Okay. So. I've been on this site for awhile now and usually just post little replies here and there but have never posted my own topic. Mostly because the only time I'm on is when I'm at work and usually after I read everything I used up my down time and my email blows up with more work to do. Anyways, to give a quick back story, I've been out to my fiancee and her family since June and they have been doing well at calling me by Evan and usuing the right pronouns and now that my finacee and I have worked out the kinks in our relationship and worked through her fears I've started making the appointments and stuff so I can get started on T. I had my Doctor's appt on Jan. 23rd... which was an experience all on it's own because she was new to this clinic (it's Chase Brexton in Baltimore, very trans friendly and they take my insurance so it's perfect) and wasn't sure how their process worked. I thought about requesting a new Doctor but I figured someone had to be her first Trans patient at this clinic so for the sake of the community I would be it. So anyways, I finally got up there on Tuesday to get the blood work done (it's an hour away so I had to find time where I could leave work early) and set up my appt for my evaluation and then went home. So I got the call yesterday (which was nice to pick up the phone and be called Evan) about my results and my LDL was high and she wants to see it go down before she gets me started on T. It's not extremely high just like 20 points over what it's supposed to be at. It's kind of bittersweet I guess and I'm just kind of blah about it. It's nice because that's full motivation to start eating better and exercising but at the same time that's more time I'm going to have to wait to start T. It's not that I'm extremely overweight, I'm probably about 10-15lbs over the healthy weight range but I definitely don't eat well. But I'm definitely out of shape and have been wanting to get in better shape anyways like I was when I used to run track for school. Thankfully my fiancee is completely supportive and wants to lose weight and get healthy as well since we are to be married in September. Has anyone else been told they have to wait because of bad cholesterol?

I didn't have to wait but I have had my doctor say he wanted to see my cholesterol go down. It has been climbing since starting T, even when I was eating better it went up. Plus, I was told if i make changes now I'll be more likely to keep that going.

I have good cholesterol but when I started T I was still an occasional smoker and, well, that's not the same thing I guess. I wasn't asked to meet any standards other than being able to demonstrate that I identified male and knew what I was getting into. Since starting hormones (roughly a year ago) my blood pressure has been steadily increasing and I've been told to keep my stress down but that's about it. I've gained a lot of weight, both muscle and fat, and I wouldn't be surprised if my cholesterol started going up too.

My kid has slightly high cholesterol. She eats veganish at home but lots of meat and cheese and milk at school and respite. Because of her behavioral stuff and lack of depth perception we've had a hell of a time incorporating useful exercise into her life.

So but everything I've read is that it is pretty malleable. That's awesome that you have somebody who is motivated to make changes with you. I don't personally think it makes sense to delay hrt for the reasons you were given, but there's no wrong reason to start taking good care of your body.

That's ridiculous.  The whole cholesterol thing is based on horrible science that has never stood up in a single study.  The levels for "healthy" cholesterol are completely arbitrary and the only thing studies have consistently shown is that people with slightly higher cholesterol have lower mortality rates and people with low cholesterol are more likely to get cancer and have strokes.  What ever you do-- don't let them put you on statins.

Cut sugar, grains and especially anything processed.  Shop around the outside of the supermarket.  Concentrate on vegetables, protein and fat-- meat, eggs, olive oil-- good whole foods.  It'll raise your HDL which will lower your LDL to pass the tests, but again-- cholesterol is mostly an arbitrary number and the only reason we became so obsessed with it was because it was one of the only things doctors in the 50s had the capability to easily measure, so they started attributing everything to it.

I replaced most of the stuff like oil and so on with olive oil, my good cholesterol went way up. Now they say, "well your good cholersterol is so high..." Of course, I understand T can lower good cholesterol, so dietary control (cut way down on simple carbs-- sugar, white bread, etc. and fats) is in order.

South Beach diet (might be able to find a list online as it has been around a long time) has a list of good fats and good carbs. It's a pretty good list. But the idea of shopping around the grocery store and not so much in the inner aisles is a very useful guide.

