What does FAA think about high cholesterol?

Discussion in 'Medical Topics' started by LDL cholesterol, Feb 25, 2021.

  1. While searching for FAA & cholesterol, I read this in the Aviation Medical Advisory Service (AMAS) article titled Cholesterol Reduction

    FAA Policy on Cholesterol Screening

    In the early 1990’s, the FAA considered measuring blood cholesterol in pilots in their Notice of Proposed Rulemaking changing FAR Part 67. Although no disqualification was recommended for elevated cholesterol levels, values above 300 mg% would have triggered a cardiovascular evaluation. Numerous objections from many interested parties were validated and the FAA dropped this proposal from the new FAR Part 67 adopted in September 1996. No blood testing is routinely required nor is any level of cholesterol disqualifying. However, nearly every cardiovascular condition requiring evaluation for the FAA includes a mandatory report of the pilot’s cholesterol, triglycerides and glucose levels.


    I have very high cholesterol TC & LDL, but combined with the rest of my lipid profile, I am not concerned. This is induced by a Low Carb diet, and I choose not to take statins. Doctor diagnosed Familial Hypercholesterolemia solely due to the high ldl with no other consideration or investigation. Does anybody know if the FAA would consider Familial Hypercholesterolemia a cardiovascular condition? In absence of any other cardiovascular condition, does the FAA have any authority to deny or defer a medical in this situation?
     
  2. Daleandee

    Daleandee En-Route

    Joined:
    Mar 4, 2020
    Messages:
    4,529

    Display name:
    Dale Andee
     
  3. steingar

    steingar Taxi to Parking

    Joined:
    Feb 6, 2007
    Messages:
    29,148
    Location:
    Land of Savages

    Display name:
    steingar
    Atkins died young, and had a history of heart attack and hypertension. Thought you should know. In fact, all the big time proponents of high fat low carbohydrate diets died young of or suffered heart attacks and stroke. Most of the proponents of vegetarian diets lived into their dotage and suffered no cardiopulmonary events at all.

    Even found a Youtube vid all about it.
     
    Last edited: Feb 26, 2021
  4. PaulS

    PaulS Touchdown! Greaser!

    Joined:
    May 29, 2007
    Messages:
    13,358
    Location:
    New England

    Display name:
    PaulS
    Don't know about the FAA, but if your doctor says get it under control, then get it under control. Had a friend who had high numbers in his late 20s, was nonchalant about it, refused statins. He had his heart attack about 20 or so years later, started on a New Years eve, fortunately he had a good outcome after walking around a few days during the attack in denial. One stent, widow maker artery like 99% blocked. Doctor told him he was hours away from a massive heart attack, fortunately his wife flipped out on him and made him go to the er after he was getting ready for work, in pain, 2 days after he his pain started. He listens to the doctor now.
     
  5. TailWheelChamp

    TailWheelChamp Pre-Flight

    Joined:
    Feb 17, 2021
    Messages:
    38

    Display name:
    Tail Wheel Chump
    I've always been skinny (bmi never ^ 20), but I've always had highcholesterol.

    In my twenties it was 240 (bmi of 17). However my HDLs were 90 to 100. Because of the high HDLs I was told it was no problem.

    Well, later on, in my late 30s, the guidance changed. They didn't care how high my HDLs were, and put me on statins. Well, I'm in the unlucky category and statins broke my blood brain barrier. I totally lost my memory. I would walk into a room and have no idea what the hell I walked in there for. Got off statins, and two weeks later, I was back to normal. Whatever that is for me.

    Anyway, they are not a silver bullet, many doctors consider them poison and avoid them at all cost. I know I'll never consider taking them again.
     
  6. brcase

    brcase En-Route

    Joined:
    Jun 11, 2008
    Messages:
    2,504
    Location:
    Boise, Idaho

    Display name:
    Brian
    Taking Statins is easy, Dealing with Coronary Heart Disease is hard.
    If you Dr recommends Statins or other Faa approved medication do it.

    Brian
    CFIIG/ASEL
     
    PaulS and ArnoldPalmer like this.
  7. I do appreciate everybody's concerns and advice. I get that it is difficult to defend myself when going against the populous view of normal. This is why I am hoping I will never have to battle the FAA over this, because it will most likely be futile. I am far from nonchalant about it. I dove deep into understanding cholesterol, lipids, and statins. This is a summary of what I think I learned and is not intended to be medical advice.

    LDL is essential for health, but not all LDL is equal, and there are many subclasses and sizes. The standard lipid panel does not tell the whole story. It is proven that oxLDL (oxidized LDL) contributes to atherosclerosis, not LDL. A person with low LDL & TC can have a high oxLDL and not know it, putting them at a higher risk of atherosclerosis. There is also remnant cholesterol that has been shown to have more potential to be atherogenic than high LDL. To really know my entire lipoprotein profile, I needed advanced lipid test. NMR & Subfractionation are 2 examples.

