Dr. Suggested a Statin - I Said No Thanks

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I had my CAC done in April 2023 and it was 0. Regardless, I am staying on my low dose statin.
 
Neither am I but I'll chime in. Two months ago:

221 Total Cholesterol
120 LDL
85 HDL
68 Triglycerides
2.60 Chol/HDL
1.41 LDL/HDL
136 Non-HDL

2.6 Total/HDL
136 non-HDL
0.8 Tri/HDL
1.8 LDL/Tri

So- LDL is high, the rest OK. My calcium score was 1 and I think my out-of-pocket for that test was $75. Sometime last year I checked my CRP (C-reactive protein) and it was very low. It's an indication of inflammation so low is good. No history of hear attacks or arrythmia, 71 years old.

About 15 years ago a doc put me on Prevastatin. Six months in, I had tendonitis in my elbows so bad that it hurt to raise a spoon to my mouth. Was getting twinges in my knees, too. I threw out the pills. Symptoms went away. That's just me- Dad was on them for decades with no issues.

So, I keep my weight at a healthy level, eat very little meat and exercise. I order my own bloodwork when I want through RequestaTest so I don't have to go through a doctor or get surprise bills.

A good AI source I just discovered: doctronic.ai. Free and it did a good job with answers to my questions on my mitral valve prolapse.
With a calcium score of 1 and a very low CRP at age 71, I suspect you are good to go without a statin. Especially considering the side effects you experienced with the statin.
 
They might have charged or "approved" the $200 charge but if you look at your Medicare Summary Notice, (MSN), they only pay the negotiated rate which, in most cases, is a fraction of what Medicare shows as approved.

Here is a current example:

DW had an x-ray taken in our local hospital for which they billed $656 which is the amount Medicare approved.

When I look at the MSN for that event Medicare's payment towards the approved amount was only $79.80 and the co-pay amount was $20.38 for a total payment to the hospital of $100.18

So, in this case the hospital writes off almost $556 even though it appears Medicare approved $656.
You are correct. Medicare "approved" $200.27 but only paid $75.62 to the facility with $19.29 billed to me but of course, paid by my supplement. So that means the actual amount paid to the facility totalled about $95.
 
I will recheck my numbers in a few months and if they have not changed I will bite the bullet and take the low dose statins.
I'm glad your doctor is on board with the Red Rice Yeast, because it isn't necessarily well-tolerated. I think it can have the same side-effects as a statin. Using only a lipid panel to make the decision about chemical treatment isn't something I'd do. Certainly, if there are things that put you in a higher risk category for ACVD and on top of that, you have a crummy looking lipid panel, certainly, a statin can extend your healthspan. But if you're otherwise low risk, you might not need to "manage your numbers".
 
You do you, but it’s just barely possible that your cardiologist that got years of specialized education and has seen thousands of patients over decades and keeps up with the science knows what he/she is doing.
+1000

Why even consult with a cardiologist, or any medical specialist, if your response to their professional, expert recommendations is going to be "Hmm, I don't know. Maybe I'll do my own research on YouTube or TikTok and see what other random, self-proclaimed 'experts' think about this." Surely folks must be aware that all manner of quackery, pseudoscience, and grifting is rampant on these platforms, and there is no practical way for even the smart, savvy layperson to do enough research to truly understand the deep, complex science well enough to sort out the wheat from the chaff. That's WHY we pay people like cardiologists the big bucks.

Of course, as others have said, it's your health, your body, so ultimately it's your call as to what you decide to do. But it strikes me as highly inconsistent to not trust your cardiologist's ability to properly diagnose and treat you, but to blindly trust airline pilots to fly you safely in a big aluminum tube 35,000 feet in the air, where even one mistake, error in judgment, or bad decision could easily cost you your life. Why exempt airline pilots from this heightened scrutiny and skepticism that you apply to your doctors, especially considering you've never even met or spoken to the pilots flying your plane?
 
I like many others try to avoid taking medication if possible. My Dr suggested a low dose of statins OR take Red Rice Yeast twice a day. I am going to try the RRY with CoQ10 and see if that helps, along with a few changes in my diet.. If that doesn't help then I am not opposed to taking a low dose. I will recheck my numbers in a few months and if they have not changed I will bite the bullet and take the low dose statins.
Not sure I understand. Is the RRY somehow not medication? You seem to be treating it as medication. How do you know what is in the package? Certainly it has been subject to less quality control than the statin tablets that I take per Dr.'s orders. Does that make the RRY somehow superior?

This idea makes no sense to me.
 
Not sure I understand. Is the RRY somehow not medication? You seem to be treating it as medication. How do you know what is in the package? Certainly it has been subject to less quality control than the statin tablets that I take per Dr.'s orders. Does that make the RRY somehow superior?

