I received this
letter from a former medical-scientific colleague of mine (her name I withheld
for professional ethical reasons), but she gave me the permission to publish
her letter to me in pink below.
Dear Dr Lim,
I am so sorry
for not being in touch for a long time.
I sincerely hope
the problem with your leg has been resolved.
I fractured my
right wrist and a deep cut on my right eyelid which required 9 stitches
recently.
I had surgery to
put in a titanium plate. I am recovering well; range of motion is getting
better, but I still need to do exercises to regain strength on my right hand.
Dr Lim, may I
consult you on my results of cholesterol and glucose levels.
I saw an
Endocrinologist on 27/11/23 and my results are as in the Table below.
The
Endocrinologist prescribed Rosuvastatin Sandoz 10mg, once a day.
Till date I have
not started this medication. Do I need to start this statin?
For the last one
week, I have had a stomach-ache when I wake up, loose stool and a bit
dizzy.
I have had a
right frontal dull headache since mid-morning (I have this type of headache on
and off). Fingers on my right hand are numb now. I am not sure the numbness is
due to my injured right wrist. I still have stiffness and slight numbness on my
right-hand fingers in the morning.
Dr Lim, I really
appreciate your kind advice.
Thank you very
much,
(Signed by my former medical
colleague)
Here’s my reply and advice to her in
blue:
My dear Colleague,
I am sorry to hear about your fall,
the surgery you underwent, the numbness of your right hand and right fingers,
and your occasional headache.
Your numbness is almost certainly due to the pressure by the titanium plate exerting on the median nerve on the flexor muscles of the forearm and hand. There may be some inflammation there that may increase the pressure over the nerve for which you may need some antiinflammatory medication.
It may go away after some time with
physiotherapy and hand exercises, else go back to your surgeon if it does not
improve over time.
Meantime take Dyna Vitbion Forte tablets ( Vit B1, Vit B6 and Vit B12) tds (3 times a day) for your numbness.
As for your headache, your
symptomatic presentation sounds to be typical migraine. Take the herbal
medicine called “feverfew” one – two tablets in the morning. Try the local
pharmacy to get feverfew, else buy them online.
Also try to avoid harsh drugs for
migraine and chronic headaches like acetaminophen, ibuprofen,
triptans or erenumab, fremanezumab and galcanezumab.
Try also to
avoid foods like aged cheeses,
alcohol especially red wine, chocolate, cured and processed meats containing
nitrates, nitrites, and MSG. Also avoid artificial sweeteners, smoked fish and
food containing yeast extract, and also contraceptive pills which may not apply
in your case.
As for your total cholesterol, a trend
during these 4 years showed your total cholesterol was hovering around 9.3 mmol
/ L when preferably it should be less than 5.2 mmol / L.
But total cholesterol level per sec
does not mean anything desirable or undesirable since your HDL averages at 3.2
mmol/ L when the optimal HDL cholesterol level for females should
be between 1.2 - 1.3 mmol/L. Yours was very good.
What is
important to know is that HDL cholesterol levels are just one part of the
overall cholesterol profile. The lipid profile should include levels of
LDL cholesterol, total cholesterol, and triglycerides, in addition to HDL
cholesterol.
But your more harmful LDL was 5.75
mmol (which was given there as null for normal level). The optimal
LDL cholesterol level should be less than 2.6 mmol/L which means it may
be harmful if you let this LDL to be oxidized by free radicals into gummy
plagues that may block your coronary arteries of your heart that may
result in cardiovascular events such as angina pectoris (chest pains) or
AMI - heart attack, or a stroke in the cerebral vessels in your brain.
The risk is there if accentuated by high blood pressure.
