Another Cholesterol Rant
It’s not something I’m proud to admit it, but up until last week it’s been about eleven years since I’ve stepped foot into a doctor’s office.
While I’d like to sit here and say it’s due to some irrational fear – akin to some people’s fear of say, clowns – sadly, it has more to do with plain ol’ stubbornness peppered with a hint of laziness and a touch of cynicism.
Knock on wood it’s not that often that I get sick. I can count on one hand the number of times I’ve been legitimately out of commission in the last decade, to the point where staying home and watching re-runs of Knight Rider seemed like a better option than “manning up” and heading to work. And even then I was usually back to normal within a 24-36 hour period.
Fever? Headache? Upset stomach? Ebola? Whatevs. Doctor schmoctor.
I think much of my “beef” with the primary care industry (and yes, it IS an industry: they’re just as interested in making money as your local Audi dealership) is that a large portion of it (not all of it) is more interested in being reactive instead of proactive.
It’s much easier to tell the type II diabetic to take eight different pills to treat their symptoms than it is educate him or her on the benefits of exercise and making wiser food choices.
I get it: doctors are trained to use medicine, not dumbbells and fish oil, to treat symptoms. It’s just kind of frustrating when I know we can save a metric shit-ton of money in preventative health care costs by educating people rather than circumventing everything with “band aid” fixes.
So yeah, I generally steer clear of the doctor’s office more so out of spite than anything else. It’s stupid and childish, I know.
But what can I say? I like Boobies.
Well, Lisa put an end to the nonsense. She’s been on me for a while now to go to the doctor’s office if for nothing else just to get a check up and make sure things are a-okay.
To her credit, Lisa absolutely adores her doctor – she’s very attentive, listens, takes her time, and takes a much more proactive approach – and mentioned to me last fall that she was accepting new patients.
I made the appointment and conveniently missed it. Oops.
I know it came across as self-sabotage, but I totally blanked and got my dates mixed up, and unfortunately, because she’s so popular, in order to reschedule I would have had to wait until January in order to see her.
To make a long story short, I ended up making an appointment with one of the resident doctors (who’s under the supervision of Lisa’s doctor) and well, it was awesome!
She asked a lot of questions, took her time, and didn’t blink an eye when I told her I ate 5-10 eggs per day. I mentioned that I was interested in getting my vitamin D checked, as well as my cholesterol but that I didn’t want the ordinary test that just gives you your total cholesterol (HDL/LDL) count.
Total cholesterol is a meaningless number and should be the basis for absolutely nothing. The old division into “good” (HDL) cholesterol and “bad” (LDL) cholesterol is out of date and provides only marginally better information than a “total” cholesterol reading.
As noted in their fantastic book, The Great Cholesterol Myth, Jonny Bowden and Dr. Stephen Sinatra state:
Both good and bad cholesterol have a number of different components (or subtypes) that behave quite differently, and the twenty-first-century version of cholesterol test should always tell you exactly which subtypes you have.
More to the point they HIGHLY recommend a Particle Size Test.
Although LDL cholesterol is known as the “bad” cholesterol, the fact is that it comes in several shapes and sizes, as does HDL cholesterol, the so-called “good” kind. These different subtypes of cholesterol behave very differently. Seen under a microscope, some LDL particles are big, fluffy, and harmless. Some are small, dense, and “angry,” and much more likely to become oxidized, slipping through the cells that line the walls of arteries and beginning the inflammatory cascade that leads to heart disease.
Total cholesterol doesn’t mean shit and should NOT be the basis for any treatment. While the media is quick to demonize high total cholesterol for the cause of heart disease, what they fail to dictate to the pubic is that 45-50% of the people who die from heart disease have what’s deemed “acceptable” total cholesterol readings.
There’s much more of the onion that needs to be peeled back than TOTAL cholesterol. What’s more, the fact that cholesterol is demonized in the first place is a bunch of BS.
Alas, the public has been programmed to think that cholesterol is our enemy……….so it only makes sense that the amount of eggs I ingest on a weekly basis would make most people cringe.
I got my blood work back the other day, and in the words of my doctor: everything came back perfectly normal.
So to all the random checkout line cashiers throughout the years who shit a tofu brick and went out of their way to express their concern about my cholesterol levels (I can’t tell how many have asked whether or not I’m ever concerned about my cholesterol) because of the number of cartons of eggs (and beef, and bacon, and cheese) I buy each week, but never said a word to the person a head of me with a cart filled with soda, ice-cream, chips, cookies, and organic Pop-Tarts…… all I have to say is:
Nah nah nah nahhhhhhhhhhhhhhh.
And, I have the coolest doctor like, ever.
Comments for This Entry
ChrisI'm interested in getting a particle size test instead of getting the normal HDL/LDL test. Did you have to go through any special loops to get it done and what's considered normal? Did you also get your vitamin D levels tested?
August 7, 2013 at 11:22 am |
TonyGentilcoreNot at all Chris. All I did was mention to my physician that that's what I was interested in getting. She was completely on board with it. I also got my vitamin D levels checked and they came back a-okay. I think EVERYONE should get that checked too.
