The outcome is not what either the cardiologist or naturopath expected. If you or anyone in your family has high cholesterol – read on.
In January 2017, I went to Tidal River at Wilson’s Promontory, with my son. A walk-up Mount Oberon provides the visitor one of the most scenic views of the whole area. As I regularly swim laps at the local pool, this walk up to the top of the mountain should have been a breeze. Half way up – shortness of breath and chest pain! The closer to the top of the mountain the worse it got. Luckily no air ambulance was required. On the way back, we ran down the mountain track to the car park.
So, what is going on here? Pain on the way up, no pain on the way down! Well I am a medical scientist, let’s test it out. For the next 10 months I tackled the 1000 steps Kokoda Track Walk in the Dandenong Ranges, once every two weeks. Every time, chest pain on the way up, no pain on the way down. The pain improved, but never went away. The “time to take this seriously” moment was when I came across a chap lying on the steps having a heart attack! Yeah, maybe it is time to have my heart checked out.
So, I walk into the cardiologist’s office. A quick family history and look at my blood work:
- Family history of cardiovascular disease – tick
- High cholesterol and LDL-cholesterol (the nasty cholesterol) – tick
- High blood pressure – tick
Cardio: “There is typical angina (chest pain), atypical angina and non-cardiac angina. In my opinion, you have typical angina!”
Cardio: “Now I can see that you are going to be one that is probably going to resist medication.” As he writes out a script for:
- Crestor (lowering cholesterol)
- Aspirin (lowering risk of clotting)
- Metoprolol (lowering blood pressure)
- Nitrolingual Spray (a nitroglycerine oral spray to be used in the event of chest pain)
Cardio: “And we will do a Cardiac CT Scan and Coronary Artery Calcium Score.”
I brace myself that soon I will be on the operating table having a stent put in or worse still, undergoing coronary by-pass surgery. The cardiologist was right – I am not keen to go on medication!
Then the universe is talking to me, as I receive in my news feed results of a recent cardiovasculat trial using stents for angina. This trial showed “The results of this trial indicate that among patients with stable angina, PCI does not result in greater improvements in exercise times or anginal frequency compared with a sham procedure. This was despite the presence of anatomically and functionally significant stenoses.”
Well that is not good news for patients going in for stent procedures if they have stable angina! So what do I do if this is the case with me?
In the film “The Martian”, Matt Damon is stranded on Mars, and has to survive until he is rescued. My favourite line out of the movie “I’m going to have to science the shit out of this.” I decide to have a serious look at this cholesterol issue.
I have always heard that cholesterol is NOT the cause of cardiovascular disease. But when you start to experience chest pain yourself, there is a part of you that thinks, well maybe in my case it is!
Let’s begin with my mainstream pathology results, cholesterol specifically.
A cholesterol reading of 7.1 (normal range 3.5 – 5.5), way over the top of the normal range. In 2013, the cholesterol reading was 7.7 (not highlighted), even higher.
Even worse, the “bad” cholesterol was 4.6 (normal range <3.5), previously in 2013 a whopping 5.1!
Doesn’t look good. This is why my GP has been trying to put me onto cholesterol lowering medication for years.
The Comprehensive Cardiovascular Profile
A comprehensive cardiovascular lipid profile can be done by an integrative pathology service that as the name suggests gives you a comprehensive breakdown of your cholesterol sub-fractions.
Yes, there is more to cholesterol than just the HDL and LDL molecules that mainstream labs test. There are many more cholesterol sub-fractions, and it depends on what size they are and whether they are oxidised that determines your risk factor for cardiovascular disease.
The results arrive!
Cardiovascular disease is not what I specialise in (up until now). Therefore, when the results arrived, it was like WOW! I had no idea that it would be so comprehensive!
I knew of LDL, but not that LDL was composed of 7 different molecules or sub-fractions.
The only LDL sub-fraction I have that is high is LDL-1. LDL-1 and LDL-2 are considered low risk for cardiovascular disease.
LDL-3 through to LDL-7 are considered to be high risk. Overall, I have a Type A Pattern – Normal
As naturopaths we always talk of oxidised cholesterol as being the risk factor for cardiovascular disease. Here too my oxidised cholesterol is well below the top of the reference range.
The science is telling me that I am not a high-risk candidate for cardiovascular disease. No need to fill the scripts for the medications that cardiologist wanted to start me on immediately. I’ll wait for the results of my cardiac CT scan and the Coronary Artery Calcium Score results.
The Results Are In
As I walk into the cardiologists office I say “Show and tell time. You tell me what you have and I’ll show you what I have.” Cardiologists I have worked out don’t have much of a sense of humour.
Me: “How bad is the damage?”
Cardio: “Results of the cardiac CT scan show that you have no plaque in your coronary arteries.”
Me: “What not even a little bit?”
Cardio: “Completely clear. I checked the scans myself.”
Me: “What about the Coronary Artery Calcium Score?” (The Coronary Artery Calcium Score measures the size and density of calcium deposits in the coronary artery. It is considered to be highly predictive of cardiovascular disease.)
Cardio: “I just had another patient with a cholesterol level of 6 and needed an operation to have a stent inserted. Your cholesterol is 7.1!”
To which I replied “You know that about 25% of patients have low cholesterol and no other risk factors and yet have heart attacks. Another 25% have high cholesterol and high-risk factors but do not have heart attacks. Cholesterol is not the issue. Oxidised cholesterol is the problem.” At which point I showed him the test results that I had.
Interest in reviewing the results – zero!
Cardio: “Well you should be happy that everything is clear.”
Me: “Why should I be happy, I’ve got chest pain!”
Cardio: “We’ll do a Cardiac Stress Test on you.”
Me: “I had one done 10 years ago and it was negative.”
Cardio: “Yes but that was 10 years ago.”
The Cardiac Stress Test
I must say that Cardiac Stress Testing has come a long way in 10 years. They are able to check not only the structure of the heart and valves, but also the size of the chambers and pressures within the heart. Just amazing technology.
On the treadmill I go, eight and a half minutes for my age. We get to eight and a half minutes and he decides to stretch it out to nine and a half minutes. In the end he says “You look pretty good to me. Hardly broke out a sweat.”
Me: “Anything come up that was unusual?”
Cardio: “Nope all is fine.”
Me: “So what are the differentials for non-cardiac chest pain?”
As I walk out of his office for the last time he hands me a script for high blood pressure medication.
High blood pressure – that is yet another story.
The important message here is that you may have high cholesterol but be at low risk of cardiovascular disease. Alternatively, if you have low cholesterol, but if your oxidised cholesterol is high (which mainstream pathology do not measure), you are still at high risk of cardiovascular disease and a “ticking time bomb”.
Statin drugs, used to bring down high cholesterol are not free of side effects. People may experience any of a long list of side effects.
In males, there is a statistically higher risk of suicide if cholesterol levels are brought down too low.
If I was anyone else, I would have been put onto a cholesterol lowering drug years ago by my GP. To do what?
If you or someone you know has high cholesterol, it would be wise to have a comprehensive cardiovascular lipid profile done. The money spent on the test will be less than the money spent on cholesterol lowering drugs (and CoQ10 which they deplete) over a lifetime – especially if you do not need them, like me.
If your cholesterol is oxidised, it is not a statin you need but antioxidant support.
If you want to lower your cholesterol, there are safer natural options.
From the movie, The Matrix:
“You take the blue pill, the story ends. You wake up in your bed and believe whatever you want to believe. You take the red pill, you stay in wonderland, and I show you how deep the rabbit hole goes.” -Morpheus