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Post by graybeard on Feb 6, 2009 16:20:08 GMT -6
Last summer a friend in Illinois said cholesterol-lowering statins made him feel just awful, and he decided he'd rather die of a heart attack than continue, in spite of Dr. warnings. Last fall, another friend, a Brit who gets care in England, said statins caused him to go lame, and he was losing muscle in his arms. He tried two different ones, and went off them, and has recovered. Just found out last week that Julie was taking statins, and I told her about the others. Here's her reply today: www.spacedoc.net/depression_statins.htmserious mood disorders www.spacedoc.net/pravachol.htmmuscle problems I'm SO glad I quit taking it--I've felt better this whole week than I have in months!! Julie ------- I eat lots of oatmeal and peanuts, and hike a mile every day, with some pushups, and my cholesterol is 135, much better than 200 or higher. GB
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Post by waltc on Feb 7, 2009 2:07:14 GMT -6
Yep, published data shows Statins can cause muscle disease, muscle damage and renal failure.
Oddly enough Merck was well aware of this back in 1990 when they applied for patenting a method to counteract the negative side effects of Statins based on Coq10.
My personal opinion is that big pharma is run by very unethical people who care little for the people they are supposed to help.
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Post by unlawflcombatnt on Feb 7, 2009 4:24:53 GMT -6
Sorry, you guys are wrong on this.
Statins are essentially miracle drugs. They will significantly lower cholesterol, especially bad cholesterol (LDL), in ~ 100% of cases.
High dose statins (including Lipitor, simvastatin, lovastatin, and pravastatin -- & excluding fluvastatin) will reduce total cholesterol and LDL by 35-40%.
Statins also have an anti-atherogenic effect that is independent of their cholesterol lowering effect. Some medical studies have shown that the use of statins improves the reactivity of arterial smooth muscle.
Several studies have shown regression of arterial plaquing, by either angiography, ultrasound, or both.
I have NEVER seen any of the muscle-related side effects in actual practice. Many, if not most of the reported cases have occurred with concomitant use of triglyceride lowering agents. It is clearly stated in reports that the incidence of myositis and rhabdomyolysis are much higher when a triglyceride lowering agent is used.
The least lipid-soluble of the statins (and thus the least likely to penetrate the blood-brain barrier and cause effects on the brain) is pravastatin.
Pravastatin also interacts less with other medications than the other statins. Pravastatin is also available generically, and can be purchased for as little as $7-8 per month.
Since a 40mg tablet of Pravastatin costs almost the same as a 10mg tablet, the 40mg tablet can be cut in ¼'s — thus reducing the price to about ¼ of the price it would otherwise be.
Of all the drugs on the market, statins are one of the best classes of drugs for effectiveness in doing what they are supposed to do — lower total cholesterol and LDL cholesterol.
Many, many studies have shown that taking statins reduces heart attacks and strokes significantly, and prolongs life significantly.
The only way statins don't work is if they never make it into your mouth and down your throat.
I put every patient I possibly can on pravastatin, because statins reduce vascular events--even in the absence of increased cholesterol or LDL cholesterol.
There are only a few things you can do "preventively" to protect yourself from heart attacks, strokes, and atherosclerosis. Lowering cholesterol, especially thru statins, is at the top of the list. (Note, once again, that statins have positive side effects — they reduce plaquing, "stickiness" of the arterial wall, and improve vasoreactivity (i.e., blood vessels will dilate better when they are supposed to dilate.)
There are LOTS of drugs out there that are essentially worthless. In fact, most of them are essentially worthless.
But statins are not in that category. They are among the most efficacious drugs available. And several are available generically.
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Post by exstatin taker on Feb 8, 2009 19:02:06 GMT -6
yeah, they're so good that last month I was so depressed I was thinking suicide. and I had a plan. I've been off them a week, now and I feel better physically (severe leg pain) and mentally than I have in MONTHS. (I started the statin May 09).
It can't be good for me if I'm dead, now, can it?
