High cholesterol problem

[obgyn65]

You may find the AAFP practice guidelines helpful:
Improving Your Cholesterol with Diet and Exercise - May 1, 2010 - American Family Physician

Any advice for food variety and things i can try to lower cholesterol would be much appreciated. Thanks

 

[Buckeye]

I tend to agree with ProGolferWannabe

I have found over the past 10 to 15 years that I am a person whose cholesterol related numbers didn't change much with diet and had a dramatic improvement with a low (10 mg) dose of Lipitor.

I recently spent 6 months eating lowish carb - overall carbs were typically between 60 to 100 mg a day - net carbs usually between about 40 and 60. I found that some numbers improved with that regime and others were worse.

Numbers last summer before starting low carb after several months of not taking Lipitor (this was experiment to see if it was still needed after I had lost about 40 pounds):

Total Cholesterol - 182
HDL - 45
Triglycerides - 128
LDL - 111
Ratio 0 4.0

Also fasting glucose - 98

Coincidentally I started eating low carb about a month after this and was retested 6 months later (no Lipitor in the meantime)

Total Cholesterol - 205 (Higher)
HDL - 46 (very little change)
Triglycerides - 90 (lower)
LDL - 141 (higher)
Ratio - 4.5 (higher)

Also fasting glucose - 82


My physician did interpret the cholesterol numbers quite negatively and put me back on 10 mg Lipitor. I'm not quite as negative as he is. The increase in total cholesterol doesn't bother me and I like the decrease in triglycerides. I realize the increase in LDL might or might not be worrisome depending on what kind of LDL is being talked about. That said, I don't know if it is an increase in the large, fluffy kind or not.

I did like the decrease in glucose to 82. I have test results from several years ago that were in the high 90s and one of 103 about 10 years ago. I do credit the lower carb eating with this number lowering.

All of that said, I took lipitor for over 10 years and in the past found it had a dramatic effect on my cholesterol numbers ) for example from about 10 years ago: 155 total, 43 HDL, 88 LDL, 3.6 ratio after taking Lipitor compared to about 256 total, LDL 174, 195 triglycerides before Lipitor)

So my plan is to continue to eat as I've been eating (I aim for net carbs below 80) but also take 10 mg of Lipitor daily.

I'm really surprised you are taking Lipitor with a total cholesterol of 205 and the other good numbers with no other risk factors. You found what caused your cholesterol to be high which was the weight and the carbs. Your doc is really aggressive about pushing the meds. I would be finding myself a new doc.

 

[braumeister]

I'm really surprised you are taking Lipitor with a total cholesterol of 205 and the other good numbers with no other risk factors. You found what caused your cholesterol to be high which was the weight and the carbs. Your doc is really aggressive about pushing the meds. I would be finding myself a new doc.

I absolutely agree. The only thing that doesn't appear to be very good is the HDL, and statins won't raise that, so why bother?
Unless you have cardiac disease risk factors, I recommend looking into this to determine if you can quit the statin.

 

[Buckeye]

I absolutely agree. The only thing that doesn't appear to be very good is the HDL, and statins won't raise that, so why bother?
Unless you have cardiac disease risk factors, I recommend looking into this to determine if you can quit the statin.

Katsmeow will have to make the decision alone and against doctor's orders because the doc has made his preference known. Not many people will buck their doc but I think if Katsmeow does some reading, it will be clear that a statin is not indicated in this situation (based on the info provided).

 

[ProGolferWannabe]

I'm really surprised you are taking Lipitor with a total cholesterol of 205 and the other good numbers with no other risk factors. You found what caused your cholesterol to be high which was the weight and the carbs. Your doc is really aggressive about pushing the meds. I would be finding myself a new doc.

A few thoughts. We obviously do not know the individual's complete medical history and health status, and even if I did, I am not competently trained to make an assessment about what medication this individual should or should not be on. Obviously, this is why we go to a physician--to put ourselves in the hands of experts who are presumably more knoweldgeable than we are, and to help us make informed decisions. Having said that, we all should take some ownership of our healthcare, and try to understand what treatment options are available. If what we hear from our physicians is different that what we understand from our own research, we should ask teh Doctor why their recommended treatment is different from what we thought was "standard".

In this case, from the Mayo Clinic's website, "If you have high cholesterol, meaning your total cholesterol level is 240 milligrams per deciliter, or mg/dL, (6.22 millimoles per liter, or mmol/L) or higher, or your "bad" cholesterol (LDL) level is 130 mg/dL (3.68 mmol/L) or higher, your doctor may recommend you begin to take a statin. But the numbers alone won't tell you or your doctor the whole story."

The poster's LDL was, I believe 141. Being on statin should not be "surprising". In conjunction with the general guidelines above, and the fact that the OP is under a MD's care, the perscribing of a statin seems very reasonable to me. It may not be the only option, and it may not be every MD's recommended solution, but it certainly passes the "sniff" test.

 

[Buckeye]

It may not be the only option, and it may not be every MD's recommended solution, but it certainly passes the "sniff" test.

This doc's approach to health (aggressive intervention with pharmaceuticals, IMHO) wouldn't work for me but it may be right on target for Katsmeow.