The science on cholesterol is pretty sorry as Devin said.


--Jay

Thanks for the advice everyone. I'm not going to lie I'm a terrible eater and always talk about eating better but rarely ever follow through. I'm with you Devin, I think it's pretty ridiculous too, I've never heard of anyone having to wait to go on hrt because of cholesterol levels but I figure I'll just use this as that extra kick to get me to where I want to be (healthwise) anyway and then the next time I talk to her I'll let her know that from my research Doctors don't typically make someone wait just because they have a somewhat high cholesterol. I'm also not extremely stressed about it because I have to wait until after my "evaluation" anyways which isn't scheduled until next month. Part of me is hitting my head on the desk looking at all the hoops that we have to go through and the other part of me is excited to finally be at this part of the journey where I can actually see forward motion and I've heard other guys talking about their experiences and can finally chime in with my own.

I just got the blood tests-- don't know if I got an A yet.
But anyway basically the doc said unless it was extremely high. It never has been anyway.
But I am guessing a lot of it for me is stress. I understand if you measure cholesterol of soldiers it will pretty much be sky high. Take the same soldiers at home and it settles down again. So I'd guess some of the cholesterol level is NOT T, but dealing with the stress of transitioning. Take the same guys 2 years later and it might settle down again. This is all a guess on my part, don't think any research would be done on this.

--Jay

Quote from: aleon515 on February 15, 2013, 03:27:55 PM
I just got the blood tests-- don't know if I got an A yet.
But anyway basically the doc said unless it was extremely high. It never has been anyway.
But I am guessing a lot of it for me is stress. I understand if you measure cholesterol of soldiers it will pretty much be sky high. Take the same soldiers at home and it settles down again. So I'd guess some of the cholesterol level is NOT T, but dealing with the stress of transitioning. Take the same guys 2 years later and it might settle down again. This is all a guess on my part, don't think any research would be done on this.

--Jay

Good luck with the test! This is the first time I've ever had it checked (at least that I know of) so I don't know how it is usually but I can say that I've been under a lot of stress at work lately. I know, I should get a little Zen garden for my office 

Quote from: Devin87 on February 15, 2013, 01:30:04 PM
That's ridiculous.  The whole cholesterol thing is based on horrible science that has never stood up in a single study.  The levels for "healthy" cholesterol are completely arbitrary and the only thing studies have consistently shown is that people with slightly higher cholesterol have lower mortality rates and people with low cholesterol are more likely to get cancer and have strokes.  What ever you do-- don't let them put you on statins.

Cut sugar, grains and especially anything processed.  Shop around the outside of the supermarket.  Concentrate on vegetables, protein and fat-- meat, eggs, olive oil-- good whole foods.  It'll raise your HDL which will lower your LDL to pass the tests, but again-- cholesterol is mostly an arbitrary number and the only reason we became so obsessed with it was because it was one of the only things doctors in the 50s had the capability to easily measure, so they started attributing everything to it.

You have got to be kidding me.  Who led you to believe that?  Are you even in the healthcare field?  What studies have you been reading?  Lipids are a lot more complicated than simple "good" and "bad" cholesterol.

I'm a little worried about this. I have high cholesterol but it's completely genetic (as far as they can tell). I'm a long distance runner, have always eaten healthy, and I have a bmi around 19. Diet and exercise aren't everything. I know people with really crappy diets who have good cholesterol and vice versa, so it always feels a bit like voodoo to me (I know it isn't though).

Anyways, the genetic component: just something to keep in mind. Of course then it's like, what then? Is there some hard limit where they won't prescribe T no matter what?

Quote from: Adio on February 15, 2013, 06:09:51 PM
You have got to be kidding me.  Who led you to believe that?  Are you even in the healthcare field?  What studies have you been reading?  Lipids are a lot more complicated than simple "good" and "bad" cholesterol.

