6 ms·

Putting off an annual checkup with a PCP (I’m 42, and the last PCP I had was a pediatrician). I had long suspected my cholesterol and triglycerides were high du

Putting off an annual checkup with a PCP (I’m 42, and the last PCP I had was a pediatrician). I had long suspected my cholesterol and triglycerides were high due to family history and my excessive love for cheese, and last week that suspicion was confirmed. I’m now more resolute than ever on lifestyle changes (exercise, less red meat, getting most of my calcium from 2% milk). On the bright side, I also got reassurance that outside the lipid panel, everything else (sugar, kidney and liver function, PSA, etc.) seems normal. Other than laziness and procrastination, a huge part of me was dreading being told I need a prostate exam and colonoscopy, but fortunately I don’t need either for at least 3 more years.

Loughla 4y ago
I learned from my father's generation that regular check-ups were vital. My oldest two uncles died from heart issues in their early 60's. The next two and my father have made it to their 70's and show no signs of stopping. There isn't really any difference in lifestyles between the dead and alive ones, other than going to the doctor regularly, and taking whatever medicine they are prescribed. I guess one uncle quit smoking. So that's probably good for him.
hacker_junky 4y ago
That's great news that your cholesterol and triglycerides were high and that everything else looks normal! Are there any other tips that you would suggest for making lifestyle changes to help lower cholesterol and triglycerides?
- ralmidani 4y ago
  I’m not a Physician or Dietitian, but my dad is a Gastroenterologist and my wife is a Registered Dietitian, so some of their knowledge rubs off on me. And my PCP gave me some tips last week that are still fresh in my mind. - Exercise can help lower cholesterol slightly. But try to have a reasonable balance between cardio and resistance training. Too much cardio risks having some muscles actually weaken if you maintain a large calorie deficit. - Diet-wise, you want to go for sustainable weight management, so no extreme or gimmicky diets. Avoid Atkins and Keto (unless a professional tells you you actually need to avoid carbs), extreme fasting, etc. - 3 moderate meals a day are better than 2 or 1 large feast(s) because they keep your metabolism going for most of the day. Your body can adapt to feast/famine and can go into ketosis, but these are survival mechanisms and harmful, even counterproductive, if you keep your body in these modes for long periods of time (you might even gain weight in feast/famine mode because when you do eat, your body converts as much sugar into fat as it possibly can, in order to prepare reserves for the next “famine”). - Some fasting is good for spirituality and to teach self-control, but it should not be a permanent state (I plan to fast Mondays and Thursdays as much as possible, leading up to Ramadan in about 50 days). Fasting every single day for the rest of your life is not realistic and probably does more harm than good. - Eat raw nuts (raw almonds have been observed to lower total cholesterol, lower LDL, and raise the HDL/LDL ratio) as much as you can within your calorie allowance. In general, more plant-based protein and fats, and less animal-based is very helpful (but watch out for high saturated fat from coconuts, and too much soy can mess up men’s hormones). Edit: the soy evidence is not conclusive - see comments below. - Keep your calorie allowance reasonable and sustainable, and try to eat a good variety of fruits, vegetables, grains, beans, legume, meats, etc. with moderation in everything.
  - boringg 4y ago
    I'm going to ask for a reference on the soy comment. I know there's a lot of fear mongering on soy but I haven't heard of any studies to prove that. Rest of the advice seems good. Lower fat in diet (specifically dairy fats), increase exercise, higher fiber, lower sugar, more nuts/avocados/salmon. Treat the disease and not the numbers - so look at all your risk factors for atherosclerosis.
    - ralmidani 4y ago
      I’m not suggesting avoiding soy altogether, just cautioning against excessive consumption of it. Studies are showing mixed conclusions, but it’s not all fear mongering: Study showing some effect: https://pubmed.ncbi.nlm.nih.gov/15735098/ https://pubmed.ncbi.nlm.nih.gov/15735098/ Study showing little effect: https://pubmed.ncbi.nlm.nih.gov/11880595/ https://pubmed.ncbi.nlm.nih.gov/11880595/ While the evidence is inconclusive, I wouldn’t take chances if I were trying to have kids. I would imagine getting __all__ of your protein from soy could potentially be harmful, perhaps even in ways other than decreasing testosterone and sperm count. In general, everything in moderation is best.
  - dibt 4y ago
