HELPING YOUR DOCTOR DETERMINE IF CHOLESTEROL MEDICATION IS NEEDED

doc and patient cropped 600The average patient assumes lab values are full of complicated data that only qualified physicians are capable of reading and understanding. With more than 43 million Americans taking cholesterol lowering drugs, do YOUR LAB VALUES show a REAL NEED based on the latest science, or are you being prescribed these medications to support the “HEALTH” and WELL BEING of the pharmaceutical and medical industry?

CHICAGO, April 5, 2016 (UPI) — “A drug that lowers bad cholesterol and significantly increases good cholesterol, which doctors expected would increase cardiovascular health, failed to reduce rates of adverse health events in a large clinical trial, according to researchers.”

“Drug maker Eli Lilly halted a trial of evacetrapib in 2015 based on a lack of reduction in heart attack, stroke, the need for surgery or hospitalization, or the amount of time high-risk patients survived to cardiovascular death, researchers said in a presentation at the American College of Cardiology’s 65th Annual Scientific Session.” (REF: Cholesterol drug fails to prevent heart attack, stroke in trial)

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WITH NEW STUDIES REVEALING NEW TRUTHS, HOW HAS THE MEDICAL FIELD RESPONDED?

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New statin (cholesterol drug) guidelines: Everyone 40 and older should be considered for the drug therapy

(REF: New Recommended Guidelines For Prescribing Cholesterol Medication)

I hope that was a GASP I just heard from you!

Where is the logic in this recommendation? As a patient, do you care if you’re prescribed medications you shouldn’t be taking?

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For patients WITHOUT A HISTORY of heart disease taking cholesterol lowering medication:

  • 98% saw no benefit at all

  • 1.6% (1 in 60) were helped by preventing a heart attack

  • 0.4% (1 in 268) were helped by preventing a stroke

  • 1.5% (1 in 67) were harmed by developing diabetes

  • 10% (1 in 10) were harmed by muscle damage

(REF: Statin Drugs Given for 5 Years for Heart Disease Prevention (Without Known Heart Disease))

For patients WITH A HISTORY of heart disease taking cholesterol lowering medication:

  • 96% saw no benefit at all

  • 1.2% (1 in 83) had their lifespan extended (were saved from a fatal heart attack)

  • 2.6% (1 in 39) were helped by preventing a repeat heart attack

  • 0.8% (1 in 125) were helped by preventing a stroke

  • 0.6% (1 in 167) were harmed by developing diabetes

  • 10% (1 in 10) were harmed by muscle damage

(REF: Statins Given for 5 Years for Heart Disease Prevention (With Known Heart Disease))

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WHAT DO YOU NEED TO KNOW TO HELP YOUR DOCTOR MAKE A BETTER DECISION!

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The Blood Lipid Panel (Cholesterol Panel) looks like the following:

typical-blood-panel-ii-cropped-700

Without having to specifically know what the different values mean, you can see if anything is out of “NORMAL RANGE” by comparing the second column (“standard range”) with the third column (“your value.”) This blood panel shows each component is within normal ranges.

If any of these values were elevated, would this explain the need for your doctor to prescribe cholesterol lowering medication? As a physician, looking at the LIMITED information provided by these GENERAL NUMBERS, I wouldn’t be able to intelligently answer this question. Yet, this is typically the information your doctor uses to determine (to a large extent) whether cholesterol medication is prescribed. Why wouldn’t a typical blood lipid panel be sufficient to determine whether prescription medication is appropriate?

We have learned new TRUTHS about HDL (good cholesterol) and LDL (bad cholesterol) and other components that must be included in our decision making process before prescribing cholesterol medications.

The following cholesterol panel is called a Vertical Auto Profile (VAP for short) This test takes the standard parameters and further breaks them down into components that more ACCURATELY determine risk profiles for cardiovascular disease and stroke. This lab profile can be read just like the traditional lab profile above. Again, even without understanding the meaning of each component,  you can see if your “ACTUAL VALUE” falls in the “DESIRABLE RANGE.” In addition it also shows if you’re at “LOW RISK OR HIGH RISK” for cardiovascular disease and stroke.