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Post by unlawflcombatnt on Feb 8, 2009 20:20:50 GMT -6
yeah, they're so good that last month I was so depressed I was thinking suicide. and I had a plan. I've been off them a week, now and I feel better physically (severe leg pain) and mentally than I have in MONTHS. (I started the statin May 09). By all means, you should stop statins if you are having side effects caused by them. But once again, very few people have such side effects — if they are taking a statin alone. Muscle pain and rhabdomyoloysis are MUCH more common if you are also taking a fibrate at the same time, such as gemfibrozil (Lopid) or fenofibrate. (Fibrates' #1 use is for hypertriglyceridemia). Regarding statins, you are least likely to suffer depression or drug interactions with pravastatin, than with the others. It would be interesting to know what particular statin you were taking, and what other medications you were taking along with it. Regarding the part about "being dead," that's what statins help prevent. It's also worth mentioning that doctors are also at risk of heart attacks if their cholesterol and or LDL are too high. And doctors take statins as well, for the exact same reason they prescribe them to patients. I'm one such doctor who is taking pravastatin, while 2 other doctor friends of mine are also taking pravastatin. None of us has had any negative side effects from pravastatin, and all 3 of us will likely live longer as a result of taking pravastatin. Negative side effects can occur with any drug. But as a group, less side effects occur from statin use than with most other drugs. And among statins, pravastatin causes the least side effects.
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Post by unlawflcombatnt on Feb 8, 2009 20:49:09 GMT -6
Having read the 1st of the articles that Graybeard posted a link to, I noticed that the reported problems were occurring mostly with Lipitor, and also with Crestor and simvastatin.
This again, is why I prescribe and recommend pravastatin, not either of the 3 aforementioned drugs.
Of all the statins, pravastatin is the least lipid soluble. This means it is the least likely drug to penetrate the blood-brain barrier. As such, pravastatin is the least likely to cause depression.
Since pravastatin is also the least likely to interact with any other drugs, it is also less likely to have its metabolism altered by other drugs the patient takes.
If you have negative side effects from other statins, and you have increased total cholesterol or LDL cholesterol, you should at least try switching to pravastatin.
Just remember, atherosclerosis kills. And lowering high cholesterol and LDL with statins reduces atherosclerosis, thus reducing heart attacks, strokes, and peripheral vascular disease.
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Post by unlawflcombatnt on Feb 8, 2009 21:19:15 GMT -6
The 2nd article that was referenced — regarding pravastatin — means very little.
Medicine is based on science, and natural science at that. (It is not a social science like economics, where little hard evidence is ever available.)
Drugs are tested on thousands of people before they ever come on the market. And statins have been used by millions as of this date. There certainly have been side effects, especially the ones referred to in the articles. But their occurrence is rare, compared to the number of people who've taken statins.
Unlike statin side effects, however, heart attacks and strokes are not rare. They are very common. In fact, they are a million-fold more common than side effects from statins.
This is one reason I try to avoid discussing medicine on this forum. The articles referenced are "anecdotal" in nature. They are one individual's verbal account. They are unscientific and not only don't "prove" anything, they don't even indicate anything. If you want to scour the globe for people who have had side effects, you can find people who have had side effects. But a dozen people — recounting their own negative effects from statins — is minuscule compared to the millions who have taken statins without side effects, and with great benefit.
If you want to find someone who's had a family member affected by atherosclerosis — from coronary artery disease or stroke — just knock on your next door neighbor's door. Or call you parents. Or your siblings.
Also remember that atherosclerotic heart disease is the #1 killer of both men and women. If you want to see what a likely victim of atherosclerosis looks like, just look in the mirror. A majority of people in this country ultimately die from some type of atherosclerotic disease.
The aggregate benefits of statin use (especially pravastatin) greatly outweigh the aggregate side effects. And even if there are side effects from statins, most are reversible with cessation of use.
Meanwhile, the "side effects" of high cholesterol and high LDL — acute myocardial infarction and stroke — are not reversible. Unlike with statins, these side effects are permanent. And the worst of these is death — which is the most common outcome of an acute myocardial infarction. Most victims never make it to the hospital.
