Discussion Board

I've been vegan for almost 4 years and love Dr. McDougall's site. My biggest concern is that, in spite of my healthy diet, I continue to have high cholesterol (LDL 160) and would like to find a local cardiologist (Orange County, CA) who won't insist that I take statins. Does anyone know if they exist?

So what is it that you want from a cardiologist if not meds? What can he do that following the McD program won't do? Tests? To what purpose? Just rhetorical as a different way of thinking of doctors. If they don't have services that you are interested in, why go?

I've inferred from what you wrote that though you may be vegan you are not yet following the McDougall plan. If that is the case, then why not try it and see what happens to your cholesterol when you follow the plan faithfully. If you believe you are following it, has it been long? Are you allowing any exceptions? etc...

The folks on the board are happy to help.

Some people just do not respond well to diet lowering their cholesterol. There are generic factor and diseases that can be the cause. I assume that you have some underlying condition that makes you go to a Cardiologist. Some are more "Mcdougall/Esselstyn/Orinish friendly than others.( I can not help you out as far as OC) But I think it would be malpractice for any MD to blanket not recommend a patient take a drug that was shown to help a medical condition. Even Dr. McDougall believes in statin usage with patients who meet the criteria.

This WOE won't cure everything, but it generally won't hurt either and the goal is to do the best you can. If you need to take statin, then take them. They do work, just not the panacea that some would like you to believe. They do lower cardiovascular risks by about a third. And you don't have to be on them for life, if you can manage to get the number down latter through food, exercise, lifestyle changes.

j

I look at this a bit differently. My cardiologist was strongly against using this program as a way to address heart disease instead of bypass. He was willing to work with me and monitor my progress. As I made progress with my bloodwork, angina, and weight, he became a more active supporter and encouraged me. It's a bit bizarre but our roles, in many ways, got reversed. As I progressed I pushed for reductions in my meds corresponding to my progress. I worked with him about goals and changes to my medications and tests as I reached them. It's all about finding someone that will work with you, not necessarily someone that fully embraces our thinking on the power of nutrition and lifestyle. Those doctors are near non-existent.
It sounds trite but the cardiology profession is learning and changing just as we are. We can be the leading edge of that change. I would simply focus on finding a doctor that will listen and monitor your efforts. Be open to his suggestions to a point, knowing you will be doing what 99% of his patients will not. It will be radically different for this doctor to have a patient that is improving, rather than sliding down that ramp to deaths door. You will be the patient he enjoys seeing walk through the door. For anyone seeing a cardiologist take note of the waiting room the next few times you go. It's a decidedly sad group of people biding time till the next cardiac event. They are simply waiting for the next shoe to drop and that is a miserable experience for patient and doctor alike. There are many cardiologists that will work with you. It's in your best interest to find one.
f1jim

Some people DO have to take statins. It's a very small % but both Dr. McDougall and Dr. Esselstyn use them in some patients. The problem is that most docs leap right to the statins w/out doing a THING about diet.

Here's Dr. McD on who should take statins. Basically only those at high risk for heart disease (i.e., risk factors in addition to high cholesterol).

http://www.drmcdougall.com/misc/2007nl/may/statins.htm

Thanks for the posts. Your stories are very impressive!

I see a cardiologist because my family has a history of heart disease and I've always had high cholesterol.

I'm 62, 5'4", 130 lbs, and I wear a pedometer and make sure I walk 45 to 60 cardio minutes every day. My blood pressure is typically 100/70. Cholesterol is my only abnormal bloodwork and my ratios are good.
Total cholesterol=262
HDL=79
LDL=164
VLDL=20
Triglicerides=98
CRP=.3
Glucose=75

I've been avoiding meat and dairy products for almost 4 years, but I still occasionally use nuts, vegetable oils, and avocado. I'm going to stop all of them and see if that helps.

My issue with statins is that I didn't sleep well when I took them. I would wake up multiple times each night with tingling and numbness in my hands and feet. It disappeared when I stopped the statins.

More than likely neither Dr. Esselstyn nor Dr. McD would prescribe statins for you, since you have no other risk factors. Also, your HDL is RIDICULOUSLY high, LOL, which isn't bad but adds to the total number, of course. [Disclaimer: I'm not a doctor, nor do I play one on the internet!]

One point however: Your BMI is in the normal range at 22.3, but most health benefits do accrue at the lower end of the BMI scale. You might try getting down to a low-normal BMI of between 18.5 (108 lbs) and 19.7 (115 lbs). Not infrequently it takes getting to the lower end of the BMI scale to "fix" recalcitrant cholesterol.

Welcome to the board.

Thanks for the additional information. Your plan to drop the fatty foods sounds like an excellent one. Some people have to be extremely strict, and it sounds like you may be one of them.

Best wishes.

