Author Topic: High cholesterol and atherosclerotic plaque  (Read 8023 times)

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Offline Avocado

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Re: High cholesterol and atherosclerotic plaque
« Reply #60 on: 26 October 2017, 05:18:25 PM »
DR Malcolm Kendrick had a post some time ago in his long running blog on the causes of heart disease, in which he said that people who have high Lp(a), that is Lipoprotein a, which gives them a much higher risk of cornonary heart disease, might benefit from taking quite high doses of vitamin C.

Lp(a) levels are a genetic thing, it comes from the time in our evolution when foods containing vitamin C might be in short supply and so, when a person cut themselves, as with scurvey caused by vitamin C deficiency, they would bleed very easily. Lp(a) makes blood clots much easier to form so helping those with a vitamin deficiencey in times gone by. Nowadays, of course, we don't usually have a vitamin C deficiency and so Lp(a) is a nuisance as it means those with high levels of it are more likely to get blood clots in their arteries and the trouble that cuases. It's something like that - I can't find the specific blog where Dr Kendrick explained it better than me, but his take home message was that anyone with high Lp(a) (and we don't seem to get that measured in the UK usually) would find no harm in taking extra vitamin C.

To be on the safe side, it doesn't seem to harm anyone to take extra vitamin C. It can upset the tummy but you can buy buffered vitamin C: magnesium ascorbate tablets or powder which doesn't cause a problem.
Anne

Atypical Type 2, thin, not insulin resistant, diagnosed March 2007. Very low carb (30 - 50g per day) Paleo diet and exercise - Prandin (Repaglinide) 0.5mg. Aortic Valve Replacement Jan 2014, Osteoporosis, Small airways disease, probable coeliac - Strontium Ranelate 2g/d, Omacor 2g/d, vitamin K2 300mcg/d, Aviticol (vit D3) 20,000 IU every week, Qvar 100 2/day.

Current HbA1c 33 Current total cholesterol 7, HDL 3.5, LDL 3.2, triglycerides 0.4

Offline nytquill17

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Re: High cholesterol and atherosclerotic plaque
« Reply #61 on: 26 October 2017, 07:17:55 PM »
Fun language fact: Vitamin C is actually named after its function as a curative for scurvy. "Scurvy" in Latin is "scorbutus" (in French, "scorbut"). The chemical name for vitamin C is "ascorbic acid". The prefix is the same "a-" prefix as in "apathetic", "atypical", "anarchy" etc., meaning "not, nonexistence of, anti-". A-scorbic acid: an acid that prevents or reverses the existence of scurvy!
T1 DX 1995
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  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
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Offline Avocado

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Re: High cholesterol and atherosclerotic plaque
« Reply #62 on: 27 October 2017, 08:56:38 AM »
I found the link to the specific blog that Dr Kendrick did on vitamin C and atherosclerosis. Here it is: https://drmalcolmkendrick.org/2017/01/16/what-causes-heart-disease-part-xxiv/

Copying some bits of it below and heavily editing it as it is very long, but you should read the whole thing by clicking that link above.

Time, I think, for a quick refresher about this whole area. Particularly as it helps to confirm my central hypothesis that CVD is a disease of blood clotting, and you would struggle to explain the vitamin C/Lp(a) axis in any other way.

At some point in the distant past, our ancestors lost the ability to manufacture vitamin C. This happened, so I recently read, around sixty-one million years ago.

….. because humans cannot synthesize their own vitamin C, we must obtain it from within our diet. If we do not manage to eat enough, we will end up with scurvy. Scurvy presents with many different symptoms, but the one I am going to focus on in this blog is bleeding.

Bleeding occurs, because vitamin C is essential for collagen synthesis – a critical building block of supportive tissue throughout the body. Loss of collagen leads to break down of various structures in the body. For example, the walls of blood vessel walls which, start to break down and ‘crack.’

As blood vessel walls crack, they leak, and bleed. This leads to the best known symptom of scurvy, which is bleeding gums.

On the positive side, after sixty-one million years, or so, evolution came up with a partial solution to the early stages of scurvy. Namely, the synthesis of a substance to block the cracks in the blood vessel walls, and control the bleeding. This substance is…. lipoprotein (a).

Lipoprotein (a) (Lp(a)) is synthesized in the liver, and it travels around in the bloodstream, looking for any cracks in blood vessels walls a.k.a. damaged endothelium. When a crack is spotted Lp(a) is attracted to the area and sticks very firmly, and cannot easily be removed.

However, Lp(a) has a very special trick up its sleeve. It mimics plasminogen.

After a blood clot forms, anywhere in the circulation, it has to be broken down, and removed – once the blood vessel underneath it has repaired.

Once a large blood clot has formed, over a ‘crack’ in the wall, it cannot stay there forever, restricting, or totally obstructing, blood flow. On the other hand, if the entire clot simply broke off, and travelled down the artery, it would get stuck as the artery narrowed – causing a complete blockage.

Ergo, there is a need for a process that removes blood clots that have formed within blood vessels. It is called thrombolysis, or fibrinolysis. To ‘lyse’ means to break down.

