Does anyone out there integrative cardiologist as I'm looking to explore as an option. My current guy I started seeing just because of BP is now pushing statins and that's a hard no from me after seeing what is has done to family members with memory loss. I'm in College Station but don't have a problem with traveling if it's the right person. Injustice don't believe cholesterol is the devil we have been lead to believe.
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Integrative Cardiologist
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Last: 1 day ago by KidDoc
When you say integrative cardiologist, do you really mean a cardiologist that believes what you believe regardless of what the evidence states? Or follows small, low quality studies?
I agree with you that I don't think cholesterol is well understood, and genetics probably play a bigger role than we think. But that being said the preponderance of evidence suggests that elevated LDL is associated with worse cardiac outcomes and development of atherosclerosis. Honestly, even LDL in the normal ranges probably contribute to atherosclerosis. Can nuance it a bit and look at ApoB, Lp(a), LpA1, etc., and find certain patterns that show better or worse outcomes, but for the vast majority of the population an elevated LDL is bad. Most cardiologists, even those anti-statin ones, will put patients on statins if they've had a history of a heart attack or stroke. But there is debate on the number needed to treat (NNT) and utility of statins for primary prevention (1st time) of heart attacks - specifically, the mortality in those cases. In other words, statins may decrease atherosclerosis, may even decrease heart attacks, but at the end of the day do the same number of people die from heart attacks.
That being said, Dr. Nadir Ali works in the Clear Lake area, and he's anti-statin. He took care of my dad for a while, and still takes care of my brother. And his son is an Aggie.
I agree with you that I don't think cholesterol is well understood, and genetics probably play a bigger role than we think. But that being said the preponderance of evidence suggests that elevated LDL is associated with worse cardiac outcomes and development of atherosclerosis. Honestly, even LDL in the normal ranges probably contribute to atherosclerosis. Can nuance it a bit and look at ApoB, Lp(a), LpA1, etc., and find certain patterns that show better or worse outcomes, but for the vast majority of the population an elevated LDL is bad. Most cardiologists, even those anti-statin ones, will put patients on statins if they've had a history of a heart attack or stroke. But there is debate on the number needed to treat (NNT) and utility of statins for primary prevention (1st time) of heart attacks - specifically, the mortality in those cases. In other words, statins may decrease atherosclerosis, may even decrease heart attacks, but at the end of the day do the same number of people die from heart attacks.
That being said, Dr. Nadir Ali works in the Clear Lake area, and he's anti-statin. He took care of my dad for a while, and still takes care of my brother. And his son is an Aggie.
Thanks for that as he seemed stunned when I asked why I had not had a test for my apoB and no calcium scores. I pushed for them and they all came back clean. My ratios have been very good as well. I'd rather go the path with less pharma and more supplements, diet and exercise.bigtruckguy3500 said:
When you say integrative cardiologist, do you really mean a cardiologist that believes what you believe regardless of what the evidence states? Or follows small, low quality studies?
I agree with you that I don't think cholesterol is well understood, and genetics probably play a bigger role than we think. But that being said the preponderance of evidence suggests that elevated LDL is associated with worse cardiac outcomes and development of atherosclerosis. Honestly, even LDL in the normal ranges probably contribute to atherosclerosis. Can nuance it a bit and look at ApoB, Lp(a), LpA1, etc., and find certain patterns that show better or worse outcomes, but for the vast majority of the population an elevated LDL is bad. Most cardiologists, even those anti-statin ones, will put patients on statins if they've had a history of a heart attack or stroke. But there is debate on the number needed to treat (NNT) and utility of statins for primary prevention (1st time) of heart attacks - specifically, the mortality in those cases. In other words, statins may decrease atherosclerosis, may even decrease heart attacks, but at the end of the day do the same number of people die from heart attacks.
That being said, Dr. Nadir Ali works in the Clear Lake area, and he's anti-statin. He took care of my dad for a while, and still takes care of my brother. And his son is an Aggie.
Definitely going to be rare in the field.
Most cardiologists by nature of their trade follow the established literature and recommendation almost like it's a religion.
They're stereotypically the ones that will quote studies and results more than any other specialist.
Most cardiologists by nature of their trade follow the established literature and recommendation almost like it's a religion.
They're stereotypically the ones that will quote studies and results more than any other specialist.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
I am in the same boat. I have a 90% widow maker blockage and am on statins. I do believe they have some use, but I do not believe LDL causes coronary artery disease. I believe damaged, oxidized LDL causes it. I do think the statin is useful in regards to lowering inflammation which contributes to CAD, so that is why I take it.
I am frustrated because I have seen 4 different cardiologists and all of them seem to be clinging to the low FAT low cholesterol theory that has been pushed for 30 years. It really seems like this has been working out well for reducing heart disease doesn't it?
