The sobering tale of small LDL

10. May 2006 William Davis (0)
Every day, I learn to respect small LDL more and more.

Small LDL particles, and its evil partner, low HDL, is among the most common reasons why someone fails to fully gain control of coronary plaque and heart disease risk.

Just yesterday, I saw a slender businessman (6 feet 1 inch in height, 186 lb.) whose small pattern persisted despite niacin, fish oil, oat bran, and raw almonds. We generally think of small LDL as an overweight person's pattern, but in some people the genetics are quite powerful and it can be expressed even in slender people.

The solution: More physical activity and exercise; cut back on processed carbohydrates, particularly wheat products like breads, pasta, crackers, breakfast cereals; think about magnesium (see our two recent reports on magnesium on the www.cureality.com membership website, the latest report to be posted this week); be sure sleep is adequate (gauge this by whether you're energetic during the day and don't fall asleep watching TV or movies). Lack of sufficient physical activity in people with sedentary jobs is probably among the most common reason the small LDL pattern persists.

Ignore small LDL and it can be like a hidden cancer in your body, growing and metastasizing (not literally, of course), fueling coronary plaque growth. Be sure your doctor assesses whether you have small LDL if you hope to gain control of your coronary risk.
Tags :

Add comment

Loading
The Russert Protocol at work

The Russert Protocol at work

25. June 2008 William Davis (6)
Without a concerted effort at prevention, heart scan scores (coronary calcium scores) grow like weeds. The average rate of growth is 30% per year.

Keith is an illustrative case. At age 39, Keith's heart scan score was 29, in the 99th percentile due to his young age. (In other words, young people before age 40 have no business having plaque. If they do, it's bad.)

True to conventional practice, Keith's doctor prescribed a cholesterol drug (Zocor), asked him to take a baby aspirin, and prescribed a blood pressure medicine. He asked Keith to cut the fat in his diet. His doctor even exceeded conventional (ATP-III) LDL cholesterol treatment targets.

Keith, an intelligent and motivated businessman, happily complied with his doctor's instructions. Eighteen months later, a 2nd heart scan showed a score of 68, representing an increase of 135%, or 76% per year.

This is the very same approach that the late Mr. Tim Russert's doctors employed: treat (calculated) LDL cholesterol with a statin drug, treat high blood pressure, reduce saturated fat, take aspirin. It was a miserable failure in Keith, whose plaque continued to grow at a frightening rate of 76% per year. It was also an obvious failure in poor Tim Russert.

Further investigation in Keith uncovered:

--Severe small LDL--80% of all LDL was small (despite a favorable HDL of 58 mg/dl)
--Measured LDL particle number (NMR) showed that "true" LDL was actually about 60 mg/dl higher than suggested by the crude calculated LDL
--An after-eating (postprandial) disorder (IDL)
--A pre-diabetic blood sugar and insulin
--Severe vitamin D deficiency
--Very low testosterone

All these patterns were present despite the steps Keith and his doctor had instituted. It's no wonder his plaque was undergoing explosive growth.

The conventional approach to coronary disease prevention is inadequate, more often than not a mindless adherence to one-size-fits-all template crafted to a great degree by drug industry interests and "experts" who often stand at arm's length from real live patients.

Keith's "residual" abnormalities are all readily correctable. He has since made dramatic improvements in all parameters. Among the strategies used is a wheat- and cornstarch-free diet that resulted in 12 lbs lost within the first few weeks of effort.

If you are on the "Russert Protocol," have a serious conversation with your doctor about the continued advisability of remaining on this half-assed approach to heart disease. Or, consider finding another doctor.
Tags :

Comments (6) -

  • Anonymous

    6/25/2008 10:23:00 AM |

    Testosterone deficiency is indeed another important factor, perhaps before vitamin D for some men.

    I guess it's no co-incidence that men's sperm rates are declining due to the range of chemicals in our environment which have an adverse affect on testosterone levels.

  • Stargazey

    6/25/2008 1:24:00 PM |

    I don't normally leave comments at your blog, but I wanted you to know that I read it regularly. Thanks for the all work you put into your posts and for the inspiration you provide!

  • Anonymous

    6/25/2008 3:01:00 PM |

    Except that for people with low testosterone (and I am one of those)when you try to correct the low testosterone with testosterone it lowers HDL. Its almost a "choose your poison" proposition.

  • Anonymous

    6/26/2008 9:44:00 AM |

    "However, only testosterone pills have been shown to lower blood levels of the good HDL cholesterol and cause heart attacks. Testosterone injections and skin patches do not (5,6,9)."
    http://www.drmirkin.com/men/M169.htm

  • Anonymous

    6/27/2008 3:09:00 PM |

    You don't mention testosterone cream, I'm on that and my testosterone went from 66 to 50,with no other changes in eating, weight, medicine . . . not a good trend.

  • Anonymous

    6/29/2008 10:37:00 AM |

    You should try Nebido (if available in the US), it's an injection that lasts up to 12 weeks - give or take a few weeks according to how you feel. It seems to be the most popular treatment in Europe due to being something you only think about 4x a year and achieves steady state levels.

    "The observed changes in the lipid profile under treatment with Nebido® were assessed as beneficial. Serum concentrations of total cholesterol, LDL cholesterol and apolipoproteins A1 and B were lowered, while HDL cholesterol, triglycerides and lipoprotein A remained unchanged.1,2,3"
    http://www.nebido.com/scripts/en/professionals/productinfo/lipid.php

    Where trigylcerides and HDL remain unchanged I guess this is where vit D and fish oil steps in.

Add comment

Loading