Just remember the above, when you read a handful of anecdotal accounts from a handful of people attributing all of their medical problems to "statins."
I've had literally hundreds of patients on statins, and only 1 patient ever complained of side effects. That patient's complaint was nausea, which resolved when switched to a different statin.
That's how common statin side effects are.
In contrast, a 45 year-old previously healthy male, walked into my office on Friday (2/6/09) complaining of chest pain. He was having a heart attack.
That's how common heart attacks are.
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Post by graybeard on Feb 9, 2009 0:02:46 GMT -6
I'd give 3 out of 3 a pretty high percentage of problems with statins. In fact, the third person was totally unaware of the link between feeling awful and the statin, until I related the experiences of the other two.
How many others with physical and emotional problems have no idea the statins could be the cause?
GB
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Post by unlawflcombatnt on Feb 9, 2009 0:25:40 GMT -6
How many patients on statins are wrongly blaming statins for their problems, when the statin has nothing to do with it?
I'll just restate that I've had hundred's of patients on statins. Yes, some did have mental problems. But I've had thousands of patients NOT on statins, and a far higher % had mental problems than those who were on statins.
I've never seen a patient on pravastatin with mental problems that didn't already have them before starting pravastatin. And I've never seen one develop new mental problems after starting.
And again, I personally know 3 people on pravastatin at present. All 3 of them are doctors. And none of them are having mental problems. (One of those is yours truly.)
If "mental problems" are the main side effect, the affected person should at least try switching to pravastatin. The majority of cases cited at the "spacedoctor's" site were from Lipitor (atorvastatin), not pravastatin.
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Post by anonymous on Feb 9, 2009 0:48:19 GMT -6
If they're so great, then you must be taking them, too, right doc?
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Post by anonymous on Feb 9, 2009 0:51:22 GMT -6
I was on Pravastatin (generic). I do have a history of anxiety and depression. I do take medication (Lexapro) for that. I believe that the statin exacerbated my depression and anxiety and other mood issues like anger and aggression.
I've been off the statins one week, and I now wake up in the morning looking forward to the day, not in horror or pulling the blankets over my head and going back to sleep.
There have been no other changes in my life to create this change except stopping the statin.
I will not go back on them. Period. I was miserable and life was not worth living.
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Post by graybeard on Feb 9, 2009 1:11:48 GMT -6
I sent snippets of this thread to friends tonight. Just received this reply from Michigan:
"My dad just recovered from this same thing. He was so weak that he could barely walk up and down stairs and couldn't breathe right. . We thought he was dying, as this came on suddenly. He went to all kinds of Dr's, upper and lower GI, lung work, blood work...finally a hematoligst reviewed his records and told him to stop with the cholesterol lowering drugs and inhaler, as both had those side effects and combined they were worse. Three days and he was back to normal. This all started after a trip to ID back in Sept. where due to high altitude and dust he was given an inhaler.
