The Healthy Librarian's Latest Lab Test Confessions: Cholesterol, Vitamin D & Vitamin B-12

 

Lab Test True Confessions

 My Adventure in Evidence-Based Living Continues

 

 

 

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It was annual physical examination time.

Although, my health plan said I wasn't due for a new lipid panel for another 3 years--because my last one was just fine--I asked my physician if I could please have a cholesterol test run, anyway.  Curiosity was getting the better of me. I wanted to know how this plant-based no-oil diet was working for me.  I write a health blog, for goodness sakes--and others want to know, too!

Where I work, the annual physical is your qualifying exam if you want to keep your eligibility for the Gold Level health insurance rebate.  $$$ saved!

All your health numbers have to be in order.  Cholesterol in the healthy range, a BMI of less than 26, no hypertension, no smoking, no diabetes, and no out-of-control asthma (I think).  That's pretty much it.   It's all about keeping any chronic conditions in check. Can't argue with that.

Either you figure out a way to do it without drugs--or if you want the big discount, these markers need to be managed with prescriptions.  I prefer to do it without diet--not drugs.

Since I've been eating plant-based for 4 years now, I asked my physician for a B-12 test, and if I could have my vitamin D level tested as well.   

 

Cholesterol Must Be Good for Something, Right?

 

 

 

What About That Cholesterol Test?

 

Believe it or not, this is an improvement over my July 2010 scores.  Take a closer look!   My LDL's dropped 6%.  My HDL's increased 41%.  The LDL:HDL ratio is 1.35   Not too shabby.

Of course my Total Cholesterol went up, but that's just because my HDL's jumped up 23 points & your total cholesterol is just the sum total of LDL's + HDL's + 1/5 of Triglycerides.   In my case:  that's 201.   No worries.

I'm resigned to never having those low-low LDL's that some people get on a plant-based diet.  Not without drugs---and no one's suggesting that I need them, thankfully.  Doesn't concern me a bit.   My body just makes more cholesterol naturally, and that's normal for me.  And the cardiovascular disease story is really more about inflammation, anyway.

I already know where I'd be if I were still eating animal products, oil, & less fiber:  probably with a total cholesterol of over 269 by now, weighing 15 pounds more, and taking blood pressure meds.   So for me, the choice is simple.   I'd rather lower my LDL's, keep my inflammation low, and keep my blood vessels healthy with my diet, rather than with drugs.

And besides, I know from a previous HS-NMR Lipid Profile that my LDL's are mostly the light and fluffy kind. Again, no worries.

As for the increase in HDL's, I'm guessing that comes from two changes I've made since July 2010. Nuts & exercise.  I exercise a lot more, I eat walnuts & chia everyday, & I use cashews in cooking, occasionally.  I figure one of those two things are probably responsible for the HDL rise.

Bottom line, the HDL story is still a research puzzle in progress and numbers don't tell the whole story anyway.   Remember the "Efflux Capacity" of HDL wrinkle?    Nevertheless, I'm thrilled with my LDL:HDL ratio of 1.35.

 

So what if my numbers don't go as low as I was hoping they'd go on a plant-based no-oil diet?  I asked Dr. Esselstyn two years ago.

Dr.  Esselstyn stressed that the health of my blood vessels is dependent upon what I'm eating--in spite of the numbers.  If I'm really eating 100% plant-based, no-oil, all whole grain, very heavy on the greens, beans, fruits, & legumes--no problem!  He says my blood vessels should be thanking me by now.  

Turns out, even the Tarahumara Indians, who had no heart disease to speak of--had LDL levels from 80-115 (my range)--and some had HDLs as low as 26--the kind of numbers that might make a cardiologist pull out a prescription pad. 

They were eating only beans, squash, & corn--not a bit of oil.  Their LDLs were the light fluffy kind and they weren't causing a bit of damage.  And their lower HDLs weren't a problem either, because the Tarahumara's weren't eating anything that was going to turn their LDLs into the small dense dangerous bad guys.  

