Re: Zetia to lower cholesterol

From: Outrider (outrider_at_despammed.com)
Date: 11/09/04 

Date: 8 Nov 2004 16:30:34 -0800

Dr. Andrew B. Chung, MD/PhD wrote:
> Thanks Zee for your contribution :-)

Everytime I get it wrong you thank me for my contribution. What is it
NOW?

> You remain in my prayers, dear Zee whom I love, in Christ's wonderful
name
> :-)

Meaningless. You love everyone. Even Listener. Stop desperately loving
everyone.

Zee

>
>
> Servant to the humblest person in the universe,
>
> Andrew (still using andrew@heartmdphd.com despite rumours to the
contrary
> ;-)

>
> --
> Dr. Andrew B. Chung, MD/PhD
> Board-Certified Cardiologist
> http://www.heartmdphd.com/
>
> **
> Who is the humblest person in the universe?
> http://makeashorterlink.com/?L26062048
>
> What is all this about?
> http://makeashorterlink.com/?R20632B48
>
> Is this spam?
> http://makeashorterlink.com/?N69721867
>
>
>
>
>
> Outrider wrote:
>
> > {Zee top posting to be consistent with Mr. Mathes' choice}
> >
> > Mr. Mathes
> >
> > "Wrong" you said.
> >
> > The study author had this to say:
> >
> > "Indeed, these approximations and numbers are for the most part
> > correct,however there are some details regarding the
> > contributions from the bile that can confound these general
> > interpretations (ie endogenous versus exogenous and apoB derived
> > cholesterol versus apoB48 derived cholesterol).
> >
> > "...over a 24-hour day period, Chylomicrons have the ability to
> > turnover or metabolise more cholesterol than the LDL pool. One of
the
> > concepts that is largely underestimated, is the fact that
chylomicrons
> > have significantly greater affinity for the LDL receptor (via apoE
> > ligand) compared to LDL itself (via apoB100). As a consequence,
> > chylomicrons are cleared very rapidly from the circulation
(clearance
> > half-life is in the
> > order of minutes), as opposed to LDL which has a comparative
clearance
> > half-life of hours.
> >
> > Over the course of a day remember than Chylomicrons are secreted on
a
> > continual basis- even in the absence of dietary cholesterol due to
the
> > availability of cholesterol from the bile (endogenous reabsorption)
and
> > therefore chylomicrons can 'turnover' as many as 100 more pools of
> > cholesterol than LDL.
> >
> > We have published example calculations on several occasions to try
and
> > emphasise this point (this one is from
> > Clin.Exp.Pharm.Physiol. (1997 24,288-293);
> >
> > Average adult plasma pool = 3.0 litres
> > Average LDL-concentration of an individual 175 mg/dL
> > Turnover is one pool per day, therefore total cholesterol
metabolised
> > by LDL would be approximately 5.25 g/day (175 x10 x 3.0 x 1.0 =
5.25
> > g).
> >
> > In contrast, the average chylomicron concentration (based on
FASTING
> > levels) is approx. 5.0 mg/dL (ie much less than for LDL at any one
> > point in time) BUT...chylomicron turnover is approximately 100
pools in
> > a day. Therefore based on an equivalent calculation chylomicron can
> > metabolise up to 15.0 g/day! (5.0 x10 x 3.0 x 100 = 15.0g).
> >
> > Furthermore we estimate that this is probably a conservative value
for
> > Chylomicrons, as we spend most of time during the day in the
> > post-prandial state."
> >
> > P.S. I have a the full study if you would like me to send it to
you.
> > Zee
> >
> > Ed Mathes wrote:
> > > You said:
> > > >According to at least one study author, most of us eat a lot
more
> > > > cholesterol than our liver produces.
> > >
> > > Wrong.
> > >
> > > Dietary intake of cholesterol averages 0.4g/day.
> > >
> > > Cholesterol exists in the digestive tract in two forms: bile
salts
> > and
> > > cholesterol.
> > >
> > > Bile salts are secreted at a rate of 24 g/day,
> > > Cholesterol is secreted into bile at the rate of 2 g/day.
> > >
> > > The bowel is quite efficient....almost all bile is reabsorbed
with
> > fecal
> > > losses amounting to only 0.4g/day.
> > >
> > > We absorb 50% of our cholesterol (ingested and biliary
cholesterol),
> > or
> > > 1.2g/day (2g/day biliary cholesterol, 0.4g/day dietary
> > intake/2=1.2g/day).
> > >
> > > The body's total synthesis of cholesterol equals total fecal loss
> > (1.6g)
> > > minus dietary intake(0.4g), or 1.2g/day
> > > synthesized.
> > >
> > > So, as you can see.....we synthesis way way more than we take in
> > (1.2g/day
> > > made vs 0.4g/day consumed).
> > >
> > > Forget the theoretical chylomicrons in rabbits.....let's deal
real
> > world.
> > >
