's great to read things like this... I wish my GP would do the same. I recently had a really high cholesterol reading (both total cholesterol and LDL). Everything else (blood pressure, blood glucose etc) seems fine. I'm 38, fit and healthy and nothing that suspect in my family history. I found the attitude of my doctor in all this quite surprising. It amounted basically to "You definitely have familial hypercholest…
Take matters into your own hands and change your diet. Nothing beats a high anti-inflammatory whole-foods plant-based diet. Check the research.
Indeed, that's what I've done. I've completely eliminated sugar and I've increased my veg intake. As of the end of last week urine strips indicate that I'm in ketosis. I'll have another set of bloods done this week before I go to see a specialist probably after xmas. I intend to take a very self experimental approach with this. At the same time, if it does turn out that I'm one of those people who doesn't metabolize saturated fat well, or I do in fact have a genetic mutation then I'll also have to consider the drug route I suppose.