If you aren't eating any inflammatory endothelial-damaging foods like fats, oils, and animal products---and you're loading up on high anti-oxidant greens you've reached the most important goal of all!  Your numbers will probably reflect this--but don't worry if they don't.

OK, 'nuff said about that.

 

Moving on to Vitamin D & B-12

 

 

 

What About That Vitamin D Test?

 

My Vitamin D level is now 42.9.   RIght were I want it to be.

The last time it was tested it was 34.3, back in February 2010.  Turns out, back then it was measured by a less accurate radioimmunoassay test, which I now know was inflated by about 23%--so it was actually lower than I thought--more like a 26!

 If you follow the Vitamin D research, the "sweet spot" for health benefits seems to fall in the 40-60 ng/mL level.  Right where I've finally landed.  Those benefits include stonger bones, less infections, breast cancer prevention,  decreased mortality, less obesity, diabetes prevention, & cardiovascular benefits. To read what the top vitamin D docs say about benefits of the sunshine vitamin, click here and here.  

To be honest, this is still an emerging area of research, and the jury isn't in yet, but far more studies show health benefits at the higher, rather than the lower end of the spectrum.

Frankly, I was surprised that I "weighed in at" 42.9.  It's summertime & I've been taking 4000 IU's (the Institute of Medicine's upper limit)--yes, you read that right--every single day now for over a year.   Rainbow Light Sour Lemon Gummies.  My daily treat.  The only vitamin I actually enjoy taking.

Looks like it was a good thing that I've been taking the 4000 IU's.  That works for me, but it may be too much or not enough for you.  Everyone is different and unless you get tested, you have no idea where you're at.  Your weight, your skin color, your age, where you live, your sun exposure, your health conditions & what you eat, all make your blood level of vitamin D unique to you!

 

New More Accurate Vitamin D Test 

Here's the reason why my latest vitamin D level was lower than I expected.  My hospital is now using a better vitamin D test, that's much more accurate than what they previously used.

The new test is a liquid chromatography-tandem mass spectrometry test with results about 23% lower than previous tests.  The one previously used was a radioimmunoassay test  (RIA).  

 

Here's the note on the lab test:  "On May 3, 2011, we have transitioned from a radioimmunoassay (RIA) method to a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method.

 
For most patients, the LC-MS/MS method will provide approximately 23%
lower results than seen previously with the RIA method, due to improved
specificity.

 
The reference range for the RIA was 19.6-83.6 pg/mL.

The reference range for the LC-MS/MS is 15.0-60.0 pg/mL.
Reference range applies to VitD 1,25 DiOH Tot only."

 

 

 

About That High B-12 Test?

 

If you're eating a vegan diet you need to take a vitamin B-12 supplement.  The amount in a multivitamin isn't enough.  The amount in nutritional yeast or enriched non-dairy milk, is not enough.  You need a supplement.  No ifs, ands, or buts.

A prominent vitamin B-12 researcher advised Dr. Esselstyn early on to recommend a dose of 1000 mcg of vitamin B-12 to anyone who is following his plant-based diet.  So that's what I take.  I used to remember to take one about 3 times a week, but once I started to leave the bottle in my car I remembered to take one every day.

There are plenty of good reasons to take B-12, even if you aren't planted-based, especially if you're over age 50.   Preventing dementia & brain shrinkage are two pretty good reasons, for starters.  I've written a lot on this subject, so if you want a quickie review on who should take vitamin B-12 & why, click here and here.

Last December 2011 I was fortunate enough to hear Dr. Donald Jacobsen of the Cleveland Clinic interviewed on Dr. Ronald Hoffman's radio show--and here's what he had to say:

 

1. All vegans need to take 1000 mcg of B-12 a day in the form of cobalamin, methylcobalamin is not necessary.

2. Take it sublingually for the most absorption. It's a safe vitamin & you cannot take in too much--any extra is excreted in the urine.