 

[braumeister]

In my (limited) experience, every doctor I know focuses like a laser on one number only: LDL. Everything else is treated as unnecessary complication. They have limited time, and considering just this number saves them a lot of it.

As has been pointed out, the whole issue is quite complicated, but if you're willing to do a lot of research, I believe any intelligent person can make a fully informed decision that will be in his or her own best interest.

 

[Buckeye]

In my (limited) experience, every doctor I know focuses like a laser on one number only: LDL.

I have been very lucky to find a local physician who looks at the whole picture. He took a different turn a few years ago when he was seeing his efforts becoming focused on the right pharmaceutical to prescribe and his patients just dying a little bit slower, not attaining health. He took a step back and started looking at the foundations of health. He is much more concerned with diet (especially carbs and protein intake) and blood sugar levels than cholesterol levels.

 

[TromboneAl]

I wonder if younger doctors, with more recent training, have a more informed view of things like this.

In any case, if you rely on your doctor alone, it is a bit of a crap shoot, because two docs can have totally opposing views, and the advice you get will depend on which one you happen to choose.

Although the same can be said of Internet research (two different web sites can have totally opposing views), at least you can read many different viewpoints. But us humans tend to decide on one point of view, and then interpret everything in such a way to support that view.

It's a mess.

 

[Mulligan]

My doctor was trying to prescribe me Lipitor last year, even though all my readings were fine. I asked him why and he said there is not much protection for males in late 40's to 50's range where the "widow maker" occurs. He is in his late 50's and has been on it himself he said for over 10 years even though his levels were fine, too. I have resisted so far. I have changed my eating habits somewhat, but still more mainstream diet. I will test myself again shortly as it has been over a year.

 

[haha]

My doctor was trying to prescribe me Lipitor last year, even though all my readings were fine. I asked him why and he said there is not much protection for males in late 40's to 50's range where the "widow maker" occurs.

I can't quite understand what his meaning was. From my reading, the only protection offered by statins is for younger and middle aged men-exactly the group you are saying there is not much protection for.

Supposedly, little if any change in all cause mortality is found for women of any age, or for men over 65. (Elderly men!)

Ha

 

[Mulligan]

I can't quite understand what his meaning was. From my reading, the only protection offered by statins is for younger and middle aged men-exactly the group you are saying there is not much protection for.

Supposedly, little if any change in all cause mortality is found for women of any age, or for men over 65. (Elderly men!)

Ha

My wording was probably not complete. He definitely saw need for it for its intended purpose for everyone and of all ages, but I think he was trying to say that it should be used more than for its direct purpose of high cholesterial. He is a true believer in Lipitor. The possibility that it could prevent a " widow maker" was sufficient enough reason to take it in his mind. It might prevent the "out of the blue" heart attacks that happen to people in this age group. I think he was specifically mentioning this age group because we were both in it.

 

[Bluemoon]

In my family most of us have elevated cholesterol but there is no record of any heart disease. I have been keeping a record of my levels since 1987 (when I was 49) through now. I have used various statins over the years and was put on Lipitor in 2004. The changes since being put on Lipitor are very evident.

July 2004 (before Lipitor)
Cholesterol - 290
HDL - 38
LDL - 186
Tryglicerides - 331

November 2011 (w/Lipitor)
Cholesterol - 195
HDL - 43
LDL - 121
Tryglicerides - 161

I am pretty sedentary although I recently started walking 3-4 times a week. I am not on a strict diet but I try not to eat red meat more than twice a week. I have taken Omega 3 for many years.

 

[Bestwifeever]

...The fact her memory was starting to noticeably fail her and she was getting confused where she had never had that problem helped convince her the "cure" was much worse than the "problem." Things improved after she stopped taking the statin and I advised her to stop getting her cholesterol tested since why ask the question....

Is memory loss a side effect of statins?

 

[Bluemoon]

Is memory loss a side effect of statins?

I don't remember!

 

[Buckeye]

Is memory loss a side effect of statins?

The bolded area describes what happened to my MIL (found with a quick google search of Lipitor and memory loss). Started after she started taking a statin, stopped when she quit. She took a generic and that was about 5 years ago so it couldn't have been Lipitor.

The link between Lipitor and memory loss

Of the approximately eighteen million people using Lipitor in the United States, about two percent have reported side effects that involve memory loss. Reported memory loss can range from short-term memory loss, feelings of disorientation, and mild confusion, to profound loss of memory that has a strongly detrimental effect on everyday life.

While researchers are hesitant to attribute this kind of memory loss solely to use of Lipitor, many patients report a reduction in symptoms if they switch to a different cholesterol medication. (Note: Never stop or change your medications, or reduce your dosages, without consulting with your physician.)

Whether or not memory loss is caused directly by Lipitor, or by other factors, there are other measures you can take to help reduce any symptoms of memory loss and generally keep your brain functioning at its best.

Lipitor and Memory Loss | Does Lipitor Cause Memory Loss?