    What causes LDL to oxidize? Carbohydrates, sugar, trans fat, vegetable oils, metabolic syndrome, diabetes, inflammation. LDL turns bad when exposed to sugar, so triglycerides are what need to be watched closely since they carry the glucose. The triglycerides/HDL ratio is a much better indicator than LDL or TC total cholesterol. Low triglycerides and high HDL with a ratio of 1.5 or less is the best profile, according to many doctors.

    I have taken and analyzed the advanced lipid tests. I am insulin sensitive, normal bmi, normal blood pressure, low hba1c, 0.9 trig/hdl ratio, low remnant cholesterol, and this is the result of a very low carb diet. I am in a steady state of ketosis. I avoid all the known foods that cause LDL oxidation, and most of the fats I eat are anti-inflammatory and do not oxidize LDL (monounsaturated and unsaturated).

    My cholesterol was normal on a typical Western Diet. LDL & TC only started climbing when I stopped eating junk food & carbs. My PCP had no explanation and didn't know anything about advanced lipid testing. Advanced lipid testing suggest I have a low risk of CVD, even with the high LDL TC.

    My view on Statins is that at first I was for taking them until I investigated. I discovered that the liver adds a little coQ10 to each LDL particle to help prevent it from oxidation. Statins reduce the production of coQ10 and makes LDL more exposed to oxidation, and reduction in CoQ10 production is likely to have a deleterious effect on heart function. For now, I will continue to order advanced lipid test and keep an eye on the truly bad cholesterol: oxLDL, sdLDL, & remnant, instead of thinking statins will fix everything.
     
    A1Topgun likes this.
  8. PaulS

    PaulS Touchdown! Greaser!

    Joined:
    May 29, 2007
    Messages:
    13,358
    Location:
    New England

    Display name:
    PaulS
    I don't think the FAA is too concerned about cholesterol unless you have other things going on too, but don't go by my word, wait for one of the AMEs to check in.

    I know people have issues with statins, but generally if one type of statin gives an issue, another won't. I've been on them for at least 20 years now, never had an issue. My doc makes me see a cardiologist every year due to family history, the cardiologist told me a while back that they are finding cholesterol level is less of an issue if you are taking a statin than if you are not. It seems that the ability of statins to prevent inflammation in arteries is key to preventing or delaying arterial issues. That's what he told me, in fact he told me the statins are so good if he could put it the drinking water he would. I can only hope he is correct.

    I've read the articles about side effects and this and that. I've read about people with memory issues, liver issues and what ever. If stuff like that happens to you then you should switch up and try another. Or you can refuse, like my friend did, maybe your outcome will be better, time will tell.

    I get a blood test every 6 months to monitor for issues, no big deal.

    I've also read about good cholesterol and bad cholesterol and diet, I'm pretty careful with diet anyway. But I am far from qualified to make the determination that I should follow that information over the advice of my Harvard Medical school graduate board certified cardiologist. YMMV
     
  9. Tom-D

    Tom-D Taxi to Parking

    Joined:
    Feb 23, 2005
    Messages:
    34,741

    Display name:
    Tom-D
    My stroke was because of cholesterol. not good stuff.
     
  10. ibflyer

    ibflyer Filing Flight Plan

    Joined:
    Mar 7, 2021
    Messages:
    5

    Display name:
    Rob
    As a family doctor and AME I would say that high cholesterol values and the medicine use to treat it are not a problem for certification. The consequences of not treating, ie premature strokes and heart attacks are big certification issues.
     
    PaulS likes this.
  11. Kenny Phillips

    Kenny Phillips Final Approach

    Joined:
    Jul 29, 2018
    Messages:
    5,074

    Display name:
    Kenny Phillips
    Atkins died at a "young" 72, of a brain bleed caused by a fall. Thought you should know. Your statement following that is suspect, and likely false.
     
    Groundpounder and Daleandee like this.
  12. steingar

    steingar Taxi to Parking

    Joined:
    Feb 6, 2007
    Messages:
    29,148
    Location:
    Land of Savages

    Display name:
    steingar
    No one healthy dies in their early 70's from a simple fall. He had a ton of underlying issues and might have failed from an infarction.
     
  13. Salty

    Salty Touchdown! Greaser!

    Joined:
    Dec 21, 2016
    Messages:
    11,932
    Location:
    FL

    Display name:
    Salty
    Ok, Doctor steingar has now asserted that hitting your head in a fall at 70 will never kill you. Oh boy.
     
  14. flyingron

    flyingron Administrator Management Council Member PoA Supporter

    Joined:
    Jul 31, 2007
    Messages:
    22,915
    Location:
    Catawba, NC

    Display name:
    FlyingRon
    Deceleration trauma. It's not the fall that kills you, it's the abrupt stop at the end.
     
