Wednesday, October 17, 2007

Knowledgeable Medical Consumers


I've always been an advocate of folks that proactively look into their health and and also folks that make sure they understand diagnoses and medicines prescribed by their health care providers.

But it gets more and more difficult trying to determine fact from fiction.

Good Cholesterol
Thaddeus recently started reading up on managing cholesterol and triglyceride levels, and found that there's significant research on using Niacin, a simple B vitamin to increase the "good cholesterol," or HDL.

It seems that they've done rigorous testing (comparable to the tests done on prescription statins, used for cholesterol reduction) on Niacin, and most resources agree that it is the cheapest way of helping your cholesterol levels.

Now, first before I say more, I want it to be clear, I AM NOT RECOMMENDING ANYTHING ABOUT YOUR HEALTH OR VITAMIN TAKING AND I AM NOT A DOCTOR!! I am however, recommending that if your cholesterol is high and/or you're on a statin that could have serious liver or muscle reactions, that you might consider researching AND speaking with your doctor about whether Niacin might be a good alternative for you. I figure that when even the Mayo Clinic is willing to come out and say that Niacin is possibly as effective or more in helping folks with high cholesterol, and with possibly less potential for side-effects, it definitely merits looking into.

For the majority of my post-30 year old life, I have had cholesterol levels that were higher than I cared to have. With a father who died at the age of 43 from a heart attack, I have always looked for alternatives. It galls me that my doctors have mentioned prescription medications for lowering my cholesterol over the years, but have never mentioned any possible alternatives. My assumption is that they rely almost exclusively on the pharmaceutical companies to educate them on the latest options, and there's no way the pharmaceutical firms would be letting doctors know about alternative options for controlling cholesterol.

But finally, I reiterate (especially if you're one of those folks that reads headlines, but not all the fine details), you should definitely make sure you're having liver function monitored if you decided to try adding Niacin as a cholesterol reducer.

Local Yarn Store Anniversary Sale
For those of you that live near New Hope, PA, Twist Knitting & Spinning store is having an anniversary sale which started on October 15 and goes through October 31st. It includes 25% off all 100% cotton yarns, including: Blue Sky, Classic Elite, Knit One-Crochet Too, Manos and Cotton Chenille. It also includes 25% off all KFI yarns including Noro, Debbie Bliss Baby Cashmerino, Katia and Elsebeth Lavold.

If anyone decides to go, check out all Deb's books by Elsebeth Lavold as well...they're spectacular.

Current Knitting/Crocheting
Keeping up with my frantic pace, I was able to get two more large stars completed, and a single filler star.



Reader Moorecat notes in comments, "I think I see a mistake (gulp). If you look at the third row from the top and the second motif from the right, it looks as if it has been joined at a different angle from the other motifs, so that it stands upright on one point, instead of two points."

Actually, I've made a couple other mistakes along the way. When I'm finished with all the crochet work, I will go back and snip these motifs out and replace them correctly. I have to admit, it amazes me that there are folks that look at blog photos closely enough to see these things. I remember a quilter friend warned me when I was putting a colorblock edge on my quilt to make sure I used the same number because there were folks out there that would actually count them to make sure there were the same number on each side.

Then again, I know some folks just have an eye that instantly spots irregularities like the one that Moorecat noted.

Readers' Comments/Questions
Cara writes, "I just saw the catalog for this show:

Radical Lace and Subversive Knitting and there were some crocheted tablecloths that you might be interested to see. Have you seen this show already?

No, but it looks fascinating. I will have to see if I can possibly arrange to see it. Thanks for sending on this kind of information.

Also, thanks to everyone who added me as a friend in Ravelry. I've been rather obsessed with the world of Ravelry lately (just ask Thaddeus), so having fast friends in this new world has been quite nice.

22 comments:

Meribeth said...

Joe, I am with you on the cholesterol bit. And I too have slightly elevated LDL and physicians who push the statins...hard. My answer has always been, Let me try to get it down using diet and excercise before I take a drug where I have to take liver function tests over a period of time. I have yet to take statins and the more we learn about them the more dangerous they seem. There have also been reports that they cause a "senility" type reaction that goes away after the drug has been stopped.
I also am constantly surprised when I see how little the physicians really know about the drugs they are prescribing and how often they are happy to write script for "anti-depressants," behavior modifications for kids and antibiotics.
I am far from being a health nut, but I do watch and read and try to use common sense. I am also human and I will do things that are not good for me, but I will not jump on the "better living through chemistry" bandwagon that the medical communities embrace. Just listen to all the ads for script on TV.
And if you really want to add more fog to the picture...check out the testing methods. Which test? What is the degree of error? Instrument calibrated to a known standard? repeatability? How much interpretation is needed?
The table cloth is exquisite. I hope you will be posting a holiday table type pic. I really want to try this...if I can ever finish the "to do and in progress list"

Laurel said...

Luckily you do not have to deal with childbirth, but the drugs and "facts" doctors often push on you at that vulnerable time are astounding. I'm just hoping to get through it without getting kicked out of the hospital for being a snarly patient. At least I have midwives who will support and encourage my decisions.