Somehow I missed that about oils, etc. Yeah, getting the veg oil out of your diet is VERY important!! Do you have Dr. Esselstyn's book? I recommend it highly if you do not.

Cacret, bet of luck finding the combination that will improve your total cholestrol. This was my primary for giving Dr. McDougall's program a shot. I did not want to rely on medication to "control" (possibly lower) my cholesterol. At 41, as of my last physical in July I felt I was too young and there were other means (such as diet) that would allow me to better regulate my cholesterol number.

I did start using a Statin after my physical, but honestly I stopped taking it as my legs were hurting, which was one of the negative side effects. The other side effect that didn't sit well with me was the possibly of a liver dysfunction. And this medication was supposed to help me.

While it took a few months longer I found Dr. McDougall and the program. I might not be 100% compliant yet...I have got some wonderful signs that my healthy is improving and I am headed in the right direction.

Initially I cut out all meats and severely limited my dairy intake. I still use a small bit of cheese from time to time, but nothing like the amount I did before October. I also stopped using oils and butters to cook with. No need to saute in oil when a telfon pan with a small bit of water worked just fine. My sugar and salt intake were never that extreme, but I have been watching both of these very close as well.

In July the results of cholesterol was 263 mg/dL with the LDL at 172 mg/dL (full results here). As of December, when I got my updated blood numbers after being on the diet for 2 months my cholesterol dropped to 199 mg/dL and the LDL was down to 120 mg/dL. Both sizable decreases.

All this by just eating a little bit different. I am truly shocked at the early results of a whole-plant diet. I still have not communicated with my doctor, but have an appointment with him next week to discuss the currently blood work compared with my numbers from my physical. I will be very curious to see just what he has to say. Good luck!

I just want to reinforce this, having just got back a few minutes ago from a medical visit in which:

1) My doctor came through the door into the examining room with a spring in his step and asked "How have you been?" with genuine enthusiasm, curiosity, and keen interest -- a dramatic change from the low-affect professional inquiry when I first started seeing him as a +500lb diabetic with high blood pressure and cardiac concerns.

2) My doctor was impressed by my loss of 15 pounds in two months over the holidays, and astonished when he took note of the fact that I lost 134 lbs from Christmas to Christmas;

3) My doctor confessed to me "I was concerned for your life when I first started seeing you..."

4) My doctor expressed interest in my diet for the first time, asking me "what exactly are you eating, anyway?" and expressing concern about my protein sources (LOL) until he found out I was eating lots of beans;

5) My doctor told me "You're doing what I wish all of my diabetic patients would do" -- despite the fact, which I tactfully avoided pointing out to him, that he never suggested anything of the sort; and

6) My doctor followed me out of the exam room and down the hall as I left, pointing me out to three different people who work in that little clinic and saying "He's lost 134 pounds in the last year, isn't that great?"

All in all, my impression was very much as Jim suggested: a doctor who was learning something from me, or if not that, at least a doctor who was enjoying the experience of having a patient unexpectedly get better instead of (inevitably, in his experience and expectations) worse.

5) My doctor told me "You're doing what I wish all of my diabetic patients would do" -- despite the fact, which I tactfully avoided pointing out to him, that he never suggested anything of the sort; and

Wow way to go Mixed grain! Congratulations on your weight loss and good numbers!! yes it does look like you're educating the Dr.good show.
Dlee

Excellent to hear Mixed Grains! It surprises me when I read of doctors not educated very well on nutrition. I am sure mine included. Just wish I could find the "guideline" he gave me in 2009 and 2010 to aid my diet and reduce my cholesterol. Let's just say it still included a fair amount of fat.

I want to make a couple other important points. First, just because someone "fails" diet and has to take a statin to get their cholesterol into the desired range (TC<150, LDL<70-80) that in no way implicates the McDougall/Esselstyn diets nor does it detract from the value of this WOE for eradicating coronary disease. Remember, most of Dr. Esselstyn's original patient cohort were on both the diet AND statins and as a result they remained virtually heart attack proof for over 20 years and demonstrated significant plaque regression. Contrast this with the millions of patients on statins alone who show only marginal mortality benefits and rarely, if ever, experience significant reversal of disease.

Second, no one has ever studied the subset of patients who rigidly adhere to this WOE but, for one reason or another, still fail to see their cholesterol levels reach the desired range. It is quite possible, and preliminary evidence seems to suggest, that they too may be immune to coronary events and can experience significant disease reversal without the need for adjuvant statin therapy. The numbers tell only a very small part of the story.

The moral of the story: keep your mind focused on the big picture and strive to perfect your starch-based diet whether or not you and your doctor ultimately decide to add a statin.

Best,
MK

Maybe Dr. McDougall should have a line of T-Shirts:)

Congrats Mixed Greens!!!

Aloha, patty