The main player in thrombolysis is plasminogen. It becomes incorporated into (almost) all blood clots that form. It is activated by tissue plasminogen activator (t-PA). This turns plasminogen into plasmin, the ‘active’ enzyme that slices fibrin apart [fibrin is a long, and very strong, string of fibrinogen molecules that wraps round blood clots and binds them together].

….. the systems of blood clotting are highly complex, and I think that explaining where Lp(a) fits in, is important.

Lp(a) is actually a lipoprotein, just like LDL. In fact, it is exactly like LDL, because it is basically LDL. It is the same size and shape, it contains triglyceride and cholesterol. However, it differs in one important aspect. Whilst LDL has a protein stuck to it called apolipoprotein B-100, Lp(a) has another protein stuck to it called apolipoprotein (a). Which is why it is called lipoprotein (a).

The fascinating thing about the protein, apolipoprotein (a), is that is has almost exactly the same chemical structure as plasminogen. So close, that you could hardly tell it apart. However, apolipoprotein (a) is completely unaffected by t-PA. It does not convert to plasmin, it is inert. So, when you want to break down a clot (fibrinolysis), the parts that have Lp(a) incorporated into it, cannot be broken down.

Which means that if you have a high Lp(a) level, you will develop bigger and more difficult to break down blood clots. Exactly what evolution had in mind for creatures that cannot manufacture vitamin C, and need to plug cracks in artery walls when the vitamin C level falls. However, not so good, if you want to stop atherosclerosis from developing.

Because these Lp(a) rich blood clots have to go somewhere, and the only place that they can go is to be absorbed into the artery wall itself, and then broken down. However, these clots are more difficult to break down, so, with repeated clots over the same area of artery wall, bigger and bigger plaques will grow.

That, anyway, is the theory.

We now know that humans cannot synthesize vitamin C, so we need to eat it. Without enough vitamin C, our blood vessels crack and bleed, and in severe cases we bleed to death.

In order to provide a degree of protection against vitamin C deficiency (scurvy), we produce lipoprotein (a) to fill up the cracks the blood vessels. However, unsurprisingly, a high level of lipoprotein (a) Lp(a) is associated with a higher rate of CVD.

‘In summary, elevated Lp(a) levels associate robustly and specifically with increased CVD risk. The association is continuous in shape without a threshold and does not depend on high levels of LDL or non-HDL cholesterol, or on the levels or presence of other cardiovascular risk factors.’ 3

This raises two inter-connected questions. Does vitamin C supplementation lower Lp(a) levels, and does it reduce the risk of CVD? It is of course entirely possible that vitamin C could reduce CVD risk by protecting blood vessels from ‘cracking’ without having any effect on Lp(a) levels.

With regard to the critical question, does vitamin C reduce the risk of CVD [with or without lowering Lp(a)]. I would say, case currently unproven. This does not mean that it does not (in fact I believe that it probably does). What I mean by ‘case currently unproven’ is that no-one has done a large scale interventional study using vitamin C to find out if it really reduces CVD.
Anne

Atypical Type 2, thin, not insulin resistant, diagnosed March 2007. Very low carb (30 - 50g per day) Paleo diet and exercise - Prandin (Repaglinide) 0.5mg. Aortic Valve Replacement Jan 2014, Osteoporosis, Small airways disease, probable coeliac - Strontium Ranelate 2g/d, Omacor 2g/d, vitamin K2 300mcg/d, Aviticol (vit D3) 20,000 IU every week, Qvar 100 2/day.

Current HbA1c 33 Current total cholesterol 7, HDL 3.5, LDL 3.2, triglycerides 0.4

Offline Liam

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Re: High cholesterol and atherosclerotic plaque
« Reply #63 on: 28 October 2017, 04:00:36 PM »
Really interesting stuff Anne. Thank you for posting and for the link.
DX Type I 1994.    Novorapid Animas Vibe pump
HbA1c 3/10 10.2%, 7/10 8.1%, 12/10 7.5%.
2/11 7.8%, 8/11 8.6% 9/11 8.3%.
3/12 62 (7.8%). 10/12 67 (8.3%)
4/13 63 (7.9%) 6/13 59 (7.5%)
1/14 71 (8.6%) 7/14 59 (7.5%) 11/14 (6.7%)
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Offline Paulines7

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Re: High cholesterol and atherosclerotic plaque
« Reply #64 on: 29 October 2017, 11:12:25 AM »
Thank you Anne.  A very interesting article. 

I now take Vitamin C with my other supplements.
Diabetes Type2 diagnosed March 2014.  Treated by diet only.  HbA1c 60 on diagnosis, 52 in June 2014, 50 October 2014, 44 December 2014, 48 May 2015, 50 Sep 2015, 53 Jan 2016, 50 Oct 2016, 56 Feb 2017, 50 Jun 2017. 50 Aug 2017.  Pacemaker fitted 2008.

