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Need help: Not sure whether to start medicine on lowering cholesterol level
Old 09-16-2014, 11:40 AM   #1
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Need help: Not sure whether to start medicine on lowering cholesterol level

Apologies if this is rather long but I need advice and views. I have high cholesterol for more than 10 years. And since 2006, total cholesterol has went up above 7.5. Every year the numbers fluctuate slightly but does not differ much from my last month's results which are - Total cholesterol is 7.7mmol/L. HDL is 1.8 and LDL is 5.3. Chol/HDL ratio is 4.2. Triglycerides is 1.1. My sugar levels are ok. This year I seem to have fluctuating BP and did go for many tests which only concluded I have fluctuating BP. BP taken at home are usually normal but when I go to the clinic or hospital, the readings are usually high. My last clinic reading last month was 134/91. No doctors have suggested medication to lower my cholesterol until this year. I've been getting a few doctor's opinions and once they look at my numbers, they suggest I take medication. Only one GP (my usual GP) did not ask me to be on medication but to increase lifestyle changes. I started last year taking oats, exercising more and cutting down on high cholesterol food. She also referred to the Cardiovascular Risk Prediction Charts and said that I fall into the green group < 10% CVD risk over the next 10 years.
Cardiovascular Disease Risk Prediction Charts - HEART UK | Expert advice from HEART UK

I know these charts are just indicative and given I am now 54 years old, I wonder whether I should indeed start medication to lower my cholesterol. I exercise everyday for 1 hour.Jogging/brisk walking, yoga, golf. I don't smoke. I am not overweight. Some of my sisters have high cholesterol and are already on medication.

So, can anyone share what made them decide to go on medication, how long they had be on medication before cholesterol numbers were within normal range, what type and amount of medication and side effects. Many Thanks.


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Old 09-16-2014, 12:07 PM   #2
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First of all, I am not a doctor. My sister is, but I don't think that counts!

Your situation seems to be similar to mine; borderline high in total, but lots of good cholesterol. One measure my doc just added is non-HDL cholesterol and your numbers look OK by that measure. I'm 61, also normal weight, in otherwise good health and very active.

Five years ago I started on Prevastatin at my doctor's suggestion. Six months later I had tendonitis that was so bad it hurt to raise a spoon to my mouth with my right hand. That's not me. I can go for a year without needing a pain reliever of any kind. I was starting to feel twinges in my knees. I threw the darn pills out. My numbers are still similar to yours (good cholesterol went up after I stopped the pills!).

My own personal decision: I stopped taking cholesterol-lowering drugs and will continue to control levels through diet and exercise.
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Old 09-16-2014, 12:09 PM   #3
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So, can anyone share what made them decide to go on medication, how long they had be on medication before cholesterol numbers were within normal range, what type and amount of medication and side effects. Many Thanks.
When I was in my late 50's (or maybe 60? I forgot), my doctor told me my cholesterol was too high and my good and bad cholesterol were out of whack too. I was on no other regular medications at that time. He said he wanted to put me on cholesterol medication, and asked me if I wanted to try lifestyle changes first.

I chose the latter, but after 6 months at my next routine appointment, my cholesterol was even worse despite my efforts. So, I decided to try cholesterol medication. My doctor put me on Vytorin 10/20.

Before the six months had passed for my next routine appointment, my cholesterol numbers had all transitioned into the very ideal range, where they have stayed ever since. I guess that has been 7 years by now, give or take a year. I have had no side effects.

I'd suggest trying 6 months of lifestyle change, and then you will have more information - - you will know whether or not lifestyle change is going to help or not in your case. Sometimes heredity plays a big role.
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Old 09-16-2014, 12:15 PM   #4
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Thanks WR2. So, did you stop the medication after 6 months as your cholesterol levels fell within range? I had tried lifestyle changes. It helped a bit but not good enough.


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Old 09-16-2014, 12:23 PM   #5
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When I was in my late 50's (or maybe 60? I forgot), my doctor told me my cholesterol was too high and my good and bad cholesterol were out of whack too. I was on no other regular medications at that time. He said he wanted to put me on cholesterol medication, and asked me if I wanted to try lifestyle changes first.

I chose the latter, but after 6 months at my next routine appointment, my cholesterol was even worse despite my efforts. So, I decided to try cholesterol medication. My doctor put me on Vytorin 10/20.

Before the six months had passed for my next routine appointment, my cholesterol numbers had all transitioned into the very ideal range, where they have stayed ever since. I guess that has been 7 years by now, give or take a year. I have had no side effects.