GB
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Post by unlawflcombatnt on Feb 9, 2009 3:12:26 GMT -6
I sent snippets of this thread to friends tonight. Just received this reply from Michigan: "My dad just recovered from this same thing. He was so weak that he could barely walk up and down stairs and couldn't breathe right. . We thought he was dying, as this came on suddenly. He went to all kinds of Dr's, upper and lower GI, lung work, blood work...finally a hematoligst reviewed his records and told him to stop with the cholesterol lowering drugs and inhaler, as both had those side effects and combined they were worse. Three days and he was back to normal. This all started after a trip to ID back in Sept. where due to high altitude and dust he was given an inhaler. GB Sounds like the inhaler was the cause, not the statins. Corticosteroids are known for causing pyschiatric problems, especially in women. ß2 agonists (like albuterol) which are the typical airway dilators in most inhalers, can make a patient very jittery. In fact, if a high dose of a ß 2 agonist doesn't cause jitteriness, it's probably lost its potency. (That's because despite ß 2 agonists being inhibitory on respiratory smooth muscle, they are stimulatory on skeletal muscle.) If the inhaler contains an anticholinergic, like ipatropium or tiotropium, it can also cause mental effects due to cerebral anticholinergic effects. The inhalers are at least 100 times more likely to have caused mental effects than pravastatin. As far as someone having a pre-existing psychiatric/mental disorder that worsens while on pravastatin, that means little. People with psychiatric/mental disorders wax and wane constantly. That's the rule, not the exception. Trying to attribute the accepted and predictable waxing and waning to pravastatin is absurd. Though I've already stated this twice already, the message does not seem to be getting through. As even the spacedoctor admits, though in a reverse way (he references pravastatin's hydrophilic nature--which means approximately the same as lipid insoluble), pravastatin has practically ZERO penetration into the brain. This means it's likelihood of causing mental effects is also practically zero. This understanding is the result of literally thousands, if not hundreds of thousands of individual results from trials and actually patients. And these studies followed those done on animals. It is possible that pravastatin can cause psychiatric/mental problems. But it is very unlikely. Documented occurrences with pravastatin are few. And again, 1 patient, 10 patients, or 100 patients that claim their psych problems worsened with pravastatin proves nothing. And even if the number is higher, it proves nothing, unless it is somehow documented, and somehow provable, and somehow explainable through some biochemical mechanism. In medicine we rely on science, not heresay. Having an acquaintance, or a handful of internet responders who report mental problems with pravastatin, means nothing whatsoever. In order to prove, or even suggest that the problem was caused by pravastatin, it is necessary to eliminate other confounding variables. From what I've read, that has not been done. Nor has it even been attempted. Medicine is not like politics, nor is it like economics. There is science involved. And there are scientific methods involved. Those of us in the medical field don't know everything, nor do we even think we do. But we do know some things. And those things have been proven by scientific methods and are generally accepted by consensus in the medical field. And we don't accept things without something like overwhelming statistics, plus some plausible explanation. Anecdotal reports at the "spacedoctor's" site are not science. They're not even close. They fulfill none of the prerequisites of science, nor of scientific methodology. They don't prove anything, nor do they even suggest anything.
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Post by graybeard on Feb 9, 2009 9:50:52 GMT -6
There are two parts of the Statin Story: psychological, and Physical. Discounting the psych accounts, which I don't, there are still the physical symptoms in every complaint I've received in talking and emailing about 40 people.
"R.. and I have done extensive research on statins. A big problem is that docs don't ask their patients about possible side effects. Of course they don't find any problem. My doc has continually recommended statins for me because of high cholesterol. I take cod-liver oil, red yeast rice, CoQ10, and exercise, exercise, exercise. Much lower LDL and C-reactive protein measures as a result.
Statins are a 27 BILLION dollar investment by drug companies that promote good results. No wonder statins are promoted. This is much more of a money than a health issue. Interestingly, not ONE study relates statin use to lower cardiac death. M..."
Here's from a dentist friend:
"Statins do what they are prescribed to do... lower cholesterol ratio. They don't seem to do what most folks think they are taking them for... lowering cardiac event rates." My mother was using them and ended up with muscle pain symptoms. I used them for about 6 months and did slightly lower cholesterol. I was able to do a few things to keep the numbers down after discontinuing the drug which allowed me to d/c it. I had no side effects and no complications. I felt no change with the drug and no change after discontinuing it. That said, this is just an anectdote... means nothing. Just as the three folks who told you their stories are also anectdotal... means nothing. Their problems may have been related to the drug, or to something else." "My suggestion is if you or your friends are having depression, muscle symptoms, or other concerns they should be urged to pick up the phone and call their physician... or go in and see her/him. Maybe the drug can be changed, maybe there is some other medical or psychological problem. I don't know what is the best thing to do... I just know that discontinuing or changing therapy on their own is a bad idea. Counseling that a friend play self physician is an even worse idea."