    > Fasting every single day for the rest of your life is not realistic and probably does more harm than good. What evidence is there for this statement? What is considered "fasting?" I can't see how a 12-hour feeding window would be problematic. I could understand some people might develop "disordered eating" if their approach is unsustainable, but "more harm than good" isn't true for those that can do it. One reason for fasting is that it improves insulin sensitivity. From: https://www.health.harvard.edu/blog/intermittent-fasting-surprising-update-2018062914156 https://www.health.harvard.edu/blog/intermittent-fasting-sur... "Based on this, researchers from the University of Alabama conducted a study with a small group of obese men with prediabetes. They compared a form of intermittent fasting called "early time-restricted feeding," where all meals were fit into an early eight-hour period of the day (7 am to 3 pm), or spread out over 12 hours (between 7 am and 7 pm). Both groups maintained their weight (did not gain or lose) but after five weeks, the eight-hours group had dramatically lower insulin levels and significantly improved insulin sensitivity, as well as significantly lower blood pressure. The best part? The eight-hours group also had significantly decreased appetite. They weren’t starving."
- broguinn 4y ago
  High cholesterol runs in the family (my grandfather exercises 7 days a week, is thin as a rail, and had a heart attack at 60). I'm 31 and learned that I have high LDL two years ago. I can only speak to my case, so YMMV. Through a liver blood panel, I learned that I had high bilirubin, SHBG, and GGH - which indicate compromised gallbladder and liver function. One doctor suggested I have my gallbladder removed. Instead, through research on pubmed and examine.com, I was pointed to TUDCA - a bile salt that helps clear cholesterol and biliary sludge. After two months of supplementation, I've seen a severe reduction in intestinal discomfort - and I suspect a follow-up blood test will show a reduction in my high liver panel and LDL. If you have abnormally high LDL for your body type and lifestyle, I would encourage you to get a liver panel and look into TUDCA.
xwowsersx 4y ago
> less red meat IIUC, they no longer believe that lipid cholesterol levels are directly correlated with intake of dietary cholesterol. See, for example: https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/cholesterol/ https://www.hsph.harvard.edu/nutritionsource/what-should-you... > The biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food. > Although it remains important to limit the amount of cholesterol you eat, especially if you have diabetes, for most people dietary cholesterol is not as problematic as once believed. I would recommend committing to getting a full blood panel (specific to your sex, male or female) at least every 6 months, especially if you are going to be making significant changes to your diet. This was a game-changer for me. I started working with a practice that does health optimization and blood work/labs and has doctors who know how to interpret the results and give recommendations based on them. For me, I had several biomarkers significantly improve by consuming more red meat. I hadn't been trying to avoid red meat consciously, just somehow over the years I started consuming a lot more chicken and turkey and really wasn't having enough beef, etc.
- boringg 4y ago
  Eating less red meat is about lowering your inflammation in your veins - which is a major part of the battle for atherosclerosis. Agreed it's not about your dietary cholesterol. Dairy fat is a big issue for atherosclerosis. However risk factors are individual so take everyones commentary as educational but apply on what's relevant look at your on individual use case.
  - rubicon33 4y ago
    It’s not red meat causing the inflammation. It’s sugar.
    - boringg 4y ago
      Sugar also a culprit - its not a red meat vs sugar thing. However one of the top researchers in cholesterol in the US told me specifically to eat red meat once a year as it has inflammation qualities that are risky for people who have higher risk factors for a cardiac event.
Jommi 4y ago
FYI the above is american-focused healthcare language. There are no annual checkups in most other countries outside of certain age or risk groups. You might however get a health checkup from occupational healthcare sometimes! Just putting this a note here for non-american readers so they don't get confused.
- toomuchtodo 4y ago
  Tangentially, it’s common for your employer’s health insurance provider to provide a discount if get an annual physical. Edit: (US specific)
  - samsari 4y ago
    Again, this is very USA-specific.
- throwaway1777 4y ago
  That being said most people in America don’t get annual checkups unless they have issues either. And there’s also a school of thought that more preventative medicine would be a good thing, so maybe other countries should consider it.
- roncesvalles 4y ago
  My family doctor in Canada does an annual check-up (BMI, basic physical, blood and urine) that's covered by provincial healthcare. In addition, those over 50 get a colon cancer check every two years that used to be a full colonoscopy but now it's a new poop sample test. I'm surprised other countries with free government healthcare don't do that. I would assume it's more economical to detect signs of serious issues early.
  - Semaphor 4y ago
    > I would assume So would I (Germany), yet it’s only one blood test every 3 years from the age of 35 on.
  - digianarchist 4y ago
lucb1e 4y ago
for anyone else confused, that's Primary Care Physician, which I take to mean GP/Hausartzt/huisarts.
- ralmidani 4y ago
  Thanks for clarifying, and sorry for the confusion - I wish I could edit my comment.
pgt 4y ago
Study: No association between eating eggs and blood lipids, cardiovascular disease, or mortality in 177,000 people in 50 countries. https://academic.oup.com/ajcn/advance-article-abstract/doi/10.1093/ajcn/nqz348/5713417 https://academic.oup.com/ajcn/advance-article-abstract/doi/1...