Mel said...

Interesting about the niacin. Nobody has ever suggested that to me, and my HDL has always trended low. Getting off excess weight has worked well for my LDL and triglycerides so far, but my dad's on a statin now to keep his down and it appears I got those genes rather than my mother's.

A Mayo Clinic Pharmacist said...

Niacin is not without its ills either. The over the counter stuff is not what was tested and taking high doses of the OTC stuff can blow your liver too. High doses of sustained release prescriprion product are required. Titration may required to get to therapeutic levels. Side effects like flushing, whih many can not tolerate, occur in most people who take it.

annec said...

The Radical Lace exhibit at MAD was wonderful! My husband & I took 2 grandsons (12 & 13 yrs old) to NYC in early April, ostensibly to show them the city, but my motive was to see the exhibit. We all were impressed--definitely NOT typical knitting! I'm just sorry we missed some of the participatory sessions, such as the "Edible Lace High Tea"!

Anonymous said...

A warning about Niacin. Be prepared for major flushing. Even with the time-released, I turned red, and often itchy, starting at my ankles and moving up to my face. Taking an aspirin with it helped for a while, but I finally couldn't take it any longer and switched to the Statins.
Leslie

Cara said...

It is always a good idea to run things like this past your doctor -- Laurel talks about being pregnant and having issues with health professionals. I just had my 2nd baby (3 weeks old), and early this summer my father heard something about omega-3 being good for expectant mothers, and was pressuring me to take supplements. When I asked my dr. he said to avoid fish oil as it likely has elevated mercury levels. He OK'ed flax seed instead. If your doctor is not forthcoming about alternatives to drugs, it's time to talk to other doctors.

And dang, but once Moorecat points out the turned motif, it really jumps out, doesn't it?

BTW, the Radical Lace show is travelling, but other than coming here to Indiana I don't know where to.

Fredda said...

Your point on so-called alternative treatments for high cholesterol is well-taken. Diet (especially a vegetarian diet) and exercise definitely help and Niacin in proper doses do as well. When did they become "alternative" treatments??

While you aren't a doctor, we love that you play one on the internet.

Your mention of your LYS's anniversary sale reminded me that Ye Olde Yarn Shoppe in Schenectady is closing and almost everything is 50-75% off. I only mention this because you have been there and written about them.

Kerry said...

Speaking as a retired pharmacist, I could not agree more about being proactive in looking after your health.
As for the Niacin article, I think the pertinent words were "cost effective". The doses needed to lower cholesterol are very high, and have the side-effects mentioned above of flushing and itching.
Weight loss and simple exercise like walking are proactive ways to help lower cholestrol.

Jill said...

Please be careful with Niacin! I had an allergic reaction to it, and had what they call "flushing". It felt like my skin was on fire and it was very painful. I'm for alternatives too, but this one didn't work for me!

Cath said...

Another niacin warning: it can play hell with vascular headaches.

janXknits said...

I would switch to fish oil capsules. 3 of 'em a day. I started taking those and saw a dramatic lowering of my cholesterol.

That niacin stuff can make it feel like your having a hot flash if you aren't careful. You'll feel like you are on fire. So start out slowly and over 2 weeks increase your mg...

Amy said...

Wow! You've got a lot of comments on your niacin stuff. And I'll add my own bit here, just for fun. Take what you will. One of the issues medicine has faced over the last 20 years is this huge shift toward what is called "evidence-based medicine" or EBM. It's what you'd like to think has always been happening, but hasn't. EBM says that we're going to look at the most current research and really evaluate closely what studies say, how much evidence they have, and how significant the study is. Tests on 80 people mean squat. Tests on 8000 mean more. Then we'll look at our patient and, along with the patient, decide what is the best treatment that gives the most good with causing the least harm. Medicine might have used to say "Well, we ALWAYS prescribe statins for high cholesterol, so I'm going to give statins." Now we say, "Hey, look, these statins tend to really suck in the population my patient is in. Or they don't really help all that much. And they might actually hurt more than they help. I'm going to look into other options, and then discuss what best fits my patient with him/her." The problem is, this truly is a paradigm shift in medicine. Especially if you're not going to academic physicians, those at a teaching hospital who do their own research as well as read others', you might not get the EBM kind. You might get the "I'm right and you have to take statins" type of medicine instead. However, even the former director of the NIH right now is iffy on EBM, so you can see that perhaps not everyone agrees with it. It's a hot issue.

At the university I'm at, we have a specialized clinic for physicians to refer patients to that specializes in alternative medicine, as many, many medical compounds and pharmaceuticals have come from natural sources. Taxol, the next big breast cancer medication, is straight out of a plant.

I don't think your docs are relying just on Pharm companies, they just aren't practicing what you and I might consider modern medicine. Some Pharm companies are even developing niacin treatments for raising HDLs. I would second the idea of finding a physician who seems more willing to discuss how you want to handle your medical care and supports you in that journey.