August 7, 2013 at 7:22 pm |
Chris CIf you're proactive and adamant about it, then you doctor should be willing to order it for you. You want an NMR(nuclear magnetic resonance), which gives the particle size and number of HDL and LDL. I'd also recommend c-reactive protein, homocystein, insulin, and VLDL.
August 7, 2013 at 10:59 pm |
fernandoHey Tony, nice article. I always thought eggs dont increase cholesterol in humans, because the hdl/ldl must be synthesized, they cant be "absorved" from foods, then, cholesterol in eggs affect us as any fat does in our diet. Even though, once a nutritonist told me to limit my consuption to 3 a week.
August 7, 2013 at 11:40 am |
TonyGentilcoreThe body will up-regulate and down-regulate it's own production of cholesterol based off one's dietary intake. Never really heard the notion that cholesterol can't be absorbed from foods.
August 7, 2013 at 7:23 pm |
fernandoYou are right, my mistake, i just looked it up. Guess i became a little more instructed today, thanks!
August 7, 2013 at 10:14 pm |
Scott | MassNERDererGlad you're healthy man!
August 7, 2013 at 1:03 pm |
TonyGentilcoreWell thanks Scott. Me too!
August 7, 2013 at 7:23 pm |
PatWhat a great point! An eggcellent point. I also had blood work done over the past year. My total cholesterol was 231 in January and 205 in July. What does that mean? I don't know, but I know I still eat 12 eggs a day sometimes. I wish I would have asked for the LDL particle tests. I love eggs. 12 eggs hard boiled. Take that, media.
August 7, 2013 at 7:02 pm |
PatI also think every one needs a Vitamin D test. My levels were hiring in January than July for some reason. I guess I have to eat more Wild Planet Sardines! I'd also recommend talking to your doctor about T3 and T4 as well as TSH. All concerning the thyroid. I never knew how much research there was on hormones!
August 7, 2013 at 8:04 pm |
KatieTimely post! My husband hadn't been to the doctor in literally 12 years either, so I did something similar and made him go. I went in for an annual check-up and he went in for the first time in well... forever. A little background: We are both fit/lean, eat clean, lift 3 - 4x/week, exercise, etc. We eat a mostly paleo-style diet [so don't shy away from the fat], plus some extras like rice & very occasional bread. All our bloodwork came back perfectly normal... except for DUN DUN DUN, our cholesterol. Since I have gone to the doctor regularly, I know I haven't had high cholesterol except for many, many years ago when I was a kid. My "good" cholesterol "kicked ass" in the words of my doctor. But my "bad" was fairly elevated too. What's interesting is I started eating paleo style post my last full blood check-up. So perhaps that style of eating is what raised it. My husband has nothing to compare to, but his was VERY high. Like, 3 away from what the doctor said he'd start prescribing statins to people. Which was super shocking to me. The more I've read the last few years about people's ideas of cholesterol being outdated, on one hand, I think.. should I even be concerned? On, the other, I can't help but feel concerned deep down and keep reading all I can. The doctor said my husband's is probably just genetic. We eat literally exactly the same [cook together every night, eat the same breakfast, etc.] so genetic factors would make sense too. There's so much contradictory information out there about cholesterol right now don't even know what to make of it all! Good to know about the particle size test, as we're going back in 3 months to get bloodwork again. We got the typical "eat less saturated fat, then get re-checked" talk to which I guess I'll try. But I'm suffering some serious cognitive dissonance with that idea after adopting a more paleo mentality about nutrition/fat...
August 7, 2013 at 8:19 pm |
TonyGentilcoreI know Alan Aragon wrote a fantastic article a few years ago dissecting someone's cholesterol reading. You might want to try to do a search on that. I wouldn't go out of my way to say you have NOTHING to be concerned about - but too, we've all been programmed to think a certain level of cholesterol is "bad," when from what I can tell it's just an arbitrary number anyways. And, for the record, avoid statins like the plague!!!!! Absolutely DO NOT allow him to take them unless he's at a high risk of heart attack. But that seems highly unlikely.