3. We only absorb 10% of B-12--which gives an actual net dose of 10 mcg.

4. B-12 taken intramuscularly is not necessary & that's been proven with research studies.

5. For the most accurate test of B-12 deficiency Jacobsen recommends the MMA (methylmelanic acid test). Note: results are inaccurate in the presence of kidney disease.

6. Jacobsen says the common Serum B-12 test is not an accurate measure because of the way B-12 binds to proteins in the blood. It can say you're level is normal, when it is not.

7. A newer B-12 test, the Holotranscobalamin Test may be a good choice--but, more research is needed. You can listen to the interview here--just 17 minutes long.http://podcast.wor710.com/wor/3231275.mp3

 

Turns out my hospital's lab doesn't use the MMA (methylmelanic acid test) that is recommended as the most accurate way to assess vitamin B-12 levels.   Oh, well, I've got to make due with less than perfect testing, which casts some doubt on my over-the-top test results.  

The hosptial uses the common serum B-12 test--so honestly, I have no idea if I need to cut back my daily dose or not.  I feel fine, and according to vegan dietitian Jack Norris, if you're regularly supplementing with B-12, and you're not experiencing any symptoms, like fatigue or tingling--don't even bother getting tested in the first place--the test results are just not that accurate, in the first place.  According to Norris, if you're supplementing--assume you're OK.  Too bad I found that out after my test.   To read more about B-12 from Jack Norris, click here.

 

Bottom Line:  I Plan to Just Keep on Doing What I've Been Doing

 

Eating plant-based no-added oil (& no sugar) has helped me to lose weight & allows me to eat as much as I want to eat.  

It's lowered my blood pressure, and encouraged me to eat a wider variety of vegetables, fruits, grains, & legumes.   High Nutrient-Density/Low Caloric Density has become my mantra.  It's upped my anti-oxidant intake immeasurably, which is a sure-fine way to curb inflammation.

I'm sticking with my 4000 IU's of vitamin D, for now.  It's got my vitamin D level right where I want it.

As for Vitamin B-12--I'm not sure yet what I'll do.  If it's safe, and you can't get too much, it may not matter if I continue to take it daily, but, I'll likey drop down to just 5 days a week.  I'll ask my doc what she suggests.

 

What about you?

Have you had your B-12 or vitamin D levels tested recently?

Is anybody else eating a plant-based no-oil diet (w/o cheating) and getting a cholesterol test like mine?  

I have a theory that women's cholesterol levels don't decrease with diet as much as men's do, & that's OK.  Has that been your experience?

 

 

 

Comments

[Willow]

A question here: when you say 'no cheating', how long do you have to wait before having a blood test? (sometimes I cheat without knowing it until later--"oh, that 'vegan' soup I served to you at my house--it was made with chicken broth base" or I'm out with friends and there is nothing on the menu I can eat and I'm really hungry)

[The Healthy Librarian]

@WIllow, by "no cheating" I meant, has anyone had their cholesterol numbers similar to mine by following the plant-based no-oil diet pretty religiously---because I know lots of people who say they eat this way, but, they make exceptions all the time. They eat "off the program" in restaurants, at the homes of friends & relatives, they make exceptions for ice cream, eat cheese pizza out, eat salmon out, eat hummus with oil & tahini---that sort of thing. That's what I meant. Eating soup with chicken broth wouldn't make a big difference. Like, years ago my sister-in-law said she was a vegetarian, except for corned beef & ribs.

[J Hamilton]

My test results arrived in today's mail! Your post was exactly what I needed to see today. I've been on the vegan-no oil program for exactly one year. My total chol came back as 159 (down from 212), HDL was 51 (up from 50) and LDL was 108 (down from 127). My triglycerides were 128 (down from 175). I have to admit I was expecting a bigger drop - although I am incredibly thankful for the results. I really wanted to be under the "magic" 150. Your post has helped me realize that sometimes there's a story behind the numbers. As a woman, I'm here to support your theory on the smaller reduction in women's numbers as opposed to men's. I can't thank you enough for all you have done to help me on my quest to live a happy, healthy and long life.