Check out Dr. Jamnadas on Youtube. Why can't there be other cardiologists that follow his methodologies?
Anyway, I would recommend reading these three books, as they are all complimentary and mostly say the same thing.
Deep Nutrition
Beat the Heart Attack Gene
The Great Cholesterol Myth
I am frustrated because I have seen 4 different cardiologists and all of them seem to be clinging to the low FAT low cholesterol theory that has been pushed for 30 years. It really seems like this has been working out well for reducing heart disease doesn't it?
Check out Dr. Jamnadas on Youtube. Why can't there be other cardiologists that follow his methodologies?
Anyway, I would recommend reading these three books, as they are all complimentary and mostly say the same thing.
Deep Nutrition
Beat the Heart Attack Gene
The Great Cholesterol Myth
I think it would be helpful if there were more cardiovascular genetic studies. By far most of them favor pharmaceuticals.
Since there is so much heart disease out there, a really good drug in the field will make a lot of money.
Kind of like semaglutide right now with weight loss.
Since there is so much heart disease out there, a really good drug in the field will make a lot of money.
Kind of like semaglutide right now with weight loss.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
If you're into books, you can also look into the following
Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure by Dr. Caldwell Essylstein
Cholesterol TRUTHS: Completely Eliminate Heart Disease by Dr. Mohammed Alo
The Essylstein/Ornish diets are ultra low in dietary fat and cholesterol, and have proven under cardiac catheterization, to open up coronary arteries. To be fair, I doubt they are reversing plaques. But it's possible the diet is doing something to enhance vasodilation.
Personally I'm not into low carb or low fat diets. I eat pretty balanced. But I try to look at evidence and hypothesis from all sides. I used to be on the high fat train, and I still do believe that dietary cholesterol isn't as bad for you as we used to think, but the data just shows overwhelmingly that diets high in saturated fat are more associated with worse outcomes.
Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure by Dr. Caldwell Essylstein
Cholesterol TRUTHS: Completely Eliminate Heart Disease by Dr. Mohammed Alo
The Essylstein/Ornish diets are ultra low in dietary fat and cholesterol, and have proven under cardiac catheterization, to open up coronary arteries. To be fair, I doubt they are reversing plaques. But it's possible the diet is doing something to enhance vasodilation.
Personally I'm not into low carb or low fat diets. I eat pretty balanced. But I try to look at evidence and hypothesis from all sides. I used to be on the high fat train, and I still do believe that dietary cholesterol isn't as bad for you as we used to think, but the data just shows overwhelmingly that diets high in saturated fat are more associated with worse outcomes.
Always seems to be some cardiologist hate on here. Maybe sometimes justified, but often exaggerated I think. But obviously I am biased. I typically steer clear of these discussions on message boards because I think most people already have their minds made up, and nothing I say will do much to change anything. Just some food for thought and then I'll hand it back over to the internet.
TLDR:
-Cardiovascular disease is complex and I caution against over simplifying it on either side.
Longer version:
-Everyone agrees that cardiovascular disease is a complex equation with many factors - some modifiable, some not. It is true that LDL is not the holy grail. But it's also incorrect to think that it doesn't matter at all. Saying LDL doesn't matter is the same over-simplification that many are upset at doctors for doing when they only look at their LDL and no other markers. The truth is always in the middle.
-Diet matters. Always has, always will. Whether you take statins or not.
-Statins are also not the holy grail. But the data is pretty clear that they help - particularly in the right patient population. The statin hate always confuses me, and is second only to anything related to COVID.
-There are so many factors that it's almost impossible to compare apples to apples. A lot of people post about their LDL and weight and calcium score and this and that. But it all has to be taken into context (age, risk factors, family history, etc.). Simply comparing lipid numbers and calcium scores or weights isn't equal.
-And finally I looked up the Ornish diet and the publication referenced about reversal of CAD because I wasn't familiar with this info. I'm not arguing for or against the diet, but a few take-home points just to consider:
--The study has 35 patients total
--Over 5 years, the % stenosis of lesions on cath reduced from 40% to 37% on the diet. The % stenosis in the control arm went from 41% to 51%. Of course, I'd much rather be in the reduction arm, but at this rate, with no dietary changes it would take roughly 15-20 years until the lesions became significant or obstructive. The average age was 62.
--Within the control arm, the patients that took statins, the % stenosis went from 46% to 51%. Patients that weren't on statins went from 41% to 60%.
---My summary would be that this is a small underpowered study, but is promising. I wish it would be validated on a larger scale, but of course there's no money in that so no one will pay for that study. Although I personally doubt the diet "reverses" CAD, it is feasible that it slows progression, which is about the best we have at this point. And even in this small study that I don't think is great, there is more evidence that statin use slows CAD progression.