August 8, 2013 at 4:02 pm |
KatieThank you for your response, Tony! I will definitely look into that article. I like Alan Aragon's writing a lot. I have been reading a bunch of Chris Kresser's articles on cholesterol since all this happened and I read this excerpt about genetics since the doc said my husband's is likely genetic: "Genetics If you have high LDL-P, but normal triglycerides, HDL, small LDL-P and your lipoprotein insulin resistance (LP-IR) score on the NMR LipoProfile is normal, and you’ve ruled out thyroid problems, infections and leaky gut, than it’s very likely that you have one of the many genetic variants that can lead to increased LDL particle number. In this case, a low-carb Paleo diet will often increase—rather than decrease—LDL-P. In my practice I will often recommend what I call a “Mediterranean Paleo diet” in these cases. This means following the basic Paleo approach, but reducing intake of fat and increasing intake of fruit and starchy vegetables. You can still eat fat as it naturally occurs in food, but try not adding as much additional fat to meals, and using more monounsaturated fat than saturated fat. In many cases this will decrease LDL-P quite significantly." That could make sense. He's Persian, and growing up, had rice with every meal. Persian food is SUPER healthy but also with the rice has a relatively high carb intake, and he definitely tolerates carbs well. In more recent years his carb intake has decreased a ton and more protein/fat oriented. Going to try to up our carb intake [I could probably use it too, in all honesty] and lower our fat intake and see what happens. It's worth a shot. I've been reading all kinds of terrible things about statins so I'm with you - I'd like to avoid that at all costs if possible. PS: I don't know what "etiquette" is about linking/quoting other articles... so please delete this is that is a no-no... my apologies :o
August 8, 2013 at 10:04 pm |
TonyGentilcoreOh, no worries at all. You gave credit to the authoer and I really appreciate you sharing it! Sounds like you just need to rule out a few things, but what he mentions about makes perfect sense to me. Hopefully your doctor will have an open mind about this.
August 9, 2013 at 6:18 am |
Donovan Gary AlanAwesome rant, bro. It was...Rantabulous (ya like that?? You can borrow it.). I do have some good news though- I train 3 doctors and they are trying to get in shape which is awesome. Every other doctor I've seen has been or is out of shape. Some even took my business card. One of these high profile clients in particular works with people with diabetes and heart health issues. Her first action is to change lifestyle behaviors, than give meds. Doctors like these, however, have to give meds when the patient doesn't comply with the instructions, pretty much to avoid being sued for negligence. Makes sense, but it was refreshing to hear this. Sooo....I think this doctor has to be the coolest. I might even go to her now. Haha
August 7, 2013 at 9:09 pm |
Ines Subashkahaha :) Tony, I love your sense of humor. I loved the end of the article. I also associate with this, because I don't go to the doctor's office, I think they do more harm than good, plus often times they are sicker than the patients and have no idea what they are talking about! The only time I visit them i s to get a blood work done, so I can say Nah nah nah nahhhhhhhh to everybody who eats fries, drinks soda and eats donuts on a daily basis, but still is highly concerned for my health and cholesterol, because I eat a bunch of eggs and pork steaks! :)
August 9, 2013 at 5:35 am |
TonyGentilcoreWell thank you Ines. I didn't mean to come across as if I felt I knew more that most doctors.......because I obviously don't. Thankfully I was lucky enough to find one that has an open mind and is willing to listen to me. Rare find these days.
August 9, 2013 at 6:20 am |
Mark Shieldsmy rant here http://www.fitnesscoachmark.com/nutrition/i-should-be-dead/
August 9, 2013 at 8:29 pm |
Shane McLeanYour a funny guy Tony. Love this. Unfortunately has the aging process takes hold of your body, the visits to the doc become frequent. Speaking from experience of course.
August 10, 2013 at 1:45 pm |
TonyGentilcoreI hear you there Shane. I recognize I'm not 25 anymore, and that I need to start being a little more cognizant of frequenting the doctor more. But at the same time, however, I'm also not going to be lame and use the excuse "I'm getting old" to not exercise, be active, eat right, etc. As I'm sure you do as well.
August 11, 2013 at 1:47 pm |
Stuff To Read 8/12/13 | Freeborn Training Systems[...] 1. Another Cholesterol Rant by Tony Gentilcore [...]
August 12, 2013 at 3:14 am |
Catalin MGreat stuff Tony! You are a great inspiration to me and we share the same views. I also hate the BS in the Fitness Industry, I love my fats and hate Bosu balls. Cheers! Catalin"Big Cat" M.
August 25, 2013 at 4:50 pm |
TonyGentilcoreThanks for the kind words Catalin - really appreciate it.
August 27, 2013 at 8:23 am |
Catalin MNo problems,Tony I'm hoping one day I'll be as good as you at writing and is good to see there there is still hope for the fitness industry. And talking about doctors-I have heard stuff like"avoid fats", "stop taking protein powder" or "stop working out"- I have heard that from doctors here in Canada and back in Europe. Yes I have been told "Stop lifting and stop taking ANY supplements" when I was 18, my blood pressure was high and they couldn't figure out what the problem was. I have figured it out myself- I was massive, bulking up, holding a lot of water. I've adjusted that and blood pressure dropped. How crazy is that? Telling somebody to stop exercising?!
August 28, 2013 at 11:17 pm |
TonyGentilcorePretty amazing stuff for sure. It dumbfounds me that some doctors out there will give that advice. Nevertheless, as always, thanks for reading and for the kind words.
August 30, 2013 at 6:36 am |
facebook.com/TrainingWithDeanYou think there's a limit to how many eggs a guy can have in a day? I really take this research to be as literal as possible and I upped my egg intake to 16 per day some time ago. Not noticed any adverse health effects so I've kept it going.
September 25, 2013 at 8:58 am |
TonyGentilcoreWell I think that's a bit extreme. I mean, too much water can have adverse side effects. 16 eggs per day may be a bit much.
September 27, 2013 at 6:45 am |