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Comments by Klhoush
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    Here is a good article: https://www.technologyreview.com/s/611713/researchers-find-way-to-mimic-clinical-trials-using-genetics/ Although only tangentially related to your question, it can give you some useful background.

    My advice is that you probably should get some more information. I think there is reasonable consensus that it is the LDL particles themselves – that is, the number of them – that confers risk. Not the amount of cholesterol they carry. So getting an actual LDL-P number assay done (NMR) would be helpful.

    Past this, if your LDL-C is very high, then your LDL-P will almost certainly be high also. Whether you choose to use statins or not should be a discussion between you and your doctor. Otherwise what is the point of having a doctor?

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      Thank you, I’ll take a look. My doctor was unfamiliar with FH, and I had to request the lipoprotein(a) test which showed my low density lipoprotein(a) was around the 300 range. Triglycerides 41, HDL 87. TC 249. I did request the Lp(a) test on the advice of my mother, who does see a cardiologist, and diagnosed her with FH by specifically requesting lipoprotien (a) testing. The problem with FH is that diet has no positive effect on Lp(a), although I’m sure I could make my LDL worse. It’s a genetic defect. Now, my lifestyle makes it much more likely I would survive the heart attack… bonus I guess. The issue is that statins seem to lower numbers overall, to include HDL, and might have negligible improvements. So much of this research I have been able to find deals with people with high triglycerides and poor HDL, when really, the only marker I have that would indicate I’m not incredibly healthy is the 400+ lipoprotien. I’m military insurance, so my doctor is whoever I happen to have at the time at the military treatment facility, and I don’t exactly have a valid reason to request a referral to a cardiologist. I mean, I’m a marathoner and my resting heart rate is 55 BPM (female).

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        You could listen to the Dayspring lipid podcasts that Peter Attia posted last week on his site: https://peterattiamd.com/tomdayspring5/

        It touches on many of the topics you mention here. Recent evidence is that high HDL isn’t actually protective–all drugs that increase it appear to have failed to produce lower levels of CVD. So at best, it is a marker for some other process that may be protective.

        Also, don’t confuse Lp(a) with LDL-P. LDL-P comes from an assay (usually NMR) that counts/calculates the LDL particles per liter of blood. Lots of small LDL particles are thought to be much more atherogenic than lower numbers of large LDL particles – even if the amount of cholesterol they carry (LDL-C) is the same. If your LDL-C is what is 300, it is still within the realm of possibility that your LDL-P is okay. But you would need to get the NMR test to tell you that.

        Lp(A) is an LDL particle with an additional lipoprotein – apolipoprotein A – added to it. Peter Attia had an earlier podcast that went into some detail on Lp(a): https://peterattiamd.com/lpa/

        If you did have your Lp(a) tested and it is high, then you should listen to this. It is currently much more difficult to treat than high LDL and many doctors know nothing about it. Just treating it with a statin is unlikely to be sufficient.

        Also, keep in mind that FH is not a single genetic condition, but rather a host of genetic predispositions to high blood cholesterol levels. Some probably do respond to changes in diet.

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          Best summary of Attia/Dayspring current lipidology knowledge I’ve seen! A keeper. Thanks!

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            Yes, I definitely had my Lp(a) tested, and last one was 333 (I pulled my last labs just to double check my numbers.) Looking for info on this topic that few know very much about was one of the things that led me here. I have been listening to some of Peter Attia’s stuff over the past couple of days to include the Lp(a) podcast you referenced, and it’s been interesting. I’ll take a look at the ones you posted, as well. Thanks!

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              I’m glad you’re investigating your options. Ask your doctor for a referral to a FH / lipoprotein specialist. Also check out the Valter Longo interviews with Rhonda. Beg Peter Attia to review your case.

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        This article suggests that most new science is wrong. Since most old medical science will be proven wrong or vastly improved upon it too is wrong.

        After studying the latest health news for several years this is my take-away message:

        Eat real food. Preferably organic. Exercise. But not to the point of obsession. Sleep well. Don’t worry about your doctor’s opinion on cholesterol levels or diet. They are always wrong and always have been. Don’t let the medical establishment extend your lifespan without extending your health span.

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          Another associative pile of scientific doo-doo.

          Broccoli consumption has been previously associated with good health.

          What’s next? Battle of the Broccoli?

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            I wonder how that compares to sunbathing which increases nitric oxide and doesn’t contain 13g of sugar.

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              Anecdotally, my mother’s blood pressure dramatically improved after she started adding in beetroot extract recently. This has been an area of concern for quite some time and it came as a very pleasant surprise. Also, possibly related: she stopped getting migraines around the same time. I think this stuff may have promise!

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              Akkermansia Muciniphila seems well studied and has been related to obesity and Alzheimer’s. It looks like pomegranate is a good prebiotic for feeding it. Can you comment on the various forms of pomegranate supplements or juice and their effects on overall health?

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                Is it possible that Alzheimer’s patients who had taken anti-viral drugs for other reasons could be tracked to see if there’s a correlation? I wonder if the data already exists but hasn’t been looked at in this way.