GB
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Post by farside on Mar 11, 2009 13:01:23 GMT -6
A University of Alabama at Birmingham physiology professor, Dr. Thalacker-Mercer, has found that simvastatin (Zocor) inhibit muscle repair and regeneration. The title of her work is ““Simvastatin Reduces Human Primary Satellite Cell Proliferation in Culture” and was publish at the September 2008 meeting of the American Physiological Society. A synopsis of her work can be found here www.the-aps.org/press/journal/08/32.htm Kind Regards, Farside
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Post by unlawflcombatnt on Mar 11, 2009 18:20:56 GMT -6
farside,
Thanks for the article and the info.
Is there a specific study that can be referenced? I noticed that the date was September 25, 2008. Has there been any follow up on the study done since that time?
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Post by farside on Mar 12, 2009 7:19:55 GMT -6
According to Dr. Thalacker-Mercer, “We are very interested in these effects in the older population. It is possible that older adults may not be able to distinguish between muscle pain related to a statin effect or an effect of aging and therefore adverse effects of statins in older adults may be under-reported. Therefore, our next step is to examine statins among older adults.” As of today, I do not know of any new publications by Drs. Thalacker-Mercer and Bamman. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ In addition, Yeon-Kyun Shin, a biophysics professor at Iowa State University, has found that statins that inhibit the liver from making cholesterol may also keep the brain from making cholesterol, which is vital to efficient brain function. Professor Shin said, "If you try to lower the cholesterol by taking medicine that is attacking the machinery of cholesterol synthesis in the liver, that medicine goes to the brain too. And then it reduces the synthesis of cholesterol which is necessary in the brain," [That ‘s bad. Farside’s comment] Source -- www.public.iastate.edu/~nscentral/news/2009/feb/shin.shtmlKind Regards, Farside
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Post by graybeard on Mar 12, 2009 8:25:15 GMT -6
An ex co-worker had a severe heart attack while on travel in Japan in about 1980. He was surprised when the Tokyo hospital fed him a single egg every morning, saying the heart needed cholesterol to rebuild. He died 20 years later when he pulled the plug after a couple years dialysis.
I still need to go back through all the replies I received from family and friends, and re-cap them. Seems like about half recognized serious adverse reactions, while the other half was pleased with the lowered cholesterol numbers.
GB
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Post by unlawflcombatnt on Mar 12, 2009 9:24:57 GMT -6
An ex co-worker had a severe heart attack while on travel in Japan in about 1980. He was surprised when the Tokyo hospital fed him a single egg every morning, saying the heart needed cholesterol to rebuild. He died 20 years later when he pulled the plug after a couple years dialysis. A patient certainly does need protein to rebuild, and egg is a source of the highest quality protein available. (Over 96% biological quality). Also, there is a feedback mechanism in the liver between how much cholesterol a person ingests, and how much the liver produces. In many, if not most people, that feedback is almost 100%. Thus in many individuals, an ingestion of 250 mg of cholesterol in the diet would reduce the cholesterol synthesized by the liver by 250 mg. Years ago I proved this feedback mechanism existed in myself. After 2 weeks of eating 9 eggs/day, my cholesterol was exactly the same as it had been when I was eating just 2 eggs/day. (At that time, I only weighed about 125 pounds.) I increased the number of eggs/day even more. It ultimately took over 12 eggs/day to make ANY difference in my cholesterol. If a patient really likes eggs, especially an elderly patient who's already somewhat cachectic to start with, I wouldn't necessarily tell them to stop eating eggs. What I'd advise instead is to 1st check cholesterol, especially LDL cholesterol (and use Direct LDL, not "calculated" LDL). If the patient's LDL is below 100, there's no need to change the diet, nor to take a statin. __________ Regarding the synopsis of the study posted by "farside," this is the kind of stuff I do pay some attention to, because a specific mechanism was mentioned in the synopsis (i.e., the suppression of "satellite" cell proliferation.) That's why I'd like to see the study. I suspect there might be something to this. I'm somewhat doubtful about the true quantitative effects mentioned, however. Few medical studies