 

[Katsmeow]

I'm really surprised you are taking Lipitor with a total cholesterol of 205 and the other good numbers with no other risk factors. You found what caused your cholesterol to be high which was the weight and the carbs. Your doc is really aggressive about pushing the meds. I would be finding myself a new doc.

Well, I think your comments are "really aggressive." I actually really, really like my doctor. He is very thoughtful and we discuss pros and cons of various approaches. I didn't get into all the numbers but for example 12 years ago my total cholesterol 2as 248 and LDLs were 175. My doctor first had me attack it through diet and -- at the time -- I had very little success. It was only after several months of no results from diet that he had me try 10 mg of Lipitor which had a dramatic effect. Even then, after a couple of years he had me again try without Lipitor and again, the LDLs in particular skyrocketed.

More recently with losing weight and low carb eating he was fine with me trying to not take Lipitor again and I stopped for 6 months but the increasing LDLs did cause him to recommend the Lipitor again.

FWIW, he is not what I would call aggressive in pushing medication. However, he does believe in preventative action. I realize that many here do not believe that high LDLs mean anything or that high total cholesterol means anything. I have done a lot of reading on this subject and I am, frankly, undecided. It is possible that the US medical establishment is entirely wrong, but I'm not ready to rest my entire well-being on that assumption. I feel that 10mg of Lipitor a day is a safe medication that I feel comfortable taking in case the medical establishment is right with the conventional wisdom.

At the same time, I also think that cutting out refined carbs and losing weight also bring benefits and I intend to keep going in that direction as well. It really isn't an either/or thing.

 

[Buckeye]

Well, I think your comments are "really aggressive." I actually really, really like my doctor. He is very thoughtful and we discuss pros and cons of various approaches. I didn't get into all the numbers but for example 12 years ago my total cholesterol 2as 248 and LDLs were 175. My doctor first had me attack it through diet and -- at the time -- I had very little success. It was only after several months of no results from diet that he had me try 10 mg of Lipitor which had a dramatic effect. Even then, after a couple of years he had me again try without Lipitor and again, the LDLs in particular skyrocketed.

More recently with losing weight and low carb eating he was fine with me trying to not take Lipitor again and I stopped for 6 months but the increasing LDLs did cause him to recommend the Lipitor again.

FWIW, he is not what I would call aggressive in pushing medication. However, he does believe in preventative action. I realize that many here do not believe that high LDLs mean anything or that high total cholesterol means anything. I have done a lot of reading on this subject and I am, frankly, undecided. It is possible that the US medical establishment is entirely wrong, but I'm not ready to rest my entire well-being on that assumption. I feel that 10mg of Lipitor a day is a safe medication that I feel comfortable taking in case the medical establishment is right with the conventional wisdom.

At the same time, I also think that cutting out refined carbs and losing weight also bring benefits and I intend to keep going in that direction as well. It really isn't an either/or thing.

I guess I need to add "compared to my doc."

 

[Helen]

So, your are correct---not taking statins is one way to assure that you will avoid possible side effects, but you will subject yourself to the near certainty of having coronary heart disease.

Could you post a link to a medical article that backs up that statement? I don't believe your statement has scientific proof behind it. There are plenty of links posted in this thread of articles that say otherwise.

In regards to statins, plenty of people have had permenant muscle damage and that does not show up on a blood test.

 

[landover]

I can't quite understand what his meaning was. From my reading, the only protection offered by statins is for younger and middle aged men-exactly the group you are saying there is not much protection for.

I read some speculation that statin benefit is not because of lowering of colestrol but due to its anti-inflammatory properties.

 

[obgyn65]

It's not a mess as long as your provider follows the right protocols and recommendations.

It's a mess.

 

[ERD50]

It's not a mess as long as your provider follows the right protocols and recommendations.

Which ones are those, and how do we know that the 'right protocols and recommendations' are really what is best?

Can you provide the back up that tells us this? It sure seems like a mess to me, I'm just not seeing the studies that make it clear that taking statins is beneficial to ones health (not just that they change some numbers, I want to see health results).

Let's not forget that not too long ago, the 'right protocols and recommendations' for treatment of ulcers were thrown out the window.


-ERD50

 

[Buckeye]

So, your are correct---not taking statins is one way to assure that you will avoid possible side effects, but you will subject yourself to the near certainty of having coronary heart disease.

So how do we explain my MIL who had high cholesterol (around 300) and lived to nearly 95 with no indication of heart disease? There is much more going on that we understand when it comes to heart disease and cholesterol.

This article pretty much sums up my and my doc's opinion on cholesterol numbers and there relevance to heart attack risk.

What your cholesterol number really says - CNN.com

 

[haha]

Which ones are those, and how do we know that the 'right protocols and recommendations' are really what is best?

-ERD50

Of course because if these protocols and recommendations are not the ones that are best, they are not the right ones.

Like, if your stocks go down, you didn't buy the right stocks. Just do right, and buy only stocks that go up.

Ha

 

[ERD50]

Of course because if these protocols and recommendations are not the ones that are best, they are not the right ones.

Like, if your stocks go down, you didn't buy the right stocks. Just do right, and buy only stocks that go up.

Ha

And yes, that bit of circular logic did cross my mind as I typed!

-ERD50