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A big cocktail and I wasn't even offered an olive.

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  • A big cocktail and I wasn't even offered an olive.

    I had an MI 1 year ago. I'm a 67 year old male family history of heart disease, both parents with bypasses and they lived to late 80's. Four stents in each of my major blood vessels, MI from right coronary 100% blocked. Everything has been fine except dyspnea since taking medications, (shortness of breath). It is a listed side effect of Brilinta the blood thinner. Also the metoprolol has the same side effect. I've always had good blood pressure but the metoprolol drops it even further. Doctor doesn't want to change anything until my stress test in July. He doesn't seem concerned about it but I'm getting a little tired of it and started researching. Found Dr. Brewer, Dr. Bosworth etc...

    I would be interested in hearing anyones take on Brilinta. One of my Docs' said I'll always be taking it. After watching a lot of videos and reading I've decided I've got to do something. I've been fasting, 16/8 and keto for 7 weeks and I have lost 13 lbs, current weight 172 lbs, 5ft 10. I went from not taking any drugs to this almost overnight.
    Here's observations any comments would be helpful.

    Meds - Brilinta and aspirin, metoprolol, atorvastatin for heart, tamsulosin for BPH, pantoprazole for gerd

    My glucose ranges from 85 fasting, to 190 if I eat out at a fast food, which I did for the first time today since keto. Scary I didn't know that was happening! A normal glucose after keto meal is 110+/-, add a fruit/avocado smoothie and it goes to 130.

    My urine keto score is 4 sometimes 8, doesn't that sound crazy high? Unless I eat Chik-fil-a super food then I'm hanging on to a 1.5.

    My last blood test I had a TGL/HDL ratio of 2. Not good but Doc said it was fine.

    I get another blood test soon I'm hoping my HDL (38) will go up some and TGL (86) down.

    Any thoughts or ideas would be most helpful as this cocktail is getting old fast. Anyone else taking Brilinta, beta blockers and get off of them?
    Last edited by OldTech; 06-06-2019, 04:38 PM.

  • #2
    Can't help with the heart meds, sorry. But there are almost always alternative meds and are always alternative doctors. Your best doctor is yourself. I lost 40 lbs in 6 months and reduced my TGL/HDL ratio from more than 7.0 to 0.4 in about 2 years as a result of a strict, almost entirely carnivore, keto diet and taking rosuvastatin and niacin, among other supplements. Get a lipid and inflammation panel from Quest. Forget about ever again eating at restaurants. They all use vegetable oils, which are toxic. If you want a chicken recipe that's better than Chick-fil-a then check out Chef Ange on YouTube. His baked chicken thigh and asparagus recipe is amazing. Good luck.


    • #3
      To my limited understanding these days stents require life-long blood thinners, and Brilinta + aspirin has had good results. As with all drugs there are side effects, some of which aren't pleasant but may well keep you alive. I heard one cardiologist mention recently that no patients ever call him in the middle of the night to thank him for the heart attack/stroke that was prevented

      If you are well into ketosis, your muscles in particular become very insulin resistant. I have heard that the reason is that your body wants to preserve any available glucose for the brain and some other glucose-required functions (making DNA for new cells for instance and some other stuff). If you consume even a moderate amount of carbs while coming out of ketosis, you will see your blood glucose levels rise sharply. This can make it a bit difficult when a person on a keto diet goes to family functions that includes a lot of carb foods. If you go for a OGTT or think that you will be eating a good amount of carbs, you could ease back into carb burning, or just accept the temporary glucose bump if you go right back into long-term ketosis. You just don't want to be doing that every few days given the insulin that goes with that glucose spike.

      Your triglyceride level doesn't look all that bad, and so continuing to lower it may not increase your HDL-C much. Some people just genetically have lower HDL-C levels. The ones who have metabolic syndrome will often experience a significant increase in HDL-C by lowering triglycerides, but that doesn't seem to be your case. I lowered my triglycerides down to 34 mg/dL, but that didn't increase my HDL-C level from what it was when my triglycerides were in the mid 80's.

      Good luck on your health, and it is almost never too late to improve your future health by what you do today.

      In thinking about this a bit more, your beta-blocker metoprolol is likely prescribed to slow down your heart to help it heal and keep from further damage. You can ask your cardiologist if you have made enough progress with your lifestyle changes to reduce the dose of metopropol.
      Last edited by Tom; 06-07-2019, 03:45 AM.


      • #4
        Did anyone explain why Brilinta was chosen as the blood thinner?

        You are on the heart disease train and it is almost impossible to get off. Don't expect your doctor to try to stop or reverse your heart disease. What they are concerned with is you not having another cardiac event and keeping you alive. It took me several years to figure that out.

        You are unlikely to find a cardiologist that will help you stop the progression of your heart disease. Much of what you find on the Internet is what you should do BEFORE you have a cardiac incident. The lining of your heart arteries are damaged and now there are short pieces of artificial tube forcing them open. There is nothing stopping plaque from building up in the other parts of your arteries (before and after the stent),

        A ketogenic diet is great unless you have a genetic based problem digesting and metabolizing saturated fat or if you are either APOE 3/4 or 4/4 for Alzheimer's. If either of these are true, a diet high in saturated fat will probably make things worse,

        BPH is another tell as it means your prostate is inflamed. Your #1 objective is ti reduce inflammation throughout your body - teeth, prostate, bladder, heart, gut, and on and on. That's why you need to be sure a ketogenic diet that includes a lot of red meat and saturated fat is anti-inflammatory for you.

        Three ways you might find a great doctor.
        1. Make an appointment with Dr, Brewer
        2. Go to Bale/Doneen web site and use their provider search to see if there is an approved doctor in your area.
        3. Search for an integrative doctor in your area and ask if they treat heart disease.
        Last edited by rich; 06-07-2019, 08:15 AM.


        • Tom
          Tom commented
          Editing a comment
          I agree that most of what a person should consider relevant when they have advanced cardiovascular disease is really narrowed, and that is because a person has a much smaller margin of error that they can tolerate and stay healthy or even alive. Choose carefully for sure.
          Last edited by Tom; 06-07-2019, 10:39 AM.

      • #5
        Thanks to everyone's answers/suggestions. I've never been seriously overweight and have tried to take care of myself. Unfortunately, when you are suddenly rushed into an emergency room and doctors are doing things you don't really care what happens. No explanation for Brilinta, I think it is what the Doc likes, I'll ask again. I think it is the metoprolol that's causing the dyspnea if I don't take it I don't notice the shortness of breath. I have my annual review coming, stress test and I've have a lot of questions.

        I agree I do believe it is a serious inflammation problem. When I was in my 20's I had angioedema (serious swellings that look like hives), but no one ever diagnosed it. By 30 it just went away.