Vap with grey cropped

If you believe your doctor wants to provide you with QUALITY CARE, he or she needs QUALITY information to provide QUALITY recommendations. Countless people are taking cholesterol medication that can be causing more harm than good. Lowering general numbers (in and of themselves) may not only be unnecessary, but harmful. Make sure you’re not “just a number” in your doctor’s office receiving sub par testing because this is what “their office does.”

You can now ASSIST your doctor by requesting he or she provide more comprehensive cholesterol testing to help determine whether medication is truly needed or not. You should also ask them to provide SPECIFIC lists of recommendations (based on your health status) regarding lifestyle choices that reduce the chances of harmful cholesterol numbers. SPECIFIC EXAMPLES might include:

  1. increasing daily vegetable servings to 5 per day (specific number of servings.) If they see you are unable to manage this, they can offer alternative methods to achieve these levels by recommending smoothies and or juicing vegetables.

  2. increasing  walking (moderate intensity/breaking a light sweat) for 20 minutes 4-5X/week (specific exercise/intensity and duration of exercise.)

Recommending exercise and “eating better” WITHOUT SPECIFIC OPTIONS is rarely successful. It is also pointless to make recommendations a patient is unwilling to follow. Therefore, recommendations must be REALISTIC and agreed upon between patient and doctor.

Most doctors are good people wanting to help their patients. The best way they can help you is by you helping them.

THE MORE YOU LEARN, THE MORE YOU CAN HELP YOUR DOCTOR PROVIDE YOU THE CARE YOU WANT AND NEED!

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9 comments

  1. That VAP panel is very cool. I’ve never heard of it and will request this the next time I get blood work done. It is truly amazing how quickly the prescription pad comes out though, without much thought.

    Liked by 1 person

    1. Some people will hesitate to request this type of blood work because insurance may not cover it. It is situations like this that frustrate doctors that care about their patients. How are we supposed to provide the BEST recommendations when we’re missing important criteria to determine these recommendations. I regularly asked my patients for a dollar amount they believed equaled the VALUE of their health. This helped me understand the boundaries of the care they believed was necessary and important. I had to frequently remind myself to offer the LEVEL OF CARE they wanted; not the LEVEL OF CARE I believed was in their best interest.

      Liked by 1 person

      1. I can certainly see how frustrating this would be for a caring doctor.

        Like

  2. A big GASP. Wow, I dunno but I think if more people were more mindful of what they eat which could be high sources of cholesterol, maybe they could less or none of that? Maybe a very simplistic approach but well in my country once more, I think it not common to hear of people on medication for just about everything and anything. Good food for thought once more

    Like

    1. It must be amazing that a land as “rich” as America requires to medicate such a larger percentage of its people. It shows the lack of “richness” in education and personal responsibility people are willing to assume.

      Rather than focusing on diet, if people focused on LIFESTYLE, cholesterol (and many other health problems) would dramatically reduce. BALANCE in healthy living is the KEY to combating many of life’s illnesses.

      Liked by 1 person

  3. This is one thing I’ve never had to worry about, but I’ve know quite a few people who will benefit from any advancement like this.

    Liked by 1 person

  4. Just remember that “NORMAL” cholesterol levels does NOT EQUATE with reduced risk of heart disease. Specific components in the VAP panel are more accurate to determine health risk. (For example: LDL levels should be under 100 for a standard cholesterol blood panel. In the VAP panel, if the IDL and Lp(a) (two components of the TOTAL LDL) are elevated, but the TOTAL LDL is under the “normal” 100, there is STILL an INCREASED RISK for heart disease and stroke. Many of these people that have had heart attacks or died had normal traditional blood lipid panels in the hospital.

    This is the purpose of this article. It is intended to show that older diagnostic methods have NOT been proven accurate to protect patient’s health properly. It is also meant to help patients become more proactive to improve the patient/doctor relationship and the quality of care received/offered.

    Liked by 2 people

  5. This is so interesting Jonathan and so true. The more ‘we’ learn, the more ‘we’ can help our doctors help ‘us’ with the care that ‘we’ need.

    Liked by 1 person

    1. Most people do not think in these terms. We rely on our physicians to “handle” our lives. We would be better off using their knowledge and experience to provide OPTIONS for us to CHOOSE from. When and if ONLY 1 option is provided, the chances are that alternative viable options are missing from your doctor’s experience “arsenal.” Always seek multiple options to make the BEST informed decision.

      Liked by 1 person

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