Why does someone have to be in the healthcare field to do their own research and recognize bad science when they see it?  It really just takes a functioning brain with average to slightly above average intelligence and the willingness to do the reading and wade through the data. 

The entire lipid hypothesis was first invented by Ancel Keys, who collected data on heart disease and cholesterol from 22 countries, picked the 7 that fit his theory that high cholesterol leads to heart disease, threw out the other 15 which didn't fit, and presented his data to Congress, which completely bought it, despite the fact that the majority of doctors at the time did not agree with Keys' research (because it was bad science).  No study that has been done since to try to prove high cholesterol raises risk of death from heart disease has ever actually proven that.  There was the Framingham Study that followed 5,100 Framingham, MA residents for two decades and tracked their dietary habits, cholesterol and rates of heart disease.  They found cholesterol has no predictive value as to deaths from heart disease.    There was the Western Electric Company study that followed 5,400 men and showed the men with lower cholesterol had a higher level of overall mortality.  Then there was the MRFIT sudy which followed 12,000 men with very high cholesterol (over 290 mg/ml) for seven years and split them into two groups-- one group told to do everything the way they were doing and one that was told to quit smoking, eat a cholesterol-lowering diet and treat their high blood pressure.  Their cholesterol and blood pressure went down yet they had higher rates of death including a higher risk of lung cancer despite the fact that 21% of them quit smoking compared to just 6% of the control group, which led the researchers to hypothesize that the lower cholesterol levels increased their overall risk of cancer.  The study that's usually cited as being the conclusive proof that high cholesterol causes heart disease and the one that sparked the famous frowning bacon TIME magazine cover took 3,800 men with high cholesterol, told them all to eat fewer eggs, fatty meat and drink less milk and gave half of them a placebo and half a cholesterol-lowering drug.   The cholesterol levels in the diet group dropped 4% and the levels in the statin group dropped 13%.  In the non-treatment group, 30 men died of a heart attack.  In the treatment group (which lowered cholesterol), 38 men died from a heart attack.  A difference of a whopping 0.2%.  And this was the groundbreaking study that cemented the "lower your cholesterol" believe into our society.  There's more, but I think that's more than enough for now.  It's a shaky history of claims being made with no evidence to back them up, studies constantly failing to prove those claims, yet the health care industry still jumping to make them because that's what the media was publishing and doing something, even if it might not do any good and may actually cause harm, was seen as better than doing nothing. 

And now there's a multimillion dollar industry formed around cholesterol-lowering drugs, low fat foods, and the AHA "heart check seal" costs companies tens of thousands of dollars to get on their products, so you know no one's going to do anything any time soon to start looking in another direction despite the fact we've been doing exactly what they've been telling us to do and things have only gotten worse since the 80s.

And I sure as heck know that it's not just good and bad cholesterol.  There's LDL, HDL, VLDL, triglycerides, etc, but for the sake of getting on T, all the guy's doctor seems to be caring about is his LDL.  It's not just laypeople who oversimplify.

For anyone interested in learning a good deal about the history of cholesterol and diet (mostly in America, but gradually this changed the recommendations through the world) which looks with greater detail into these studies, check out the book Good Calories, Bad Calories by Gary Taubes.  It's pretty science heavy and there's a lot to it-- it's a commitment, but it's the best introduction out there.

And I know this is a very controversial topic.  I don't expect everyone to agree with me.  I just hope everyone does their own research and chooses their diet and health regimen based on their own research and study and not based on what the media tells them or even their doctor (not that I want you to disagree with everything your doctor says-- just research it and learn on your own to supplement what he tells you and realize even modern medicine isn't perfect).  Agree with me, disagree with me-- just think for yourself.  That's all I ask.

I agree with the cholesterol thing being b.s. I personally know a few people in the medical industry (as well as a nutritionist with a PhD) and they agree basically with what Devin87 is saying.

I'll also add that the pharmaceutical industry is still raking in millions on cholesterol drugs – even though almost all of them have lawsuits against them that they're actually detrimental to health.