attempt to equate the concentration of a drug used in a culture with a specific dose. So the suggestion of effects at "40 mg./day" is dubious. Also, it would be very interesting to see something similar done with Pravastatin. This would be still more significant, since Pravastatin is the least lipid soluble of the statins, and thus has the least penetration of the blood-brain barrier. As such, any effects on the brain (either biochemical or psychiatric) should be less than with Simvastatin, or any other statin. However, I don't know if lipid solubility has an effect on muscle pain or damage. Since cell membranes are lipid-rich, lipid solubility should have some effect on penetration into all cells. That would include muscle cells. But it would also include liver cells. So the fact that poorly-lipid-soluble Pravastatin works almost equally well per milligram as the other highly-lipid soluble statins is concerning, because it is obviously penetrating liver cells. Also, worth noting, is that some drugs have no deleterious effects until a certain threshold level is reached. This has to do with the metabolism (catabolism) of the drug through a primary, non-toxic pathway below a certain concentration, and then metabolism through a 2nd, toxic pathway when a certain concentration threshold is exceeded. Tylenol (Acetaminophen) is a classic example of this. Below an daily ingestion of ~ 10gm, Tylenol is metabolized through a primary, non-toxic pathway. Over 10gm the primary pathway becomes saturated (overwhelmed), and metabolism takes place through a secondary, highly-toxic pathway. Above this threshold level, Tylenol does cause liver damage. Below that level, Tylenol causes absolutely 0 damage. (more on this later). So in this manner, it is possible that there is a threshold level for each statin--below which it causes no damage, and above which it does cause damage.
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Post by proletariat on Mar 12, 2009 9:37:46 GMT -6
I was on Gemfribrozil (not a statin) and it kicked my ass. When I got off my CK levels were over 500. I definitely noticed a change in depression, energy levels etc when I got off. The reason for getting off was stomach issues - feeling like I was going to throw up. The psychological issues I had not associated with the medication until after getting off the stuff.
Currently I am on Niaspan. My issue is more with triglycerides than cholesterol per se. To graybeard's story I found out the eggs are a niacin rich food.
My sense is reactions are very real. Medicine is not always as scientific as it imagines. I would say each of has a 9 out of ten chance to be the 1 out of ten in these studies. In either case this has to be something you do with your doctor.
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Post by unlawflcombatnt on Mar 12, 2009 11:32:21 GMT -6
I was on Gemfibrozil (not a statin) and it kicked my ass. When I got off my CK levels were over 500. I definitely noticed a change in depression, energy levels etc when I got off. The reason for getting off was stomach issues - feeling like I was going to throw up. The psychological issues I had not associated with the medication until after getting off the stuff. Currently I am on Niaspan. My issue is more with triglycerides than cholesterol per se. To graybeard's story I found out the eggs are a niacin rich food. My sense is reactions are very real. Medicine is not always as scientific as it imagines. I would say each of has a 9 out of ten chance to be the 1 out of ten in these studies. In either case this has to be something you do with your doctor. Thanks for sharing, Proletariat. Your post brings up several important points. Gemfibrozil is also noteworthy for causing muscle pain, even more so when combined with a statin. In addition, many of us in the medical field do not believe that increased triglycerides by themselves create any increased cardiovascular risk, nor any increase in atherosclerosis. If I have a patient with isolated hypertriglyceridemia, with normal cholesterol (Total < 200), normal HDL ("good" cholesterol, with a level >50), and a normal LDL ("bad" cholesterol, with a level <100), I don't treat the hypertriglyceridemia. Triglycerides also affect the calculation of LDL. Increased triglycerides subtract from the "calculated" LDL. Thus, if your triglycerides are elevated, your LDL will appear to be lower than it actually is. That's why I recommend using Direct LDL, instead of "calculated" LDL. This is also the main reason labs/doctors want a fasting cholesterol level. Eating raises triglycerides, which in turn reduces calculated LDL. In contrast, direct LDL is unaffected by triglyceride levels.
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