[Heidi]

Interesting. I am 52, female,no meat,eating nuts and avocados, minimal oil,and mostly unprocessed. Do eat eggs from our own free-range chickens. This is except when eating out or when my husband decides to cook. In those cases I eat more processed, more oil,and sometimes dairy (still not meat)

My last cholesterol in 08/2011 was total 150, HDL 51, LDL 83, triglycerides 78.

I will be interested to see how it changes next time as I get much much more exercise now (average 20 miles a week running plus some weights and other things) and also use some coconut oil which I am not real convinced about as far as good/bad yet.

[Rebecca Cody]

In North America at least 40% of us have a genetic polymorphism, MethylTetraHydroFolateReductase (MTHFR), which means we don't methylate folate well. This also affects how we absorb B12. This results in our inability to detoxify through the liver. For example, with two copies of one form of the defect, it means I detoxify at the rate of about 7-10% of normal. For anybody with this genetic defect, it IS necessary to use methylcobalamin, which is the methylated form, and probably to give yourself prescribed B12 injections, at least until levels come up to normal. It is also necessary to take a methylated form of folate (not the artificial folic acid) until levels are normal. I think everybody needs to be tested for MTHFR because there is a supplement protocol developed by Dr Rawlins in Richland, WA, to help with methylation.

[Hadley V. Baxendale]

Last month, my total cholesterol was 118. When I started my cholesterol was 162; 3 months later it was 142; 3 months after that it is 118. All my other numbers are equally good. So eating a whole, low fat, high fiber plant-based diet (lots of beans, greens, fruits, and limited nuts and flaxseed) has been working so far.

[Jessica]

How timely! I just got my first lab results ever in the mail (I'm 43). I've been vegetarian for more than 20 years and vegan for the last 1 1/2 years. I was still doing oil and the occasional non-vegan pastry until recently. My total cholesterol is 140, HDL is 62, LDL is also 62, triglyceride is 82 and ratio is 2.3. To be honest, I don't really know what all of it means, but your post has helped me figure some of it out. I've recently stopped the pastries and all added sugar and am using almost no oil, so perhaps the numbers that should drop further will. I love your blog and your Facebook posts.

[Pamela Wildermuth]

Great test results for you, so pleased to read about it all. I found it all very satisfying to get my test results, I felt that I had won the lottery and helps me to continue on with Plant base eating, NO OIL. Those that believe, like you, me and a lot of others feel great in the knowledge that we are helping ourselves to a happy, healthy and long life.
Look forward to more of your blogs full of information, Pamela.

[Caryn]

Interested in your observation about gender and reducing cholesterol with diet. I am eating like you except more nuts and less exercise. Likely my grain and fruit to leafy vegetables is not as favorable as yours either. My cholesterol was 215 after a year of this diet. I am 50. Every single one of my other numbers are excellent except for cholesterol. I haven't taken any drugs until last week when I started inderal for migraines and C-PTSD.

I had the fluffiness test but it was not good. I am increasing my exercise by adding Taekwondo. One would think that with two kids under 9 and home-schooled I would get lots of exercise but it has worked out to be trickier than I thought. I hope to go bring down the nut munching. I don't cheat in any other way. I like lots of exercise and so I betcha this will come together nicely.

Your blog brings our whole family lots of joy and health!

[Kate H.]

Last September I had my blood test and after being faithful on the diet (for 10 months) was disappointed that I did not see a huge drop in my total cholesterol. Total went from 222 to 199; HDL 93 to 90; LDL 114 to 92; so the drop was mainly with the LDL which is very good. I do want to note that at the time I was eating 10 prunes a day (Remember the post about it being good for bones? I could not maintain that and hardly eat them anymore.)so my Triglycerides went from 73 to 84 I think due to the prunes. Anyway, thanks for the post. It has helped me to better understand my cholesterol numbers.

