Researchers Say LOW Cholesterol May Be Not Much Better Than HIGH Cholesterol. WTH! They Are Saying THAT Now?

Since I was a little girl and able to understand scary stuff, my mother said that her body "manufactured" too much cholesterol. Never mind the fatty foods she ate like red meat and extra buttery toast and cheesecake, her favorite dessert. She stood by her story to the end. I was scared I would inherit the same "manufactured" condition. But I was spared even though I had a hemorrhagic stroke that was from Protein S deficiency. (Don't get me started on a lousy gene pool).

My mother probably familial hypercholesterolemia, this news  brought you by US National Library of Medicine, a disorder that is passed down through families. It causes LDL (bad or think of loathsome) cholesterol level to be very high. The condition begins at birth and can cause heart attacks at an early age. My mother didn't have a heart attack, but she could have had one easily. 

Familial hypercholesterolemia is a genetic disorder. It is caused by a defect on chromosome 19. The defect makes the body unable to remove low density lipoprotein (LDL, or bad) cholesterol from the blood. This results in a high level of LDL in the blood. 

This condition makes you more likely to have narrowing of the arteries from atherosclerosis at an early age. The condition is typically passed down through families in an autosomal dominant manner (that is, inheriting a disease, condition, or trait depending on which type of chromosome was affected). 

And that's probably what she meant by manufacturing high cholesterol. So I thought to myself, I'm lucky that I escaped the high-cholesterol syndrome, and now that I am a pescatarian or, as I like to say, a vegan with fish. That got me thinking: Can your cholesterol be too low? The answer scared me more. 

In April of 2019, a study by the American Academy of Neurology said that low cholesterol was linked to a higher risk of "bleeding [hemorrhagic] stroke" in women. 

A study found out that women who have levels of LDL cholesterol 70 mg/dL or lower may be more than twice as likely to have a hemorrhagic stroke than women with LDL cholesterol levels from 100 to 130 mg/dL. 

The study also discovered that women with the lowest triglyceride levels, that is, fat found in the blood, had an increased risk of hemorrhagic stroke compared to those with the highest triglyceride levels.

"Strategies to lower cholesterol and triglyceride levels, like modifying diet or taking statins, are widely used to prevent cardiovascular disease," said Pamela Rist, ScD, study author of Brigham and Women's Hospital in Boston and a member of the American Academy of Neurology. 

"But our large study shows that in women, very low levels may also carry some risks. [I'll say]. Women already have a higher risk of stroke than men, in part because they live longer, so clearly defining ways to reduce their risk is important. Women with very low LDL cholesterol or low triglycerides should be monitored by their doctors for other stroke risk factors that can be modified, like high blood pressure and smoking, in order to reduce their risk of hemorrhagic stroke. 

"Also, additional research is needed to determine how to lower the risk of hemorrhagic stroke in women with very low LDL and low triglycerides," Rist said.

My head was spinning. Low cholesterol and low triglyceride are considered bad now? I wanted to find out more. 

The study of 27,937 women age 45 and older participated  in the Women's Health Study (supported by the National Institutes of Health) who had total cholesterol, LDL cholesterol, high density lipoprotein (HDL or good cholesterol), and triglycerides measured at the beginning of the study. Researchers reviewed tons of medical records to determine how many women had a hemorrhagic stroke.

With an average follow up at 19 years, researchers identified 137 women who had a bleeding stroke. Nine out of 1,069 women with cholesterol 70 mg/dL or lower, or 0.8 percent, had a bleeding stroke, compared to 40 out of 10,067 women with cholesterol 100 mg/dL up to 130 mg/dL, or 0.4 percent. 

Some other factors were weighed in that could affect risk of stroke, such as age, smoking status, high blood pressure and treatment with cholesterol-lowering medications, and researchers discovered that those with extremely low LDL cholesterol were 2.2 times more likely to have a bleeding stroke.

Researchers divided the women into four groups for triglyceride levels. Women in the group with the lowest levels had fasting levels 74 mg/dL or lower, or non-fasting levels of 85 mg/dL or lower. Women in the group with the highest levels had fasting levels that were higher than 156 mg/dL, or non-fasting levels that were higher than 188  mg/dl. Researchers found that 34 women of the 5,714 women with the lowest levels of triglycerides, or 0.6 percent, had a bleeding stroke, compared to 29 women of the 7,989 with the highest triglycerides, or 0.4 percent. 

The study's key limitation was that cholesterol and triglyceride levels were only measured once at the beginning of the study. In addition, menopause was evident in a large number of the women, which prevented researchers from examining whether menopause status may be the missing link between cholesterol and triglyceride levels and bleeding stroke. More study is needed.

