I’m a pharmaceutical rep (in a different specialty) and I agree with the statements above that in general, most physicians simply follow outdated guidelines. Part of it is that they’re simply doing what they were trained to do and what has been drilled in their heads for years as “THE correct way” to do it and also, many of them are very resistant to change - especially if they’ve been practicing for decades. I literally had a doctor tell me recently “I’m old and I’ll be retiring in a few years, I don’t want to learn about anything new”. CAN YOU BELIEVE THAT?!?!?!?!
And with guidelines, some like to use the analogy of trying to turn a huge ship versus a speed boat. Obviously, research and data is the speed boat and can turn quick and easy whereas guidelines are like the worlds largest ship and takes FOREVER to turn. But it’s actually more like the captain of the worlds largest ship is in a coma and eventually comes out of it to FINALLY start turning things around. It’s really sad and a LOT of people suffer for it.
Anyway, I recently had my lipid panel run for the first time in over a decade and I panicked a little over the cholesterol results because I didn’t know the data, especially the latest data…
My results:
Total: 342
LDL: 230
HDL: 88
Trig: 109
I freaked the f out! My doctor, however, did not. He said: you’re 39, you’ve never smoked, you’ve never drank, you exercise daily and are active, you have no family history of heart disease, your diet is solid, and I’m more concerned about a persons Trig:HDL ratio (you want to be less than 2:1) than total cholesterol. I wouldn’t hear what he was saying and just kept focusing on the total and LDL so he said to go get a Calcium Heart Score just to be sure. So, I did. It was a zero (what you want). No further worries on my part. As long as I keep my Trig:HDL ratio below 2 (mine is about 1.25), I have nothing to worry about.
Fortunately for me, my doc is up on the latest data and he dragged me kicking and screaming into reality.
In the end, the analogy I came up with is that blaming cholesterol for heart disease is like blaming fire fighters for the fire when in reality, it’s there because there was a problem.
Mertdog - a quick question… you mentioned earlier that sugar causes damage to the blood vessels. My (sub-elementary) understanding was that it was actually insulin which causes the damage, not sugar. In most people, they go hand-in-hand (exceptions being diets where fructose is the primary carb as it’s not really insulinogenic - yay fruit!), but I was curious to know if you were aware whether it was definitely sugar itself, or the body’s response to sugar so that I could patch up my own knowledge. Thanks!