[Willow]

Thanks for the response :) If I know that I've eaten something that has oil in it, I just 'start over' the next day and work again on plant based/no oil foods which is so much easier when I'm eating out of my own kitchen (which is normally the case). I've read in Dr. E's book that changes were found within 4 weeks on his regimen, so I'm wondering how much difference it makes if there has been olive oil on roasted potatoes eaten 3 weeks ago, etc.

I am encouraged by your analysis of your numbers. Mine are similar and everything is in 'normal' range except the total cholesterol number is almost the same as yours.

And again, thanks for spending so much time sharing this information with everyone via your blog and facebook! It's greatly appreciated!

[Shauna]

I'm saying this out of curiosity in regards to your cholesterol. I know you have posted going out to eat a couple times on your blog. I'm not sure how often it happens but I don't see you talking about asking restaurants to make no oil food for you. I'm wondering if this can add up over time and can affect your cholesterol...Just a thought....

[Betsy]

I'm not vegan, although I am eating more plant-based meals, thanks to your encouragement and enthusiasm, and I'm just a few years younger than you, HL (I'm 57). The reason I'm commenting is because I wonder about the wisdom of eating vegan for people like me who don't have high cholesterol or triglycerides. The lipid panel I had done last February said my cholesterol was 170, HDL 75, calculated LDL 81, triglycerides 68, Vitamin D: 50 (LCMSMS, it says; that's the new, more accurate test, right?). Perhaps small servings of wild game (my husband's a hunter) and locally grown meat (we purchase beef and have it butchered and processed locally) occasionally is okay for someone like me, and perhaps even healthy? I don't know. Or maybe you can't go by my good numbers? I'd appreciate any comments you might have.

[Anna]

Over the lsst 18 months I've done my lipids a few times, once after 3 months on the plant based no oil diet - with no exceptions, more recently after one month of no exceptions and I've also done my lipids when I'm eating 90% of my calories from the diet but with a max of one meal a week that includes some dairy (haven't eaten any meat since I was 9). I had super high cholesterol (known genetic predisposition) prior to beginning. So my pre LDL was 212, pre HDL was 104 Post diet LDL 131 post HDL 85. Ratio 1.5 , triglycerides 62 (can't remember pre-triglycerides but they were low then too). It didn't vary when I tested while eating one meal a week that included dairy (this is a meal out or at a friend's place - we don't buy animal products). So my cardiologist would still like me to take a statin to get my LDL below 77 - her cut off for people with a family history of heart disease. Interestingly my post diet numbers are identical to my father's numbers eating a standard (NZ) diet but taking a statin. I eat chia every day and walnuts, avocados and cashews a couple of times a week. Interesting theory about women's lipids not changing as much on the diet, I'll pay more attention to that with my patients. I'm hoping to get access to the test for "fluffy" LDL some time and have a form to check for MTHFR because I suspect that is what causes my family history of pre-eclampsia and premature heart disease.

[The Healthy Librarian]

Thank you so much to everyone who wrote in to share their experience & ask questions. I don't have time for detailed responses right now--and I'll be out-of-town & then working with no time to post until Friday.

I just want to make one point clear.

Cholesterol numbers (excluding in familial hypercholesterolemia) are NOT accurate measures of what'e going on in our blood vessels--but they're something we can measure & track, so we do it. Even angiograms, & stress tests aren't accurate measures. You can have a normal angiogram or stress test & still have intravascular plaque. "Over half the time this “Tim Russert-kind-of-disease won’t show up on a stress test, or an angiogram, & your cholesterol numbers may be normal. It’s not about clogged arteries--it’s rupture plaque embedded in artery walls.”