Meribeth said...

Pardon me for jumping back and posting again.

For those who want to take fish oils..for the omega acids...and are concerned about mercury, there are products that are extremely pure and have no fishi-ness to them. Nordic Naturals is one such product and is pharmaceutical grade. I have been taking them for a while, and I can assure you that it makes a world of difference. Also, I am not in anyway associated with the company. BTW, I started taking them because of the threat of high cholesterol, and my own bad habits..and I was feeling generally crappy. They work.

Also a couple of glasses of wine is supposed to be a cholesterol buster too!

Kathy said...

oh dear, Joe; here you are in the middle of something you likely did not anticipate...

Amy says even the Director of NIH is iffy on EBM--and that's because if the E is iffy, the reviews and syntheses are worse. In a situation where there are many well-conducted studies across robust demographics, there's absolutely no doubt that EBM provides for the best empirical data for decision-making. Many disciplines in the clinical world are grappling with the appropriate role of EBM in formulating practice guidelines, of which the systematic evidence review is a single component. Researchers all know this: garbage in, garbage out.

And there's the rub with a lot of alternative medicine. While many alternative modalities may indeed be viable options, they tend to be less well studied by virtue of their independence from licensure review and/or sponsorship from major pharmaceutical interests. Of course we all know that modern medicine is part of the licensed health community: no surprise they largely study and dish out licensed interventions.

A final note on EBM: its appeal and acceptance are growing. The Cochrane Collaboration provides a number of tools for evaluating available systematic reviews at Cochrane.org/reviews. I checked out niacin and LDL, other tags for cholesterol, and found nothing although their lead article is on vitamin C and the common cold...

Patti said...

I'm an infrequent commenter but am compelled to add to the cholesterol/niacin debate. My cholesterol and triglyceride numbers have inched up in recent years. My doctor told me to get them under control with diet and exercise or she would need to put me on statins. When I asked for specific guidelines, the nurse in the office told me the standard "reduce animal products" recommendation. By my next appointment, I was hungry all the time, had gained weight, my blood sugar levels were up, and the cholesterol/triglyceride number had increased dramatically. The doctor sent me to a nutritionist as a last resort to the statins.

The nutritionist put the meats and cheeses (low fat of course, but that's what I was eating before) back into the diet and took out carbs. I started taking a multi vitamin, fish oil, and niacin. In 3 months, my numbers were almost half of what they were and in the normal range. Admittedly, the nutritionist said most people's levels don't go down as much that fast (maybe most people cheat).

Regarding the flushing caused by niacin...buy flush free niacin.

There was a "Ye Olde Yarn Shoppe" on route 9 in Latham that closed 15-20 years ago (loved that shop). Is the one in Schenectady the same business?

Cara said...

On the issue of low carb vs. low meats in cholesterol reduction: my mother went on the Atkins diet 4 years ago, and saw a noticeable reduction in her 'bad' cholesterol levels. I don't know what other things she does (or pills she takes) to help her cholesterol.

Lisa said...

I second what Fredda said about a vegetarian lifestyle. Even just one or two meatless dinners a week cam make a huge difference. One cookbook I highly recommend is Deborah Madison's Vegetarian Cooking for Everyone. I've been a "junk food vegetarian" since high school but have recently gotten serious about eating healthy. Of course, I counteract that with the occasional cigarette, but whatever. Baby steps. As far as niacin, I've had customers order a meal and then take niacin along with other supplements. Within minutes they were flushed, itchy, and miserable. One couple ended up in the emergency room. The reaction can be uncomfortable and immediate.

Seanna Lea said...

As a vegetarian (lacto-ovo, because I love real homemade ice cream), I have never really worried about high cholesterol.

Going vegetarian is a lot easier than most people think. The more recent research indicates that balancing proteins is not an issue, because your body reacts to foods and levels of proteins over time (so, you do not need to balance within the same meal).

I still get my cholesterol tested on a regular basis, but I'm paranoid about it.

Holly said...

Sorry I'm a day late to the discussion, but you might look into finding another physician.

My husband takes Niaspan, an extended release Niacin prescribed by his physician to aid in control of his cholesterol. Well-informed medical professionals DO know about this and SHOULD discuss it as an option with a patient. Since yours or Thaddeus' didn't, I'd be concerned about what other current medical managment information they are not up to date on.

Anonymous said...

Hi. I (and I make my husband) take Quercitin (that should be fairly close to the correct spelling), non-acidic. It helps with cholesterol, and of all things allergies - my original reason for taking it. It's made from apples and onions. My hubby is 50+ and just had a physical and the Dr. couldn't believe he wasn't on any med.'s and his tests all came back way better than his age group. It won't give you the "flush" factor, nor will it make you sleepy or hyper like anti-histamines.

Best of luck to you, and Thaddeus, and Nico too!

T B

Moorecat said...

Sorry, Joe, my eye for detail - and mistakes - is (in)famous in the s'n'b group I attend. I certainly didn't mention it to offend you/be a smartarse.