WELCOME TO CHECK. CHANGE. CONTROL. CALCULATOR, compliments of the American Heart association (AHA). 

https://ccccalculator.ccctracker.com/

Through blood tests, CBC and Lipid Panel, and vitals like blood pressure, you can fill in the blanks on the form to see if you're susceptible to a heart attack or stroke. Shouldn't you know rather than guess?

Statins are effective at lowering cholesterol and protecting against a heart attack and stroke, although they may lead to side effects for some people.

The Mayo Clinic says that doctors "often prescribe statins for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke." But they have been associated with the onslaught of muscle pain, digestive problems, and mental confusion in some people who take them and may cause liver damage, albeit rare.

Statins include: 

• atorvastatin (Lipitor)
• fluvastatin (Lescol XL)
• lovastatin (Altoprev)
• pitavastatin (Livalo)
• pravastatin (Pravachol)
• rosuvastatin (Crestor, Ezallor)
• simvastatin (Zocor, FloLipid)

The reason that doctors prescribe statins is that they block a substance your liver needs to make cholesterol, and causes your liver to remove cholesterol from your blood.

If you're already on statins, talk to your doctor before stopping them. My doctor told me to stop reading articles on the Internet. Hoo, boy. Like that's gonna happen. 

If you have muscle pain, the statin you're on may be producing  rhabdomyolysis which can cause severe pain, liver damage, kidney failure, and death. The risk is very low, and numbers are equal to a few cases per million people taking statins. Rhabdomyolysis can happen when you take statins in combination with certain drugs so ask your pharmacist.

Or statin use could cause an increase in liver inflammation. But if the increase is severe, you may need to try a different statin because all statins are not alike. Again, talk to your doctor, if you also have unusual and increased fatigue or weakness, loss of appetite, pain in your upper abdomen, dark-colored urine, or yellowing of your skin or eyes.

It also possible your blood sugar level may increase when you take a statin, which may lead to developing type 2 diabetes. 

The risk is barely significant but important enough that the Food and Drug Administration (FDA) has issued a change on warning labels regarding blood glucose levels and diabetes with statin use prevalent.

Also, the FDA issues a warning on statin labels that some people have memory loss or confusion while using statins.

Everyone who takes a statin may not experience side effects. 

Risk factors include:

• Being female
• Being age 80 or older
• Having kidney or liver disease
• Drinking too much alcohol
• Having certain conditions such as hypothyroidism or neuromuscular disorders including amyotrophic lateral sclerosis (ALS)
• Having a small body frame
• Taking multiple medications to lower your cholesterol

If your doctor says it's fine, take a small break from statin and see whether the muscle aches or other problems you're having are statin side effects. It may be just part of the aging process.

Or switch to another statin drug if that's ok with your doctor. 

Or change your dose with the doctor's permission. Another option is to take the medication every other day, especially if you take a statin that stays in the blood for several days. Again, talk to your doctor.

More than usual exercise may increase the risk of muscle injury. And it's difficult to know if your muscle pain comes exercise or a statin. 

One more thing. Is your diet healthy enough not to produce high cholesterol and, by the way, high triglycerides? My mother, again, probably had Familial hypercholesterolemia, the inherited gene that you could help by eating healthy, exercising, and not smoking, all of which my mother did not do. No wonder it's taking researchers so long to relate strokes to the countless number of variations in lifestyles. 

Life's Lessons: I Ain't as Good as I'm Gonna Get, But I'm Better Than I Used to Be

I admit it. This refrain was borrowed and comes from Tim McGraw's country song, Better Than I Used To Be, the song that asserts he could finally stand the man in the mirror that he sees. I love that song and realize that now, almost 11 years post stroke, that song could have been written about mostly me. I turned the negatives that were mentioned in the song around to positive ones. 

Please listen:

https://www.youtube.com/watch?v=WO0keYA21oI&list=RDWO0keYA21oI&index=1

He sings:

Hold a grudge

I used to hold grudges--like, forever. But no more. For example, there was my his-way-or-the-highway sibling and his super-controlling wife. I realized, or pretended to imagine, that they liked to have power, but I wasn't going to be a party to that. Or my colleagues that didn't listen to my demands for speaking without confrontation. Or my neighbors who didn't throw the mouse in the rubbish when it came to land in our shared driveway with my two kids playing. Having no grudges means I'm free of all that negativity and that the cliche Life Is Too Short really means something. You must let...it...go! 

The hearts I've broke

Yes, I broke some hearts because, and as my sons say, I liked men with edge because of my sheltered past, not nice guys who would gamble and fight rather than the nice ones who would have been perfect husbands and fathers. I was married to an edgy guy for 18 years who threw food on the floor if he didn't like it, broke furniture in a fit of rage, once inches away from my infant son, and threatened me countless times. The other person was simply a mistake that lasted 16 years when I should have known better. There were signs, yes. But they're both now dead to me, the first literally, the other figuratively. I found a couple of nice ones I'm sort of interested in, but time will tell if those feelings are returned. And I'll be smarter this time around.