Even the so-called "good cholesterol" HDL, has been called into question, with some types good, & some types that are atherogenic. Dr. Steven Nissen, the head of Cleveland Clinic's Institute of Cardiovascular Medicine will tell you flat out that half of the people in the coronary care unit will have normal cholesterol--or on statins.

What's going on inside of our blood vessels--unseen--is what's important. As I see it--we have two choices.

Eat in such a way that we repair our blood vessels & not injure them with processed foods, fats, sugars, or oils, reduce inflammation, and increase anti-oxidants, and not worry about those lipid numbers if they are in the normal range. Or, be willing to take statins for the rest of our lives--with all the attendant risks, & microscopic muscle damage--and know that even with statins there will be no guarantees unless we are willing to take a dose that's high enough to lower our LDL below 70--which increases the risk of adverse effects. And know that with the drug route, you'll still have to figure out a way to lose weight & control your blood pressure as you age. I'm sticking with high-nutrient plant-based no-added-oil---until I have a really good reason to change me mind.

Here's the BIG FIGURE I neglected to mention. My LDL's dropped 33% (from 157 to 105) when I switched from a healthy Mediterranean Diet to a Plant-Based No-oil Diet. That's a 33% drop without any statin. That's as good as any statin would do.

Hope that helps!

[Rosemary Evergreen]

A good question to ask your physician or lab would be what the margin of error is on each individual test. Small differences from year to year may not actually reflect actual changes so much as the non-repeatability of the test.

[Lisa Austin]

I have been plant-based since May 1, 2011 my numbers have dropped in every category except Trigycerides, still over 150. LDL is 91. Started at over 150. Lost about 22-25 lbs. Workout in spurts, train for sprint tris and volume of training goes up & down over 3 months, but play lots of tennis. I am 58.

My cheats are snacks - chips,etc. No meat, only cheese when I can't pick it off at restaurant. A little walnut oil in some salads, and some canola spray. Eat chia & flax daily. Some nuts and/or avocado weekly.

My fasting glucose also came down 16 pts.
Vit.D says 62 indicates supplementation which is correct. I take some daily.
B12 is 428, folate is 24.
Also Dr. says protein in blood is good. Indicates not protein deficient.
Could you discuss this in blog? I was getting fatigued when upping brick workouts for triathalon and increased beans and grains like quinoa.

My husband's experience has been different than mine on this diet. He never has problems with Tricyl. He has had particle testing and went from small & dense to big & fluffy. He had calcium test was in bad shape. Can't remember proper name - it looked at deposits in arteries. Not calcium in blood work. Would be curious to see if this changed.

Maybe this is diff. between men & women? Men already have more damage. So diet makes more dramatic change?

Totally agree with your summation. Just can't get Dr. to recognize the diet component.

[Eric]

I've been on an oil-free Esselstyn diet for 5 years now, and I saw an almost immediate drop in my TC from 160's to 113 that persists to this day. My Tri's went up a bit for the first year, but those have come down. LDL remains well below 80. TC did go up a little one year when I slacked off on a few details, but has come down again since. For me, I find that little details make the difference, so I make an effort to not eat anything with any oil listed in the ingredients at all, and keep nuts, avocado's, and Tahini to an absolute minimum, as in less than an ounce a day--usually none at all.

I did notice that a number of your recipes had Field Roast in them, which does have a little bit of oil. I know the per serving amount is small, but as Dr. E shows, sometimes just these small amounts can add up. I would try completely avoiding anything with oil in the ingredient list and see if that makes a difference. I think if I started eating food like Field Roast, I would definitely see my TC go up.

