70 year old patient with an elevated CAC score after 2 years on a LCHF diet? – Nutrition Network Responds

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The Nutrition Network recently received a question from a member, regarding a 70 year old patient who showed an elevated CAC score after following a LCHF diet for 2 years.

Question: 

I’m an OBGYN NP.  2 years ago one of my 70 year patient’s was complaining about weight/fatigue/pre-diabetes. I introduced her to The Obesity Code/IF/LCHF. She ran with it and has never felt better! Routinely 16/8.  LCHF, more in the 80% carnivore. Weight went from 185 to 147. She’s off all meds. Her CAC was 237 on 4/10/19 and 255 on 6/2/20.

I’m not her PCP, but he is wanting her to go on a statin with the elevation in the CAC. Her comment “I’m 72 years old and feel amazing”. If the statin would reduce my risk for a cardiovascular event by 5-10%, then no thank you”.

What am I missing with the elevated CAC?

Response by Dr. Neville Wellington

This is a dilemma for some. While her calcium score is high, she has clearly done well and a LCHF diet may well have ‘healed’ more plaques by changing diets and improving inflammation. Possibly this may explain the slight increase. The Lipogram trend is towards lowering trigs and increasing HDL, which is a good thing.

It would be interesting to know what her glucose, HbA1c levels have done.

Personally, I would not be treating a 70 year old woman with statins, unless they had had a heart attack, were a smoker and were not prepared to change lifestyles. This lady has done so well her benefit from statins would be minuscule, but side-effects may outweigh any benefits, in my humble opinion.

You may find this article by Malcolm Kendrick useful.

https://drmalcolmkendrick.org/?s=Calcification&submit=Search.

I am not aware of any risk scores using CAC scores that would define when statins should be used. I used the Reynolds Risk and had to assume her Systolic BP was 140 and hsCRP of 1. The score comes out at a 9% chance of having a MI in 10 years, which is still below the threshold for giving statins.

The site is www.reynoldsriskscore.org.

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