OK board, fire away.
TLDR:
-Cardiovascular disease is complex and I caution against over simplifying it on either side.
Longer version:
-Everyone agrees that cardiovascular disease is a complex equation with many factors - some modifiable, some not. It is true that LDL is not the holy grail. But it's also incorrect to think that it doesn't matter at all. Saying LDL doesn't matter is the same over-simplification that many are upset at doctors for doing when they only look at their LDL and no other markers. The truth is always in the middle.
-Diet matters. Always has, always will. Whether you take statins or not.
-Statins are also not the holy grail. But the data is pretty clear that they help - particularly in the right patient population. The statin hate always confuses me, and is second only to anything related to COVID.
-There are so many factors that it's almost impossible to compare apples to apples. A lot of people post about their LDL and weight and calcium score and this and that. But it all has to be taken into context (age, risk factors, family history, etc.). Simply comparing lipid numbers and calcium scores or weights isn't equal.
-And finally I looked up the Ornish diet and the publication referenced about reversal of CAD because I wasn't familiar with this info. I'm not arguing for or against the diet, but a few take-home points just to consider:
--The study has 35 patients total
--Over 5 years, the % stenosis of lesions on cath reduced from 40% to 37% on the diet. The % stenosis in the control arm went from 41% to 51%. Of course, I'd much rather be in the reduction arm, but at this rate, with no dietary changes it would take roughly 15-20 years until the lesions became significant or obstructive. The average age was 62.
--Within the control arm, the patients that took statins, the % stenosis went from 46% to 51%. Patients that weren't on statins went from 41% to 60%.
---My summary would be that this is a small underpowered study, but is promising. I wish it would be validated on a larger scale, but of course there's no money in that so no one will pay for that study. Although I personally doubt the diet "reverses" CAD, it is feasible that it slows progression, which is about the best we have at this point. And even in this small study that I don't think is great, there is more evidence that statin use slows CAD progression.
OK board, fire away.
DeepintheHeart, are you out of Houston or is your practice somewhere else? I might be interested in getting an appt to try and sort out my varying/changing opinions. Thanks in advance.
I've read the Great Cholesterol Myth, and it really has got me thinking. I'm looking hard at sugars in all that I consume and reducing inflammation. My insulin numbers are always low as are blood sugars. My Triglyceride to HDL is below 1. My exercise has dropped off due to work and my mother's condition as she transitions from home to assisted living. I'd love to get off the BP meds, but I'll hold on that for no.Bonfire97 said:
I am in the same boat. I have a 90% widow maker blockage and am on statins. I do believe they have some use, but I do not believe LDL causes coronary artery disease. I believe damaged, oxidized LDL causes it. I do think the statin is useful in regards to lowering inflammation which contributes to CAD, so that is why I take it.
I am frustrated because I have seen 4 different cardiologists and all of them seem to be clinging to the low FAT low cholesterol theory that has been pushed for 30 years. It really seems like this has been working out well for reducing heart disease doesn't it?
Check out Dr. Jamnadas on Youtube. Why can't there be other cardiologists that follow his methodologies?
Anyway, I would recommend reading these three books, as they are all complimentary and mostly say the same thing.
Deep Nutrition
Beat the Heart Attack Gene
The Great Cholesterol Myth
DeepintheHeart06 said:
Always seems to be some cardiologist hate on here. Maybe sometimes justified, but often exaggerated I think. But obviously I am biased. I typically steer clear of these discussions on message boards because I think most people already have their minds made up, and nothing I say will do much to change anything. Just some food for thought and then I'll hand it back over to the internet.
TLDR:
-Cardiovascular disease is complex and I caution against over simplifying it on either side.
Longer version:
-Everyone agrees that cardiovascular disease is a complex equation with many factors - some modifiable, some not. It is true that LDL is not the holy grail. But it's also incorrect to think that it doesn't matter at all. Saying LDL doesn't matter is the same over-simplification that many are upset at doctors for doing when they only look at their LDL and no other markers. The truth is always in the middle.
-Diet matters. Always has, always will. Whether you take statins or not.
-Statins are also not the holy grail. But the data is pretty clear that they help - particularly in the right patient population. The statin hate always confuses me, and is second only to anything related to COVID.
-There are so many factors that it's almost impossible to compare apples to apples. A lot of people post about their LDL and weight and calcium score and this and that. But it all has to be taken into context (age, risk factors, family history, etc.). Simply comparing lipid numbers and calcium scores or weights isn't equal.
