Non-Medication cholesterol control

[Fabkiwi06]

Monthly labs back today and my cholesterol is way up. Damn. "Genuis" nurse of mine was no help - it was a struggle to get her to even give me the actual number over the phone - so I'm coming to you guys for advice instead.

In addition to (again) overhauling my diet and adding more exercise, is there anything else that has helped people lower those numbers without going on a pill? I'd like to avoid adding another medication if I can help it.

It's frustrating because, as usual the foods that typically are recommended to lower cholesterol are not recommended for renal patients.

Anyone have luck with whey protein or fiber supplements?

[Deanne]

My doctor took me off prescription meds and has me on Red Yeast Rice. It's still a pill, but not prescription anyway. I'm not sure if that's making the difference or if it's because I'm getting a lot more exercise that's doing the trick.

[Fabkiwi06]

I was just reading about red yeast extract. I was hoping to find more about it's use with renal patients to make sure it wouldn't mess up my kidneys any more than they already are. Fish oil is supposed to help too. I'll have to see if I can find them at my pharmacy.

Thank you!

[Charlie B53]

I took fish oil for many years.   I can't say that it made much difference.  I never really paid that much attention to labs.

I'm a 'Guy'.  Most of those years I simply went to the Dr appts because it was 'recommended'.   As a 'Guy' I never could admit to myself that my diet and lack of heart-rate increasing exercise could contribute to health problems.

Live and learn.   Why does it take most of a lifetime to learn what should be taught as a way of life to children?

Heart-rate is far more important in developing and maintaining health than most any other thing ever.   Many dietary inadequacies can be synthisized by the liver, IF, the heart is active enough.   Too bad it would takek me 40 years to prove this.  I don't have 40 years left.  Unless there is some major shift in the medical field.  And I ain't holding my breath waiting for that to happen.

[Athena]

Fabkiwi,

I'm in the same boat as you with regards to cholesterol and I'm also facing the prospect of starting a statin. I don't think dietary changes or any sort of non-prescription supplement can really make much of a difference to be quite honest - at least, not according to medical opinion. I also don't want to introduce another drug into my system but it looks like I will have to capitulate.

I wish there was some real alternative that was both effective and safe. My Neph has just had a stern discussion with me about my need to lower my LDL cholesterol urgently. Unfortunately we are at great risk of cardiovascular issues just from having CKD as it is. We don't want to invite a stroke or heart attack by running around with high cholesterol. That is the message that has just been drilled into me!

I'm playing with the idea of starting fish oil supplements for the next 2 or 3 months to see whether they may make much of a difference. Changing my diet to a high carb/low fat one is not an option for me since I am a diabetic.

[kickingandscreaming]

Controlling cholesterol is a lot more about restricting carbs than it is about restricting fat.  The whole fat obsession is really off base as most modern research is showing.

I am sure that since starting PD and swimming in dextrose will raise my LDL soon.  Before I started,  total cholesterol was 188 and I was eating low carb.  I'm still eating low carb, but my peritoneum is "gorging" on sugar that I can control.  I expect that my next cholesterol reading will b seen as problematic.  I wish they would come up with an alternative to filling diabetics with sugar water.!!!

From my reading, there is little substantiation that lowering cholesterol has any impact on heart health.  And statins can wreak havoc.

[Charlie B53]

............. an alternative to filling diabetics with sugar water.!!! .......................

That reminds me.

That link you gave me to the paper on alternative PD Solutions that was written by MY Neph.   I asked him about those and learned that even though these alternative solutions do have amino acids the solutions ARE still sugar based.  Mostly with Ico, which I am already using for my long dwell all day.

No real advantage for us diabetics.


The best course is to stay aware of your fluid intake so as to reduce the need for the increased sugar concentrations needed to pull off more water.

[kickingandscreaming]

That link you gave me to the paper on alternative PD Solutions that was written by MY Neph.   I asked him about those and learned that even though these alternative solutions do have amino acids the solutions ARE still sugar based.  Mostly with Ico, which I am already using for my long dwell all day.

No real advantage for us diabetics.

Thank you for checking, Charlie.  But that doesn't quite compute with what I've read. For example:
"Glucose remains a popular osmotic agent in conventional PD solutions due to its low cost, relative safety and effectiveness. Increasing glucose concentration allows for greater ultrafiltration due to the larger osmotic gradient. However, increasing glucose concentrations also means increased glucose absorption, which may result in metabolic abnormalities like hyperglycemia, hyperinsulinemia, obesity and hyperlipidemia[10]. Non-glucose based osmotic agents such as icodextrin (used in Extraneal solution) and amino acids (used in Nutrineal solution) are often used in glucose-sparing regimens to reduce the metabolic impact of glucose absorption. The icodextrin molecule is large sized and does not cross the membrane easily, thus producing a prolonged osmotic gradient and sustained ultrafiltration. The enhanced ultrafiltration achieved with Extraneal results in better fluid balance with improved blood pressure control[11], and a reduction in left ventricular mass[12].

Nutrineal is an amino acid based PD solution which is generally considered equivalent to a 1.5% glucose bag with respect to osmotic power. Although the pH of the solution is 5.5 (low), it contains no glucose and hence is considered biocompatible. No study has shown any mortality benefit with this solution but improvements in nutritional parameters like albumin, transferrin and protein catabolic rate has been observed in some malnourished PD patients[13,14]. Both these non-glucose based PD solutions are licensed to be used once a day."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4317632/

Since I am dry days and have no long dwell (only 4 short 1 hr/40 min. dwells, I am not eligible for Icodextrin.  So I'm totally swimming in dextrose and my blood glucose(and A1c) have both risen dramatically since beginning PD. I'm not happy about that. At all!  And, as it says in this article-- and many others-- the sugar does ultimate damage to the peritoneum.  That's why they always talk about PD as "PD first" as if to imply that there will inevitably be a second since the trreatment itself screws up the peritoneum--not to mention the metabolism.

