Yup, I read Attia and even met him once when I bumped into him when we were on the same flight. I think he'll be the first to tell you that the conventional rules the medical industry follows to put people on statins are absurd. You are right, it's complicated, there is no one-size-fits-all standard.
Yup, I read Attia and even met him once when I bumped into him when we were on the same flight. I think he'll be the first to tell you that the conventional rules the medical industry follows to put people on statins are absurd. You are right, it's complicated, there is no one-size-fits-all standard.
IMO the closest we have to a universal screen is triglycerides to HDL ratio, the lower the better. Mine is around 1 because I eat a low carb diet and avoid all sugar. Low TG:HDL is related to all sorts of good things like pattern A LDL (large, low density), and it's also inversely related to metabolic syndrome.
My point is that the general idea that one needs to "lower their cholesterol" and must take drugs to do it is ridiculous. Very low cholesterol is clearly associated with poor health outcomes, particularly in the elderly. What's much more important is a the profile and the absence of metabolic syndrome.
The only real reason to lower cholesterol with drugs is familial hypercholesterolemia (a genetic condition) and even there the evidence isn't very strong.
Yup, I read Attia and even met him once when I bumped into him when we were on the same flight. I think he'll be the first to tell you that the conventional rules the medical industry follows to put people on statins are absurd. You are right, it's complicated, there is no one-size-fits-all standard.
IMO the closest we have to a universal screen is triglycerides to HDL ratio, the lower the better. Mine is around 1 because I eat a low carb diet and avoid all sugar. Low TG:HDL is related to all sorts of good things like pattern A LDL (large, low density), and it's also inversely related to metabolic syndrome.
My point is that the general idea that one needs to "lower their cholesterol" and must take drugs to do it is ridiculous. Very low cholesterol is clearly associated with poor health outcomes, particularly in the elderly. What's much more important is a the profile and the absence of metabolic syndrome.
The only real reason to lower cholesterol with drugs is familial hypercholesterolemia (a genetic condition) and even there the evidence isn't very strong.