> > > As for Psyllium, pectin, etc....they do work, but in amounts that
> > exceed
> > > most people's capacity to ingest comfortably.
> > >
> > > Ed
> > >
> > >
> > >
> > > ----- Original Message -----
> > > From: "Outrider" <outrider@despammed.com>
> > > Newsgroups: sci.med.cardiology
> > > Sent: Sunday, November 07, 2004 10:36 PM
> > > Subject: Re: Zetia to lower cholesterol
> > >
> > >
> > > >
> > > > Ed Mathes wrote:
> > > > > This ignres the fact that 75% of absorbed cholesterol is not
> > ingested
> > > > as
> > > > > cholesterol but manufactured by the liver and dumped into the
> > > > intestine as
> > > > > bile.....
> > > >
> > > >
> > > >
> > > > How does it ignore it? Psyllium, oat bran, pectin and other
similar
> > > > foods carry cholesterol out of the intestine. Granted they may
not
> > do
> > > > this as effectively as the bile acid resins, but they do.
> > > >
> > > > And according to at least one study author, most of us eat a
lot
> > more
> > > > cholesterol than our liver produces.
> > > >
> > > > "{Proctor} has been examining the role chylomicrons play for
> > several
> > > > years, with colleagues at Curtin University of Technology at
Perth,
> > > > Australia. "You actually eat a lot more cholesterol than is
made by
> > > > your liver,' Proctor explains."
> > > >
> > > > Zee
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > > >
> > > > >
> > > > > "Outrider" <outrider@despammed.com> wrote in message
> > > > > news:1099875168.190059.50760@c13g2000cwb.googlegroups.com...
> > > > > >
> > > > > > Dennis Roark wrote:
> > > > > > > My physician has suggested Zetia (10 mg/day) to reduce
high
> > > > > > cholesterol.
> > > > > > > I cannot take statins, at least Lipitor produces
cognitive
> > > > > > difficulties
> > > > > > > both times I have begun taking it. I have no liver or
kidney
> > > > > > impairment,
> > > > > > > but am nevertheless concerned about the possible effects
of
> > Zetia
> > > > on
> > > > > > the
> > > > > > > liver. Both online sources and the drug insert say that
> > liver
> > > > enzyme
> > > > > >
> > > > > > > markers can increase with Zetia and should be monitored.
> > Does
> > > > anyone
> > > > > > have
> > > > > > > experience or knowledge regarding the risk/reward of
Zetia?
> > > > Should I
> > > > > > stay
> > > > > > > away because of the reported increase in liver enzymes?
> > > > > > >
> > > > > > > --
> > > > > > > Dennis Roark
> > > > > > >
> > > > > > > denro@sio.NOSPAMmidco.net
> > > > > > > Starting Points:
> > > > > > > http://sio.midco.net/denro/www
> > > > > >
> > > > > >
> > > > > >
> > > > > >
> > > > > > Mr. Mathes' comment: "It works by blocking the absorption
of
> > > > > > cholesterol at the brush border of the small intestine."
> > > > > >
> > > > > > Dennis have you considered dietary options to control your
> > > > cholesterol?
> > > > > > I believe the following foods would behave similarly to
Zetia's
> > > > brush
> > > > > > action. Presumably one could do both foods and Zetia if the
> > foods
> > > > > > failed to bring you to your desired level.
> > > > > >
> > > > > > Both NIH and Harvard nutrition sites advocate oat bran,
> > psyllium,
> > > > > > pears, kidney beans, barley, okra etc. So does this article
> > from
> > > > LEF
> > > > > > Magazine. I am not a proponent of supplements, but much
here is
> > > > just
> > > > > > food:
> > > > > >
> > http://www.lef.org/magazine/mag2004/nov2004_report_statin_01.htm
> > > > > >
> > > > > > Zee
> > > > > >
> > > >

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  • Re: Zetia to lower cholesterol
    ... > contributions from the bile that can confound these general ... > cholesterol versus apoB48 derived cholesterol). ... > turnover or metabolise more cholesterol than the LDL pool. ... > concepts that is largely underestimated, is the fact that chylomicrons ...
    (sci.med)
  • Re: Zetia to lower cholesterol
    ... > contributions from the bile that can confound these general ... > cholesterol versus apoB48 derived cholesterol). ... > turnover or metabolise more cholesterol than the LDL pool. ... > concepts that is largely underestimated, is the fact that chylomicrons ...
    (sci.med.cardiology)
  • Re: Zetia to lower cholesterol
    ... contributions from the bile that can confound these general ... cholesterol versus apoB48 derived cholesterol). ... turnover or metabolise more cholesterol than the LDL pool. ... is the fact that chylomicrons ...
    (sci.med.cardiology)