I'd suggest trying 6 months of lifestyle change, and then you will have more information - - you will know whether or not lifestyle change is going to help or not in your case. Sometimes heredity plays a big role.
Once you start taking the cholesterol drug do you need to keep taking it or only long enough to lower it to your desired levels.
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Old 09-16-2014, 12:25 PM   #6
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Thanks WR2. So, did you stop the medication after 6 months as your cholesterol levels fell within range? I had tried lifestyle changes. It helped a bit but not good enough.
No, I did not stop taking it because it was working and has continued to provide exactly the same great results. I have never even skipped one pill for cholesterol since then.

I had already proven to myself that lifestyle changes were insufficient to improve my cholesterol (in my case). My doctor said that was because my cholesterol problems had a hereditary component. That isn't always the case, though it is for some of us.
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Old 09-16-2014, 12:29 PM   #7
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Once you start taking the cholesterol drug do you need to keep taking it or only long enough to lower it to your desired levels.
Sorry to all that my post was unclear! OOPS

Yes, I am still taking Vytorin every night at bedtime. The dosage has not been increased but I am still taking it. No side effects.

The main problem is the cost because it is not yet available as a generic, but my doctor is reluctant to change it to something with a generic equivalent.
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Old 09-16-2014, 12:31 PM   #8
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Mine has been borderline high for a long time. A friend swears by red rice yeast and I have taken it but unfortunately not consistently enough to judge its effectiveness one way or another.
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Old 09-16-2014, 12:39 PM   #9
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You should do your own research on cholesterol and statins since few of us are qualified to give reliable advice. that said, my own research on the topic has convinced me that most doctors don't know much about it either. They simply parrot the guidelines which many doctors believe to be ridiculous. For what it is worth, DW and I took statins for more than a decade. She had significant muscle soreness - a know side effect. After a little research I concluded that statins were a net negative for me so so we both dropped them. Her muscle pain disappeared. Both of our cholesterol numbers went up. But, we then started eating low carb and our numbers vastly improved. Cholesterol containing foods (like eggs) are not a problem at all. Sugar is.
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Old 09-16-2014, 02:23 PM   #10
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I know you are going to get a bunch of confusing and conflicting advice and I only have little to contribute. The main thing point I can bring to the table is that current opinion is that Dietary Cholesterol does not contribute to your body chemistry -- yeah, you can eat all the eggs you want.

I can also point you to a very outspoken critic of Statins:

Dr. Malcolm Kendrick | Scottish doctor and author of 'The Great Cholesterol Con'

Beyond that there are large number of "Healthy Eating" Blogs that are (or should be) required reading. I could list them but there are many posts in this Forum that cover it better than I can here.
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Old 09-16-2014, 02:24 PM   #11
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But, we then started eating low carb and our numbers vastly improved. Cholesterol containing foods (like eggs) are not a problem at all. Sugar is.
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Old 09-16-2014, 03:14 PM   #12
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No doctors have suggested medication to lower my cholesterol until this year. I've been getting a few doctor's opinions and once they look at my numbers, they suggest I take medication.
...
I wonder whether I should indeed start medication to lower my cholesterol.
A bit of research seems in order (there's plenty of available information online, much of it wrong).

The question is WHY do these doctors suggest medication to lower your cholesterol?
Have you been given any explanation for it, apart from "these are the recommended guidelines."?
Have you seen any serious evidence that lowering your cholesterol is good for anything?

Obviously, I'm not a doctor, so my opinion may be utterly worthless (and you should NOT rely on it), but I think that a high HDL and low triglyceride level are the only things to strive for in this regard. That's what I've concluded based on my own research. If I were you, I'd consider doing some serious investigation of the topic before agreeing to put new drugs in my body.
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Old 09-16-2014, 03:36 PM   #13
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If I were you, I'd consider doing some serious investigation of the topic before agreeing to put new drugs in my body.
I couldn't agree more.

Again, I have no dog in this fight but am somewhat knowledgeable in spite of that. This is a stuff I picked up doing on doing research on Glucose intolerance.
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Old 09-16-2014, 03:38 PM   #14
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I'd have to see some pretty unequivocal statistics to get me to take any medications for rest of my life. Side effects and costs seem to make many of the meds of questionable value to me. I'll admit I have been blessed with good health supplemented by a fair degree of activity, but am very skeptical of many of the drugs. Especially if they are heavily marketed. Goes along with the philosophy of - if you have to sell me on it, I probably don't need it. And then there's all the marketing to the doctors. I know, I'm just a cynic.
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Old 09-16-2014, 04:25 PM   #15
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I've been on 20 mg pravastatin for probably 20 years. No side effects that I know of.