Loughla 4y ago

I learned from my father's generation that regular check-ups were vital. My oldest two uncles died from heart issues in their early 60's. The next two and my father have made it to their 70's and show no signs of stopping. There isn't really any difference in lifestyles between the dead and alive ones, other than going to the doctor regularly, and taking whatever medicine they are prescribed. I guess one uncle quit smoking. So that's probably good for him.

hacker_junky 4y ago

That's great news that your cholesterol and triglycerides were high and that everything else looks normal! Are there any other tips that you would suggest for making lifestyle changes to help lower cholesterol and triglycerides?

ralmidani 4y ago
I’m not a Physician or Dietitian, but my dad is a Gastroenterologist and my wife is a Registered Dietitian, so some of their knowledge rubs off on me. And my PCP gave me some tips last week that are still fresh in my mind. - Exercise can help lower cholesterol slightly. But try to have a reasonable balance between cardio and resistance training. Too much cardio risks having some muscles actually weaken if you maintain a large calorie deficit. - Diet-wise, you want to go for sustainable weight management, so no extreme or gimmicky diets. Avoid Atkins and Keto (unless a professional tells you you actually need to avoid carbs), extreme fasting, etc. - 3 moderate meals a day are better than 2 or 1 large feast(s) because they keep your metabolism going for most of the day. Your body can adapt to feast/famine and can go into ketosis, but these are survival mechanisms and harmful, even counterproductive, if you keep your body in these modes for long periods of time (you might even gain weight in feast/famine mode because when you do eat, your body converts as much sugar into fat as it possibly can, in order to prepare reserves for the next “famine”). - Some fasting is good for spirituality and to teach self-control, but it should not be a permanent state (I plan to fast Mondays and Thursdays as much as possible, leading up to Ramadan in about 50 days). Fasting every single day for the rest of your life is not realistic and probably does more harm than good. - Eat raw nuts (raw almonds have been observed to lower total cholesterol, lower LDL, and raise the HDL/LDL ratio) as much as you can within your calorie allowance. In general, more plant-based protein and fats, and less animal-based is very helpful (but watch out for high saturated fat from coconuts, and too much soy can mess up men’s hormones). Edit: the soy evidence is not conclusive - see comments below. - Keep your calorie allowance reasonable and sustainable, and try to eat a good variety of fruits, vegetables, grains, beans, legume, meats, etc. with moderation in everything.
- boringg 4y ago
  I'm going to ask for a reference on the soy comment. I know there's a lot of fear mongering on soy but I haven't heard of any studies to prove that. Rest of the advice seems good. Lower fat in diet (specifically dairy fats), increase exercise, higher fiber, lower sugar, more nuts/avocados/salmon. Treat the disease and not the numbers - so look at all your risk factors for atherosclerosis.
  - ralmidani 4y ago
    I’m not suggesting avoiding soy altogether, just cautioning against excessive consumption of it. Studies are showing mixed conclusions, but it’s not all fear mongering: Study showing some effect: https://pubmed.ncbi.nlm.nih.gov/15735098/ https://pubmed.ncbi.nlm.nih.gov/15735098/ Study showing little effect: https://pubmed.ncbi.nlm.nih.gov/11880595/ https://pubmed.ncbi.nlm.nih.gov/11880595/ While the evidence is inconclusive, I wouldn’t take chances if I were trying to have kids. I would imagine getting __all__ of your protein from soy could potentially be harmful, perhaps even in ways other than decreasing testosterone and sperm count. In general, everything in moderation is best.
- dibt 4y ago
  > Fasting every single day for the rest of your life is not realistic and probably does more harm than good. What evidence is there for this statement? What is considered "fasting?" I can't see how a 12-hour feeding window would be problematic. I could understand some people might develop "disordered eating" if their approach is unsustainable, but "more harm than good" isn't true for those that can do it. One reason for fasting is that it improves insulin sensitivity. From: https://www.health.harvard.edu/blog/intermittent-fasting-surprising-update-2018062914156 https://www.health.harvard.edu/blog/intermittent-fasting-sur... "Based on this, researchers from the University of Alabama conducted a study with a small group of obese men with prediabetes. They compared a form of intermittent fasting called "early time-restricted feeding," where all meals were fit into an early eight-hour period of the day (7 am to 3 pm), or spread out over 12 hours (between 7 am and 7 pm). Both groups maintained their weight (did not gain or lose) but after five weeks, the eight-hours group had dramatically lower insulin levels and significantly improved insulin sensitivity, as well as significantly lower blood pressure. The best part? The eight-hours group also had significantly decreased appetite. They weren’t starving."
broguinn 4y ago
High cholesterol runs in the family (my grandfather exercises 7 days a week, is thin as a rail, and had a heart attack at 60). I'm 31 and learned that I have high LDL two years ago. I can only speak to my case, so YMMV. Through a liver blood panel, I learned that I had high bilirubin, SHBG, and GGH - which indicate compromised gallbladder and liver function. One doctor suggested I have my gallbladder removed. Instead, through research on pubmed and examine.com, I was pointed to TUDCA - a bile salt that helps clear cholesterol and biliary sludge. After two months of supplementation, I've seen a severe reduction in intestinal discomfort - and I suspect a follow-up blood test will show a reduction in my high liver panel and LDL. If you have abnormally high LDL for your body type and lifestyle, I would encourage you to get a liver panel and look into TUDCA.