[Wayne]

My problem is not cholesterol but hypertension. I'm late 40's with a big time family history working against me. I started on Engine 2 plant-based about 6 months ago and then merged this into Dr. Esselstyn's program (which is a bit more rigid) to see if I had a chance to circumvent blood pressure meds. In short, it has helped considerably. My blood pressure is now normal and averages 120/65, however it still can be transient. Tonight one reading was 143/79 and 5 minutes later it's 124/66. Has anyone else observed this also? My doctor says this is OK as long as the average is in a normal range and the higher readings come back down on a re-check, which they seem to do. Nevertheless, I was curious to see what has happened over the past 6 months and went for a quick lipid test at a local clinic and my results were total cholesterol of 100 and fasting glucose normal. Prior to plant-based in December, Total cholesterol 104, so not much has changed. I think I just seemed to have inherited a "good cholesterol clearing mechanism" (Thanks Mom!) as Dr. E puts it in his book. It's never been higher than 120 even when I was eating fast food, tri-tip steaks, mexican food all of the time etc. Of course, this is not a good diet for anyone and when my BP got higher and higher the past 2 years, I decided it was time for a change. As far as the diet goes, I think the two biggest components for me are no oil and sugar. Supposedly the oil and sugar really take their toll on hypertension. I have completely eliminated all added oil or sugar. The sugar in the fruit supposedly is OK as it is bound to the fiber. I consumed low sodium for years (and still do) and it didn't help at all.

[old_lady2]

I know Anna said up above the cholesterol test results may show you are normal, but cannot tell you what is 'really happening inside', I would still recommend the tests as a gauge and as she stated to continue with the healthy lifestyle of plant based eating and keeping the body active (cardio, weights, yoga, pilates, etc). I believe that is the best humanly possible we can do for our bodies.

Over the past few years, moved from meat based diet to plant based. My total cholesterol is 168, in 2009 it was 210. HDL is 52, in 2009 it was 66. I know the comments are for no oil/nuts, though I do the occasional (raw)nuts/seeds. I take a food based multivitamin. I love this website...I learn so much.

[Chris G.]

Thanks to the Healthy Librarian, I have changed my eating habits: dropping all sugar, nearly all animal products (save for some omega-3 rich wild seafood), and nearly all oil, have steel cuts oats every AM, greens at least 2x/daily, and no calories via beverages (save for an occasional beer or glass of wine). My cholesterol dropped 70 points (210 to 140) and my HDL:LDL now stands at nearly 2:1 (90:50) with my omega-3 levels at 8. I run 20 - 25 miles / week but did so before the diet changes. Since we all eat least 3x/day, everyday, diet trumps exercise for sure. Thank you for the diet enlightenment, Healthy Librarian. My body and mind have become significantly sharper as I enter my mid-40s.

[Rachel Frost]

I am not convinced that gender has anything to do with total cholesterol numbers. For instance Ruth Heidrich, who is mentioned in both Esselstyne and McDougall's books, started out with a TC over 200 and it dropped to 129 on a no-oil plant-based diet. Yet Dr. Joseph Crowe who was cited in Esselstyne's book had a total cholesterol of 156 yet had arterial blockage. It does not appear to be gender but some other factors (in Crow's case 156 was not low enough and he developed a blockage but when he adopted a no-oil or added fa,t plant-based diet his TC dropped to 89).

[Wayne]

Gender should have no impact on the degree of cholesterol reduction on a plant based diet. Everyone responds differently. I know others who cannot reduce their cholesterol no matter what they do and statins are the only viable solution to reduce to <150. As I indicated above, my total cholesterol only dropped 4 points since starting plant based, so it apparently had no impact whatsoever. The lab tech asked me how I manage to keep my cholesterol so low and I told her not much of anything seems to affect it which probably means it's genetically programmed. The biggest benefit for me was average blood pressure reduction.

[Scott]

A recent article from Dr. Oz indicated that Vitamin D levels less than 50 are considered low and that over 80 is getting too high. Levels over 500 are considered toxic. Since its the "sunshine vitamin" it helps to live at a latitude south of a line from Atlanta to Los Angeles. Just 15 minutes per day of sunshine can boost levels considerably.