-And finally I looked up the Ornish diet and the publication referenced about reversal of CAD because I wasn't familiar with this info. I'm not arguing for or against the diet, but a few take-home points just to consider:
--The study has 35 patients total
--Over 5 years, the % stenosis of lesions on cath reduced from 40% to 37% on the diet. The % stenosis in the control arm went from 41% to 51%. Of course, I'd much rather be in the reduction arm, but at this rate, with no dietary changes it would take roughly 15-20 years until the lesions became significant or obstructive. The average age was 62.
--Within the control arm, the patients that took statins, the % stenosis went from 46% to 51%. Patients that weren't on statins went from 41% to 60%.
---My summary would be that this is a small underpowered study, but is promising. I wish it would be validated on a larger scale, but of course there's no money in that so no one will pay for that study. Although I personally doubt the diet "reverses" CAD, it is feasible that it slows progression, which is about the best we have at this point. And even in this small study that I don't think is great, there is more evidence that statin use slows CAD progression.
OK board, fire away.
DeepintheHeart06
I'd be curious what your thought are on statins and memory loss? I've seen it in my Mom and my brothers all stopped when they started showing signs of memory loss and muscle loss. Why have we not seen the numbers go down in heart disease when more meds are being dispensed than ever, is it the food that we all eat?
I've been on a statin since turning 40. I'm still young so memory problems haven't occurred yet. My dad and two of his brothers had heart attacks between 48-60 years old (two died). Two others dropped dead of heart attacks before 70. I figure if it helps me live long to have memory problems that's a win.
You are in great shape, then. I wouldn't even be worrying about anything.Quote:
My Triglyceride to HDL is below 1.
Can I make an appointment to see you and call it a day to get my wife off my back!Bonfire97 said:You are in great shape, then. I wouldn't even be worrying about anything.Quote:
My Triglyceride to HDL is below 1.
I was on a statin for a bit and stopped in early December mostly due to the muscle issues. It didn't bother me until I started to get more into lifting as the doctor gig doesn't use that much muscle. Once I started to push lifting a bit my recovery was long and painful and it is much improved since stopping the statin.
My pre-statin profile wasn't that concerning, LDL 140ish HDL 90is TG under 100 so I figure I'm safe for now. No HTN, DM, or family history for early cardiovascular disease.
My pre-statin profile wasn't that concerning, LDL 140ish HDL 90is TG under 100 so I figure I'm safe for now. No HTN, DM, or family history for early cardiovascular disease.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
I can't recall if I mentioned this before, but have you looking into decreasing frequency and dose of your statin? Crestor is water soluble, which hypothetically can decrease risk of statin associated myopathy (https://pmc.ncbi.nlm.nih.gov/articles/PMC8172607/)
Additionally, weekly dosing may be a reasonable happy medium to getting close to goal LDL with fewer side effects (https://pubmed.ncbi.nlm.nih.gov/21784377/).
My lipid panel is pretty good, but I have started taking a once weekly 5mg Crestor. Will see how it affects my lipids in May (have been taking it since December).
And yes, the Ornish diet study and "reversibility" of plaques was definitely a weak and underpowered study. My point of posting it was to showcase that it is the opposite of what is currently in vogue (diets high in saturated fats) but it probably has more evidence behind it than the carnivore/high saturated fat diets.
Additionally, weekly dosing may be a reasonable happy medium to getting close to goal LDL with fewer side effects (https://pubmed.ncbi.nlm.nih.gov/21784377/).
My lipid panel is pretty good, but I have started taking a once weekly 5mg Crestor. Will see how it affects my lipids in May (have been taking it since December).
And yes, the Ornish diet study and "reversibility" of plaques was definitely a weak and underpowered study. My point of posting it was to showcase that it is the opposite of what is currently in vogue (diets high in saturated fats) but it probably has more evidence behind it than the carnivore/high saturated fat diets.
Thanks will look into it pending my next lipid panel!
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
How did you get the percentage? Did you get scanned? I am very curious because I'm 51, and my doc has wanted me on a statin for several years now.
I'm going to make a concerted effort at some lifestyle changes to bring my LDL down, before considering the statin. My doc has never asked about diet, exercise, alcohol or tobacco. They've also never scanned or tested me for anything, just take this pill for the rest of your life.
I went to a Life Line Screening last year, and they said that my arteries and veins were clear.
I'm going to make a concerted effort at some lifestyle changes to bring my LDL down, before considering the statin. My doc has never asked about diet, exercise, alcohol or tobacco. They've also never scanned or tested me for anything, just take this pill for the rest of your life.
I went to a Life Line Screening last year, and they said that my arteries and veins were clear.
You may want to check out Deep Nutrition, really changed my antiquated 1990's lipid education.
Don't forget trying to increase your HDL, hit those weights!
Don't forget trying to increase your HDL, hit those weights!
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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