What does FAA think about high cholesterol?

L

LDL cholesterol

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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?
 
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.
 
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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.
 
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.
 
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.
 
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
 
My stroke was because of cholesterol. not good stuff.
 
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.
 
steingar said:
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.
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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.
 
Kenny Phillips said:
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.
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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.
 
steingar said:
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.
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Ok, Doctor steingar has now asserted that hitting your head in a fall at 70 will never kill you. Oh boy.
 
Salty said:
Ok, Doctor steingar has now asserted that hitting your head in a fall at 70 will never kill you. Oh boy.
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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?
 
steingar said:
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?
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More than I know that died from COVID.
 
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.
 
lsaway said:
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.
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I knew a pediatric respiratory therapist that smoked... when she was pregnant.

Knowledge does not guarantee good judgment
 
Salty said:
More than I know that died from COVID.
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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.
 
Extrapolation from your own experience to everyone else is so often flawed (this applies to each end of the spectrum).
 
steingar said:
Find 500,00 people who fell down and died and I'll believe you.
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Cervieres said:
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.
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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.

Bob Noel said:
Extrapolation from your own experience to everyone else is so often flawed (this applies to each end of the spectrum).
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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.
 
Salty said:
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.
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I agree with you. I understand the context and then people went off the rails, taking your answer out of context.
 
Bob Noel said:
I agree with you. I understand the context and then people went off the rails, taking your answer out of context.
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This is the whole problem with emotional argument. It's too difficult to see the flaws past your feelings. Think of the children!
 
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