People I let down

Sure, I let people down, and I had reasons, albeit faulty and selfish, to do so. But show me people who don't have any regrets in their whole lives, and I'll show you liars. From not agreeing with contentious friends to not cooking what I said I was going to bring to a pot luck supper, I let people down, so down that they stopped speaking with me. But, come on! Over politics or Shepherd's Pie? I enjoy the present now, not dwell upon the past or have apprehension about the future.

There's some dirt on me

Absolutely, there's some but not a whole lot, like the time I used my friend's mascara when I had an eye infection on Saturday and then two days later on Monday she found out after she used that mascara on Sunday the day before (ouch! that was really a bad one) or how about the time I applied for the same position as my colleague, and  gossiped to people I knew would spill the beans about her secret drug addiction,  and she didn't get the job. I did. As Oscar Wilde once said, "Experience is simply the name we give our mistakes."

But I have one thing that wasn't in the song. Patience! Do you know how I got patience where there wasn't any before? From my stroke. Talk about a silver lining! It took a while to develop it, but now patience is with me all the time. People write to me occasionally to ask how I developed patience instead of constant anger and frustration. I practiced becoming patient because, in truth, it doesn't come naturally, at least to me. You have to want it, and it will come, not right away but eventually.

Maybe, in time, I'll become like that character from the television show My Name is Earl, a f-up who won $100,000 in the lottery and decided to correct all the wrongs from his past. Or maybe, and most likely, I'll begin again in "it's-never-too-late" fashion  to make the right decisions this time around. Whichever I choose, I, too, could finally stand the woman in the mirror that I see.

Kobe Bryant and Me: Thoughts on Life and Death

I never knew Kobe Bryant even though we each lived in Pennsylvania at some point in our lives, less than 30 minutes and years apart --me for 60 years and Kobe for 18 years when, upon graduation, he went to his only team, the Los Angeles Lakers where he had a 20-year career. He was scouted as #1 in the country and played in the National Basketball Association (NBA). Among his many accomplishments, as a shooting guard, he won five NBA championships, was an 18-time All-Star, and got to be the best shooter ever after Wilt Chamberlain.

Unless you've been sequestered with jury duty or living under a rock, Kobe died Sunday along with his daughter and 7 others in a foggy and then fiery helicopter crash which killed them all. 

I watched the news reports Sunday and, after a while, stopped watching because the reporters occasionally brought up that incident where in 2003, Bryant was accused of sexual assault by a 19-year-old hotel employee. Shortly after, Bryant issued a public apology, with his wife by his side, but that action resulted in several endorsements which were cut off immediately including McDonalds and Nutella.

Then the devil sat on one shoulder and said, "Was that really necessary to bring that up considering all the good things he did, like the Kobe and Vanessa Bryant Family Foundation whose goals were helping young people in need of support, encouraging the development of physical, emotional, and social skills through sports, and assisting the homeless? Didn't the good things eventually overpower the bad? Can't we just move on?" 

But the angel who sat on the opposite shoulder said, "Can you really get over sexual assault?" The angel won.

It was 1 in the morning now on Monday. But I was really into it--the thinking, I mean. I sat on my comfortable sofa, for 3 hours, just hammering out what had happened. The Grammys were on Sunday as well in the Staples Center where the Lakers played. I started feeling overwhelmed.

I said to myself, if Kobe was so famous, and people tend to forget even the famous over time, little by little, what chance do I, a regular person, have to be remembered? I fell asleep somewhere in the middle but didn't lose direction one bit, returning to the internal discussion at hand.

Then around 2 on Monday, I thought of my father who was killed in his North Philadelphia store in 1971, and I didn't even think of him every day after awhile, except right around the holidays which were important to him because, other than working seven days a week to support his family, he liked fun. 

It was about 3:30 on Monday. The only thing was the country by Randy Travis called Three Wooden Crosses that pulled me out of whatever had taken over my mind. The song is  about four people--a farmer, a teacher, a preacher, and a hooker--going down to Mexico in search of various things. He was awarded the Academy of Country Music Award for Song of the Year. Listen to it for a moment.

https://www.youtube.com/watch?v=LT1sNrgnJZc

It's the refrain. 

I guess it’s not what you take when the you leave this world behind you.

It’s what you leave behind you when you go. 

And then I also knew. My father left his incredible work ethic, Kobe left his iconic basketball fame, and I guess people will remember me, too, albeit I don't know for what. 

I asked one of my sons the next day, "Will you miss me when I'm gone?"

He took a long time to answer and then he said, "You have your moments."

That's good enough for me, wiseass.