When I get old I don't want people thinking
                      "What a sweet little old lady"........
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Offline Quantum Learning

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Re: High cholesterol and atherosclerotic plaque
« Reply #65 on: 30 October 2017, 09:46:56 AM »
I had been taking 1000mg a day for over 20 years but Dr Bernstein recommends diabetics not to take vit c supplements so I stopped a month or so ago, don't know what to do now  :(
Type 2 dx Nov 2012 with fasting BG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9% Chol
Metformin SR 2000mg, Candesarten Cilexetil 4mg Omeprazole 20mg, Fexofenadine 180mg Co-Codamol 30/500g when needed. Amitriptyline 20mg
Toujeo/NovoRapid, Allergic to Levemir.

Offline nytquill17

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Re: High cholesterol and atherosclerotic plaque
« Reply #66 on: 30 October 2017, 12:13:28 PM »
Does he say why? My understanding is that Vit C is basically harmless and any unneeded amount just gets urinated out!
T1 DX 1995
Levemir + Novorapid
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Avocado

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Re: High cholesterol and atherosclerotic plaque
« Reply #67 on: 30 October 2017, 12:15:51 PM »
I had been taking 1000mg a day for over 20 years but Dr Bernstein recommends diabetics not to take vit c supplements so I stopped a month or so ago, don't know what to do now  :(
Hi Quantum - Dr Bernstein says that large doses of supplemental vitamin C may interfere with the chemical reaction on the bg tesing strips and make the results appear erroneously low. And he says high doses can actually raise BG though you wouldn't, I suppose, be aware of it if the test strips are giving an erroneous reading. But he says 250 mg a day in timed release form is okay. Dr Bernstein also says that dietary vitamin C is important to good health, he doesn't say you can't eat foods high in vitamin C, it's just supplements he is 'warning' about - fruit is out but green veggies have vitamin C in too and they are low carb.

Remember though, this thing about vitamin C being important as regards CHD which Dr Kendrick is writing about is relevant when a person has high Lp(a). Who of us gets tested for that ? (I know Americans are tested for that). Of course getting a good amount of vitamin C from diet and some supplements could be important just in case.....
Anne

Atypical Type 2, thin, not insulin resistant, diagnosed March 2007. Very low carb (30 - 50g per day) Paleo diet and exercise - Prandin (Repaglinide) 0.5mg. Aortic Valve Replacement Jan 2014, Osteoporosis, Small airways disease, probable coeliac - Strontium Ranelate 2g/d, Omacor 2g/d, vitamin K2 300mcg/d, Aviticol (vit D3) 20,000 IU every week, Qvar 100 2/day.

Current HbA1c 33 Current total cholesterol 7, HDL 3.5, LDL 3.2, triglycerides 0.4

Offline Dr DeEath

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Re: High cholesterol and atherosclerotic plaque
« Reply #68 on: 31 October 2017, 01:56:42 PM »
I
Remember though, this thing about vitamin C being important as regards CHD which Dr Kendrick is writing about is relevant when a person has high Lp(a). Who of us gets tested for that ? (I know Americans are tested for that). Of course getting a good amount of vitamin C from diet and some supplements could be important just in case.....

I currently have cut it out as I have now had three upset stomachs in two weeks. I suspect it is not the cause but I am trying to get a medication review in case I am being over-medicated. In the meantime I am just tying to eliminate things. The first time may have been the meal we had but the last two very unlikely!
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Offline Avocado

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Re: High cholesterol and atherosclerotic plaque
« Reply #69 on: 31 October 2017, 02:03:58 PM »
I currently have cut it out as I have now had three upset stomachs in two weeks. I suspect it is not the cause but I am trying to get a medication review in case I am being over-medicated
I can only take buffered vitamin C (magnesium ascorbate) as the regular vitamin C (ascorbic acid) really upsets my tummy very badly. 
Anne

Atypical Type 2, thin, not insulin resistant, diagnosed March 2007. Very low carb (30 - 50g per day) Paleo diet and exercise - Prandin (Repaglinide) 0.5mg. Aortic Valve Replacement Jan 2014, Osteoporosis, Small airways disease, probable coeliac - Strontium Ranelate 2g/d, Omacor 2g/d, vitamin K2 300mcg/d, Aviticol (vit D3) 20,000 IU every week, Qvar 100 2/day.

Current HbA1c 33 Current total cholesterol 7, HDL 3.5, LDL 3.2, triglycerides 0.4

Offline Quantum Learning

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Re: High cholesterol and atherosclerotic plaque
« Reply #70 on: 02 November 2017, 01:44:23 AM »
There is some vit c in the multivits I take, I'll have to check how much.
Type 2 dx Nov 2012 with fasting BG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9% Chol
Metformin SR 2000mg, Candesarten Cilexetil 4mg Omeprazole 20mg, Fexofenadine 180mg Co-Codamol 30/500g when needed. Amitriptyline 20mg
Toujeo/NovoRapid, Allergic to Levemir.

Offline Pattidevans

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Re: High cholesterol and atherosclerotic plaque
« Reply #71 on: 02 November 2017, 08:48:05 AM »
If it’s multivits probably not much.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


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