xwowsersx 4y ago

> less red meat IIUC, they no longer believe that lipid cholesterol levels are directly correlated with intake of dietary cholesterol. See, for example: https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/cholesterol/ https://www.hsph.harvard.edu/nutritionsource/what-should-you... > The biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food. > Although it remains important to limit the amount of cholesterol you eat, especially if you have diabetes, for most people dietary cholesterol is not as problematic as once believed. I would recommend committing to getting a full blood panel (specific to your sex, male or female) at least every 6 months, especially if you are going to be making significant changes to your diet. This was a game-changer for me. I started working with a practice that does health optimization and blood work/labs and has doctors who know how to interpret the results and give recommendations based on them. For me, I had several biomarkers significantly improve by consuming more red meat. I hadn't been trying to avoid red meat consciously, just somehow over the years I started consuming a lot more chicken and turkey and really wasn't having enough beef, etc.

boringg 4y ago
Eating less red meat is about lowering your inflammation in your veins - which is a major part of the battle for atherosclerosis. Agreed it's not about your dietary cholesterol. Dairy fat is a big issue for atherosclerosis. However risk factors are individual so take everyones commentary as educational but apply on what's relevant look at your on individual use case.
- rubicon33 4y ago
  It’s not red meat causing the inflammation. It’s sugar.
  - boringg 4y ago
    Sugar also a culprit - its not a red meat vs sugar thing. However one of the top researchers in cholesterol in the US told me specifically to eat red meat once a year as it has inflammation qualities that are risky for people who have higher risk factors for a cardiac event.

Jommi 4y ago

FYI the above is american-focused healthcare language. There are no annual checkups in most other countries outside of certain age or risk groups. You might however get a health checkup from occupational healthcare sometimes! Just putting this a note here for non-american readers so they don't get confused.

toomuchtodo 4y ago
Tangentially, it’s common for your employer’s health insurance provider to provide a discount if get an annual physical. Edit: (US specific)
- samsari 4y ago
  Again, this is very USA-specific.
throwaway1777 4y ago
That being said most people in America don’t get annual checkups unless they have issues either. And there’s also a school of thought that more preventative medicine would be a good thing, so maybe other countries should consider it.
roncesvalles 4y ago
My family doctor in Canada does an annual check-up (BMI, basic physical, blood and urine) that's covered by provincial healthcare. In addition, those over 50 get a colon cancer check every two years that used to be a full colonoscopy but now it's a new poop sample test. I'm surprised other countries with free government healthcare don't do that. I would assume it's more economical to detect signs of serious issues early.
- Semaphor 4y ago
  > I would assume So would I (Germany), yet it’s only one blood test every 3 years from the age of 35 on.
- digianarchist 4y ago

lucb1e 4y ago

for anyone else confused, that's Primary Care Physician, which I take to mean GP/Hausartzt/huisarts.

ralmidani 4y ago
Thanks for clarifying, and sorry for the confusion - I wish I could edit my comment.

pgt 4y ago

Study: No association between eating eggs and blood lipids, cardiovascular disease, or mortality in 177,000 people in 50 countries. https://academic.oup.com/ajcn/advance-article-abstract/doi/10.1093/ajcn/nqz348/5713417 https://academic.oup.com/ajcn/advance-article-abstract/doi/1...