However,
your total /HDL ratio was
2.9 when it should ideally be less than 5.0. Overall, your blood cholesterol
level is not very desirable if cholesterol was truly the cause of coronary
heart disease? See my comment and opinion on this here:
https://scientificlogic.blogspot.com/search?q=cholesterol
See also my
letter to Consultant ENT Surgeon Professor Andrew about:
The Truth about
Cholesterol, HDL and LDL and Heart Disease here:
Your FBS (fasting blood sugar) was
6.65 when the normal fasting blood sugar range is approximately
3.89 to 5.49 mmol/L. but given there as less than 5.6 mmol / L. A fasting blood
sugar level of 6.65 mmol/L may suggest impaired glucose tolerance or mild
diabetes or pre-diabetic status. However, a single elevated reading may not be
sufficient for a diagnosis. Other tests such HbA1C as a long-term duration of
existing diabetes showed that your HbA1C from 25/7/2019 till 14/11/2023 hovered around an average of 5.65 %
which is not too bad when the normal HbA1C is 5.7 %. I think you are just at
the border line (pre-diabetes status). Pre-diabetes and Type 1 diabetes can be
addressed through dietary means including using botanical medicine such as
consumption of bitter gourd, fenugreek (Trigonella foenum-graecum):
Fenugreek seeds have been studied for their potential to lower blood sugar
levels. They may also help improve insulin sensitivity, cinnamon (Cinnamomum
verum): Cinnamon is a spice that has been studied for its potential to improve
insulin sensitivity and lower blood sugar levels, ginseng (Panax ginseng): Some
studies suggest that ginseng may have anti-diabetic properties and could help
improve insulin sensitivity, aloe vera (Aloe barbadensis miller): Aloe vera has
been studied for its potential antidiabetic effects, particularly in type 2
diabetes, berberine: Although not a plant per se, berberine is an alkaloid
found in several plants, including goldenseal and barberry. It has shown
promise in improving insulin sensitivity and glucose metabolism, turmeric
(Curcuma longa): Curcumin, the active compound in turmeric, has
anti-inflammatory and antioxidant properties and may have potential benefits in
managing diabetes.
Some nutritional
products like a combination of chromium and niacin called ‘glucose tolerance
factor (GTF) help dramatically.
I have a lot of
clinical experiences using chromium and niacin to manage diabetes among staff
and colleagues working with me at the Institute for Medical Research in the
1970’s to 1980’s. The clinical efficacy with GFT is very high and impressive.
But I don’t
think you need to take anti-diabetic drugs such as sulfonylureas (glipizide,
glyburide, gliclazide, glimepiride), meglitinides (repaglinide and Nate
glinide, and the more popular biguanides (metformin) normally prescribed in
Malaysia or even using thiazolidinediones.
Try to avoid
using all these antidiabetic drugs. They don’t “cure” diabetes, as they need to
be taken every day just to control it. I don’t suggest you use all these
drugs either as yours is just pre-diabetes that can easily be controlled by
nutritional and dietary approach.
As for your
blood cholesterol I don’t think Rosuvastatin, Atorvastatin (Lipitor),
Simvastatin (Zocor), Pravastatin (Pravachol) or any of these statins are
necessary as they can damage your liver. Use dietary approaches such as
oats and barley.
These
whole grains contain beta-glucans, a type of soluble fibre that can help reduce
LDL (low-density lipoprotein) cholesterol. Consume fatty fish rich in omega-3
fatty acids found in fatty fish like salmon, mackerel, and trout may help lower
triglycerides and increase HDL (high-density lipoprotein) cholesterol. Then
nuts like almonds, walnuts, and other nuts are rich in monounsaturated and
polyunsaturated fats, which may help lower LDL cholesterol. Cook food in olive
oil especially extra virgin olive oil, a source of monounsaturated fats that
may contribute to heart health. Plant sterols and stanols, compounds found in
small amounts in various plant foods They can help lower LDL cholesterol. Avoid
margarine, white refined sugar especially. Use raw garlic as some studies
suggest that garlic may have a modest cholesterol-lowering effect. I suggest
turmeric that has curcumin, the active compound in turmeric with antioxidant
and anti-inflammatory properties that may have cardiovascular benefits. All raw
vegetables are very rich in antioxidants that will prevent the oxidation of
harmful LDL cholesterol into gummy products that may stick on to the coronary
blood vessels as plagues. Drink green tea as green tea contains antioxidants
called catechins, which may contribute to heart health. Apples or any
tropical fruits that contain soluble fibre, which can help lower cholesterol
levels. Lastly, I suggest consuming legumes such as beans, lentils, and
chickpeas are rich in soluble fibre and can help lower cholesterol levels.
Fruits like avocado that are high in monounsaturated fats and may help improve
cholesterol levels. Some studies suggest that cinnamon may have modest
cholesterol-lowering effects. So do psyllium husk and oats.
!00 mg of
aspirin (standard dose of aspirin is 300 mg) a day after meals to thin the
blood is useful against heart attack and also against colon cancer. Salicylates
(in aspirin) are also found in abundance in curry powder. The Indians who eat
curries everyday have the lowest rate of colorectal cancer, but the Chinese who
don’t eat curry or very seldom, have the highest statistics in colon cancer
incidence.
Do this instead
of all dosing yourself with all those statin drugs as they may harm the liver
with long-term usage.
Kind regards and
get-well dear.
Lim ju boo
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