Recently I had a stress test which revealed that I had one artery 40% blocked. The other arteries are clear. My heart clinic tells me that my results are good for a 69 year old man. My heart clinic will not take corrective measures until an artery is 70% blocked. They also did a CT scan of the arteries in my throat which were also clear.

I have to give pravastatin at least part of the credit.

As a disclaimer, I have had other cardiovascular issues: high blood pressure, atrial fibrillation, atrial septal defect, DVT (Deep Vein Thrombosis), mini-strokes.
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Old 09-16-2014, 04:47 PM   #16
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Have you seen any serious evidence that lowering your cholesterol is good for anything?
This would be my concern. I once listened to an excellent podcast on the subject, shortly after new guidelines came out in the US that would roughly double the number of adults for whom cholesterol-lowering meds were recommended. Already 1 in 4 take them. It was "Sound Medicine" and, unfortunately, IUPUI (branch of Indiana U) no longer produces it so older ones may not be available. The doctor they interviewed was unconvinced that lowering cholesterol decreased risk of heart disease and said it was pretty much just changing an "abnormal lab result".

I've made the decision that in my case, with no major risk factors and a healthy lifestyle (I just did a 38-mile bike ride last weekend and felt I could have gone further!), statins would do more harm than good.
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Old 09-16-2014, 06:20 PM   #17
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This is likely the best mainstream explanation.

From the ancedotal evidence I have, the risk of side effects (especially myopathy) are understated. I was prescribed statins 10 years ago, but instead chose alternate treatment (especially fish oil), and so far I haven't croaked. But that's a small sample space. Statistics show that, if you don't have a major risk factor (previous heart attack, diabetes, smoking), then taking statins yields a negligible risk reduction. Since this remains an inexact science, I think that physicians are encouraged to over prescribe, rather than under prescribe, to err on the safe side, despite the risk of side effects.
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Old 09-16-2014, 11:27 PM   #18
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Thanks WR2. So, did you stop the medication after 6 months as your cholesterol levels fell within range? I had tried lifestyle changes. It helped a bit but not good enough.


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Were you aggressive enough with lifestyle changes? How about exercise? Could you get maybe 5 miles in most days?

Then there are eating habits. These changes are tough and not for sissies!
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Old 09-17-2014, 01:04 AM   #19
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About 15 years ago when I was in mid-40s I was put on Lipitor - 10 mg. My overall number was high, my HDL was borderline, just barely normal. My LDL was high. Triglycerides were OK. (I'm not familiar with numbers in your format so don't know how that translates to your situation).

I first tried dietary and exercise interventions. This was back in the dark ages and they recommended then a low fat diet so I tried that. It didn't help. Neither did exercise or anything else.

The Lipitor had a dramatic effect. Within a very short time, the numbers were really good. Now, whether that in fact reduced my cardiac risk (since I was so low risk overall) I have no clue.

I took Lipitor off and on until a couple of years ago. I would take it for a few years, then would want to not take it and would go off it awhile and the numbers would rise.

About 3 years ago I was hopeful things would be better. I lost 40 pounds and I was exercising regularly and I went on a low carb diet.

None of that helped. On the low carb diet my triglycerides went down (but they were already in the normal range), overall cholesterol and LDL went up (expected) and HDL went down slightly (not expected).

So, I started taking Lipitor again. About six months after that I moved and when my prescription ran out I just haven't found a new doctor here to get another one. I'm uncertain in my case whether to do it or not.
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Old 09-17-2014, 02:25 AM   #20
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Thanks everyone for the very helpful input. I have been doing a lot of research on this and heard different opinions from various doctors. One doctor used scare tactics on me saying that if I don't go on medication, I have a strong likelihood of heart disease. Another doctor just looked at my numbers and said I need to eat meds - I guess that seems a textbook interpretation.

I'll like to give myself another few more months to I make more lifestyle changes. I've cut down a lot on red meat, animal skin, shell fish, squid, goose liver, butter, milk, etc. (all the food I love). I mainly eat white meat, fruits and vegetables and cook most of my meals. The problem is I love traveling and do that every 3 months. Those are the times I eat a bit liberally but I still take my oatmeal everyday. I think I can add on to exercise though I already get urges to cramp every time I get off the treadmill. Currently I manage 6.5 km 5 times a week. The other 2 days is a golf and a yoga day.

Someone in this thread mentioned about cutting carbs helped to reduce cholesterol. How does that help? Although I've cut down on my pasta, rice and bread, I still like carbs a lot.

Another question I have is that since 2006, my cholesterol level has been as high as it is now. I was 46 then and 54 now. Does my aging make it less successful to lower cholesterol by change of lifestyle alone?


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