[Jean]

I have used no-flush niacin for a few years now and it works great. Better than the statins, which I really dont want to take because they make my legs almost too weak to walk. yes, of course, I asked my neph first.

[Charlie B53]

I am told the left side of my heart is quite markedly enlarged.  So?  It isn't as if I feel any different.  It still pumps and I am alive.   But this may be one of the reasons Dr has me using Ico and not relying on higher sugar solutions during the night.

I had to quit one of the statins long ago.  Far too much muscle ache and tiredness.  Makes me wonder now if the statin I am taking is also contributing to my chronic aches and tiredness.  I have very little endurance.  I have to stop and let parts 'rest'.  Mostly my legs even though with the inguinal stents on both sides all dopler flow studies claim good flow.

I still get there, it just takes me a little longer than most.

[Athena]

I've just made some more enquiries about lowering cholesterol and it seems that the 2 non-statin substances that may alleviate high cholesterol (invariably high LDL) is:

1. Red yeast rice (a chinese herbal extract), or
2. Niacin.

Fish oils, a low-fat diet combined with exercise really does not appear to be all that effective for most people with elevated cholesterol.

I have asked my naturopath to find out whether red yeast rice extract is kidney-friendly or not. I will also ask my Nephrologists (although I doubt it is studied in med school & therefore don't expect to really get an answer). I hope to get some answers soon.

I would like to avoid a statin for dear life now, after reading about all of the potential side effects (which includes rhabdomyolysis).

[kickingandscreaming]

I think the wide-spread use of statins is one of the biggest and worst medical "jokes" perpetrated on the public.  But a blockbuster for Big Pharma.  I also think it's important not to fixate on lowering LDL but to focus also on raising HDL ("good" cholesterol). The overall number score you get is a combination of the 2.

[Athena]

I think the wide-spread use of statins is one of the biggest and worst medical "jokes" perpetrated on the public.  But a blockbuster for Big Pharma.  I also think it's important not to fixate on lowering LDL but to focus also on raising HDL ("good" cholesterol). The overall number score you get is a combination of the 2.

Hello K&S, It's good to hear from you. It seems to be over-rated but a new Nephrologist I've just seen has urged me to start taking a statin. He told me that a heart attack, not ESRF, is most likely the next thing that is most likely to kill me. He revealed that he too has just started taking a statin himself and has reported no side effects! What does one do in the face of all this professional advice? I'm bamboozled.

I didn't get a chance to respond by saying to him that he is not likely to have CKD, so the impact on him of the statin may be quite different to someone like me (that's for another time). What I did end up asking him is that a CKD-induced cardiovascular event is probably more likely from the phosphate-calcium "debacle" rather than from high LDL itself. He seemed to nod in acknowledgement of this question.

I think the established medical protocol that all doctors need to follow is to prescribe a statin whenever there is any elevated cholesterol, no matter what.

[kickingandscreaming]

What does one do in the face of all this professional advice?

Keep reading and thinking for yourself.   Medical "science" is stuck in old pattern and they can't let go.  I like the balanced way this functional health practitioner thinks about stuff like this. I'm attaching a link to a pdf e-book. Or this link: https://chriskresser.com/the-diet-heart-myth-statins-dont-save-lives-in-people-without-heart-disease/

[Fabkiwi06]

Thanks for all the input.

I've made the appointment with my PCP to discuss my options. I've also upped my gym time and switching my focus to more cardio.

It's always something, eh?

[Athena]

There always is, Fabkiwi! Always other things to worry about. I see my CKD as like being on a leaky boat - there's always a new hole to fill in so as to prevent the whole boat from sinking!

[Charlie B53]

LOL    My old boat CAN'T sink!     I keep her on her trailer in the back yard.


Someday I will get around to replacing all the rotted flooring, seats wiring, etc..   Replace that original 19962 motor with a Merc a bit newer, not a lot, just a late 60' or early 70's.   Put the drain plug back in an float the Old Girl again.     She may be getting oldl, but she's a Classic, and I will never give her up!


Unlike us fleshy humans, she is skinned in aluminum and will outlive us all.   I only get to use her for my short lifetime.  Then she will move on.

[Athena]

Well Charlie, I've become quite fond of my leaky boat too and I will never give up on her. I take her out sailing every day. The holes get plugged up quite nicely and it's smooth sailing most days. When stormy weather arrives, I pay particular attention to all the weakest links in her body and keep a watchful eye on the storm clouds and sea conditions at all times. Lol.

[kristina]

Monthly labs back today and my cholesterol is way up. Damn. "Genuis" nurse of mine was no help - it was a struggle to get her to even give me the actual number over the phone - so I'm coming to you guys for advice instead.

In addition to (again) overhauling my diet and adding more exercise, is there anything else that has helped people lower those numbers without going on a pill? I'd like to avoid adding another medication if I can help it.

It's frustrating because, as usual the foods that typically are recommended to lower cholesterol are not recommended for renal patients.

Anyone have luck with whey protein or fiber supplements?

Hello and I am very sorry about your experiences. My own experiences are that the "whole issue" is down to moderation and slow evaluation about what we can and what we can't eat and the reaction of our body to certain food-choices... I don't think there is any quick answer to this because in my experience it it not down to what is allowed and what is not allowed, because everyone's body is different and reacts differently to all sorts of food-choices. For example, I have been a vegetarian for decades and fortunately I always eat very little portions anyway and because of that I always combine all sorts of different food-choices in a way that I never eat too much of any one food and so my lab-result don't give any cause for concern...(... and touch wood it continues like that...!)
I wish you good luck and all the best from Kristina.