[Cathy]

My husband and I (75 and 66) have been pretty faithful to Esselstyn's diet since 2/10/12 (very low oil,plant-based). My CHO (data back to '94)averaged 225, HDL 67, ratio 3.6, LDL 144. One week into the diet my CHO was 208, HDL 72, LDL 121 VLDL 15, Triglycerides 73. By 7 weeks CHO was 162 (!!), HDL 73, LDL 81, VLDL 8 and Trigly 38. I look forward to a 6-month draw. Q: am I just one of those who respond to this diet, or can this "do it" for everyone?
My husband's been on a statin for years, so his numbers are medically altered; he saw a 5-lb drop in weight to my 10 (we both row, hard, so exercise is constant, wt loss not a main goal). His lipids results encouraged him to cut his statin in half. Before, full statin, "normal healthy" diet: CHO 159, HDL 55, LDL 86, Trig 92, CHO/HDL 2.9; after: CHO 155, HDL 56, LDL 81, Trig 89, ratio 2.8. My personal goal for him is to drop the statin but the Doc's say it's protective of the vessel linings. I say if diet can protect them, get off the simvastatin with its possible long-term side effects. Besides, I'd like to see his numbers without the statin. Opinions, anyone?
We're concerned about CV health and his prostate, my (surgically removed) breast and skin cancer, his subclavian vein clot. He has low-grade prostate cancer, with PSA which was slowly increasing (1.1 - 1.2)but with one data point may be leveling off. I'd like to see them stop his annual biopsies, if we can control it.
Conclusions - works for me, less obvious for The Man. More questions than answers, but we feel we're doing the right thing for us, and it amuses our kids.
BTW, we've found a way to bypass insurance requirements, called Accesa Labs. Pay your money and get your test, like the old days. It's reasonable and timely, and anonymous if that's important.

[Cathy]

Wayne, yes, my husband's BP varies quite a bit - he had hoped to track it lowering with the diet change, but no... He - and his Mom, who's 97.5 and still living alone - have BP's that spike and lower, same numbers as yours. His resting HR is around 45, can't remember his max, probably 165. My HR's about 50-55, with max aound 195, BP usually around 116/64.
I understand that it's not our blood CHO but what our body does with it that matters. A CAT scan to examine his blood clot revealed plaque deposition in his coronaries, which brought him on board when a friend linked us to Forks Over Knives (Thanks, Ellen!).

[Ellen (Gluten Free Diva)]

Debbie - can you share the vitamins you take (brands)? I'm curious for example what you take for the B12. Thanks!

[Analyn Woods]

Hi Ellen,there are several vitamins and nutritional facts that we can have, but the question is, "Are they really effective?" or even "Can we trust the maker or the source of Vitamins and supplement?". One thing I've been using for about half a year now is the vitamin b12 I've got from Dr. Mercola. I do trust him because Dr. Oz have been inviting him in his show and they discussed about many things including this http://products.mercola.com/astaxanthin/ which is Astaxanthin that Dr. Mercola is talking about on Dr. Oz's show. What do you think?

[The Healthy Librarian]

@Analyn Woods, you're right that if you're taking a supplement you need to know if it has the amount that it says it has, & that it doesn't have any contaminants. I subscribe to Consumberlab http://www.consumerlab.com/ which is the only organization that I know that's a watchdog on supplements & vitamins. They test many of the products that are on the market, publish reports (just like Consumer Reports) & provide info on the products with the best value. Astaxanthin is a carotenoid that is found mostly in fish--it's the red color in salmon. When it comes to carotenoids, which are plentiful in real food--I prefer to get them from food, rather than supplements. I pretty much stick to the supplements that I can't get enough of from the foods I eat, or from sunlight, like B-12, vitamin D, & DHA.

[Dawn]

Debby--I was also wondering which specific vitamins you prefer. I have almost used up some multi-vitamins that I had and am wondering which to buy now. I know I need B-12 and Vitamin D. But brands would be most appreciated.
Thanks,
Dawn