    BrianNC and TCABM like this.
  15. steingar

    steingar Taxi to Parking

    Joined:
    Feb 6, 2007
    Messages:
    29,148
    Location:
    Land of Savages

    Display name:
    steingar
    Like I said, he had a crapload of underlying maladies. He wasn't healthy by any stretch of the imagination, and I'd be shocked if his underlying conditions didn't play into his demise. How many other people do you know who've died from just falling down?
     
  16. Salty

    Salty Touchdown! Greaser!

    Joined:
    Dec 21, 2016
    Messages:
    11,932
    Location:
    FL

    Display name:
    Salty
    More than I know that died from COVID.
     
    Groundpounder and BrianNC like this.
  17. crash7

    crash7 Line Up and Wait

    Joined:
    Nov 23, 2008
    Messages:
    518

    Display name:
    Crash7
    Well played...


    Sent from my iPhone using Tapatalk
     
    BrianNC likes this.
  18. BrianNC

    BrianNC En-Route

    Joined:
    Feb 2, 2009
    Messages:
    2,965
    Location:
    Atlanta

    Display name:
    BrianATL
    He didn't die 'from just falling down'. He died because he hit his head on concrete when he fell down. Yes, people die from that no matter what their age even if they are healthy.
     
    Kenny Phillips and Daleandee like this.
  19. lsaway

    lsaway Pre-takeoff checklist

    Joined:
    Dec 8, 2019
    Messages:
    266

    Display name:
    lsaway
    Dr. Atkins was obese at 258 pounds when he died. Everybody I know that is on a legitimate LCHF diet has trouble keeping weight on, even if they used to be obese when they started. Just because Dr. Atkins created the Atkins diet, it doesn't necessarily mean he followed it in his later years.
     
  20. Tarheelpilot

    Tarheelpilot Final Approach PoA Supporter

    Joined:
    Dec 5, 2010
    Messages:
    6,924
    Location:
    North Carolina once again.

    Display name:
    Tarheelpilot
    I knew a pediatric respiratory therapist that smoked... when she was pregnant.

    Knowledge does not guarantee good judgment
     
  21. lsaway

    lsaway Pre-takeoff checklist

    Joined:
    Dec 8, 2019
    Messages:
    266

    Display name:
    lsaway
    Do as I say, not as I do.
     
  22. steingar

    steingar Taxi to Parking

    Joined:
    Feb 6, 2007
    Messages:
    29,148
    Location:
    Land of Savages

    Display name:
    steingar
    Find 500,00 people who fell down and died and I'll believe you.
     
    172andyou likes this.
  23. Kenny Phillips

    Kenny Phillips Final Approach

    Joined:
    Jul 29, 2018
    Messages:
    5,074

    Display name:
    Kenny Phillips
    "number of deaths due to falls in the United States was 37,455 in 2018"
     
  24. Cervieres

    Cervieres Pre-takeoff checklist

    Joined:
    Jun 5, 2020
    Messages:
    285

    Display name:
    Antione
    I’ve had three acquaintances in the medical field die from Covid in the last 12 months, none from falls. This kind of denial ceased to be amusing a long time ago.
     
  25. Bob Noel

    Bob Noel Touchdown! Greaser! PoA Supporter

    Joined:
    Jun 7, 2008
    Messages:
    20,570

    Display name:
    Bob Noel
    Extrapolation from your own experience to everyone else is so often flawed (this applies to each end of the spectrum).
     
    Tarheelpilot and PaulS like this.
  26. BrianNC

    BrianNC En-Route

    Joined:
    Feb 2, 2009
    Messages:
    2,965
    Location:
    Atlanta

    Display name:
    BrianATL
    Not an insignificant number in light of such a ‘benign’ act.
     
  27. Salty

    Salty Touchdown! Greaser!

    Joined:
    Dec 21, 2016
    Messages:
    11,932
    Location:
    FL

    Display name:
    Salty
    He asked how many people do I KNOW. I don't know 500,000 people who died of COVID. I actually still don't know a single person personally. I know people that know people, but I'm not aware of anyone I personally know that has died of it.

    This is true, but it is not the context of the question he asked. He asked for my personal experience. I knew two people that have died from hitting their head in a fall, and none that have died of COVID. The moral of this, is that his original taunt to me was filled with flawed logic. I simply used valid logic to demonstrate the flaws.
     
  28. Bob Noel

    Bob Noel Touchdown! Greaser! PoA Supporter

    Joined:
    Jun 7, 2008
    Messages:
    20,570

    Display name:
    Bob Noel
    I agree with you. I understand the context and then people went off the rails, taking your answer out of context.
     
  29. Salty

    Salty Touchdown! Greaser!

    Joined:
    Dec 21, 2016
    Messages:
    11,932
    Location:
    FL

    Display name:
    Salty
    This is the whole problem with emotional argument. It's too difficult to see the flaws past your feelings. Think of the children!