There's also clear evidence that cholesterol levels can be genetic. I have almost the same levels as my dad I found out when I had a blood test last year. And the level was in the "high" range.

You want a real indicator of cardiovascular health check your c reactive protein levels.

I'm sure it's not all bunk or all proven. But the things that can help lower it are good for other reasons and totally worth putting effort into.

Quote from: Felix on February 16, 2013, 09:37:45 AM
I'm sure it's not all bunk or all proven. But the things that can help lower it are good for other reasons and totally worth putting effort into.

Some is, some isn't.  Exercise is good for you.  Quitting smoking obviously.  Eating more vegetables is good.  But ever since we started eating less fat and more grains we've gotten fatter and sicker than ever (and studies show the average American, at least, actually DID cut the amount of fat in the diet from about 45% of the diet to about 35%, so people ARE eating less fat than ever).  More people diet and exercise than ever yet people are fatter than ever.  We completely changed the macro-nutrient makeup of our diet in the past few decades and, honestly, it's not working out too well for us.  We're just concentrating on the wrong thing.

Quote from: Devin87 on February 16, 2013, 10:12:39 AM
Some is, some isn't.  Exercise is good for you.  Quitting smoking obviously.  Eating more vegetables is good.  But ever since we started eating less fat and more grains we've gotten fatter and sicker than ever (and studies show the average American, at least, actually DID cut the amount of fat in the diet from about 45% of the diet to about 35%, so people ARE eating less fat than ever).  More people diet and exercise than ever yet people are fatter than ever.  We completely changed the macro-nutrient makeup of our diet in the past few decades and, honestly, it's not working out too well for us.  We're just concentrating on the wrong thing.

But that's old information. In my generation at least, cutting fat has never been a prevalent message and certainly not an explicit recommendation. I've never dieted in my life and I've never been asked to. I have been asked to not be sedentary and also not to eat fast food or drink soda. Honestly I still eat fast food when I can afford it and feel like it, but that's digressing. Anyway the fat thing is really old school and not current in any of the cities I've lived in or under the insurance plans I've been on.

You still sorta see the emphasis on cutting fat in evil marketing tactics by food companies. Stuff that is really not all that great for you has large print saying fat free! on the packaging, so some people buy it thinking they're doing something good for themselves.

That's marketing though and not doctor recommended, of course, so Felix's point is probably still true.

I know someone who was convinced that cutting out fat and living off pasta would make them lose weight. They never listened to my telling them it didn't work like that.

I can really see the sense in the primal thing, I've had really bad cravings for fresh veg and rare meat all week, but can't get any. It sucks.

Quote from: spacerace on February 16, 2013, 10:59:00 AM
You still sorta see the emphasis on cutting fat in evil marketing tactics by food companies. Stuff that is really not all that great for you has large print saying fat free! on the packaging, so some people buy it thinking they're doing something good for themselves.

I've always thought it was funny how companies will make crazy implications by announcing what isn't in their product. I mean like they could throw on a huge print colorful exclamation that the item contains no plutonium and it would probably increase sales.

@Felix: The thing is I think is that when Americans (say) started eating more grains and less fat, they also started eating more sugar, processed foods, and salt. I think if we ate less processed food, more veggies and fruit, more whole grains (and less simple sugars and starches), we would be better off. The amt of stuff some people eat with almost zero food value is very high.

I agree re: what is NOT said in the large print. I love these sugary cereals will say "added whole grain" or something. What it doesn't say is it has more sugar than a candy bar or the amt. added is about 1-2% of the total food in the box.

--Jay

Quote from: Felix on February 16, 2013, 11:37:16 AM
I've always thought it was funny how companies will make crazy implications by announcing what isn't in their product. I mean like they could throw on a huge print colorful exclamation that the item contains no plutonium and it would probably increase sales.

I saw lettuce in a bag proud of itself for being gluten free. thanks leafy vegetable, I was so sure you might have wheat in you.