This idea makes no sense to me.
That's because it is nonsense! So many people fall for the "it's natural, so it can't be bad" story. In fact, the active ingredient in RRY is structurally in exactly the same class as all the marketed statins, so the only difference is that, as you say, OldShooter, there is little to no quality control.
 
Not sure I understand. Is the RRY somehow not medication? You seem to be treating it as medication. How do you know what is in the package? Certainly it has been subject to less quality control than the statin tablets that I take per Dr.'s orders. Does that make the RRY somehow superior?

This idea makes no sense to me.
I think some people prefer RYR over statins because it's "natural". Red yeast rice contains monacolin K, which is chemically very similar to a particular statin drug. So by taking RYR (an herbal supplement), one is lowering their cholesterol "naturally" and can feel good about not taking a medication or pharmaceutical.
 
+1000

Why even consult with a cardiologist, or any medical specialist, if your response to their professional, expert recommendations is going to be "Hmm, I don't know. Maybe I'll do my own research on YouTube or TikTok and see what other random, self-proclaimed 'experts' think about this." Surely folks must be aware that all manner of quackery, pseudoscience, and grifting is rampant on these platforms, and there is no practical way for even the smart, savvy layperson to do enough research to truly understand the deep, complex science well enough to sort out the wheat from the chaff. That's WHY we pay people like cardiologists the big bucks.

Of course, as others have said, it's your health, your body, so ultimately it's your call as to what you decide to do. But it strikes me as highly inconsistent to not trust your cardiologist's ability to properly diagnose and treat you, but to blindly trust airline pilots to fly you safely in a big aluminum tube 35,000 feet in the air, where even one mistake, error in judgment, or bad decision could easily cost you your life. Why exempt airline pilots from this heightened scrutiny and skepticism that you apply to your doctors, especially considering you've never even met or spoken to the pilots flying your plane?
The funny thing is that I do my best not to fly anymore. :)

But seriously, I trust the cardiologist but like anything, we “argue” around the edges. They did a test to ensure my heart was pumping well and his evaluation was that the pain I was feeling was blood pressure related and concluded that there was no reason to believe that I had a blockage. I’m currently wearing a monitor to see if we can capture anything related to my now sporadic pain and some palpitations that I experience. His advice for the statins was taken under advisement but I personally did not think the benefit was worth the risk. I don’t view that as not respecting his education and place in my healthcare team. It’s worth noting that I’ve also been with a holistic doctor that is nationally recognized and fwiw, is an MD with decades of experience. I’ll be discussing the recommendation of the cardiologist with him (not exactly SGOTI). However, I doubt he’ll feel any different. Now, he may recommend a dietary change or something but we both share a desire to reduce medication and focus on the body repairing itself when possible. And, fwiw, he was the one who referred me to the cardiologist.
 
I had always had cholesterol above 200. One doctor said I should be on statins, but my PCP never said a peep. One of my older brothers had a heart attack. I asked my PCP what I should do. He sent me in for a calcium scan about 5 years ago. It came back zero.

When I retired in 2023, I decided to see if I could lower my cholesterol. I looked up foods that were good for that. I changed my diet. The first two months I lost 10lbs each month. I decided to get real serious about creating a sustainable diet that would be healthy. I studied a lot. In one year I:

weight: lost one third of my weight to a normal range
cholesterol: 235 -> 185
HDL: 35 -> 66
Triglycerides: 235 -> 35

I don't know why the doctors didn't say change your diet. I don't know why I neglected my diet for so long. I guess it was being sidetracked with a job and family. I am only good at focusing on 1 or 2 things at a time, but once I lock on to something, I'm like a pitbull.
 
Why even consult with a cardiologist, or any medical specialist, if your response to their professional, expert recommendations is going to be "Hmm, I don't know. Maybe I'll do my own research on YouTube or TikTok and see what other random, self-proclaimed 'experts' think about this."

There's tik-tok (don't have an account) and Dr. Oz (who seemed to be pitching a different superfood/supplement every day when I saw him on TV in the gym) and there are more credible sources including Dr. Peter Attia and the highly-respected people he interviews.

I have a brain and I'm going to use it. I've also lived in this body 71+ years and know what's "normal" and some of its peculiarities.

Of course, as others have said, it's your health, your body, so ultimately it's your call as to what you decide to do.

Exactly. Rather than your airline comparison, I compare it to taking your car in for maintenance or to address a problem. They have superior expertise but they may be wrong and if they want to do something expensive I might get another opinion.

I've just been through a round of consultations on my mitral valve prolapse. Last January, the cardiologist checked my echocardiogram and said to come back in a year. I got concerned after some research (and a small change in the results) and I got a second opinion from an interventional cardiologist who ordered an exercise echo. He sent me to the cardiac surgeon who said, yeah, he COULD operate right now but I'm functioning pretty darn well and the potential improvement is outweighed by the risks of open-heart surgery. Come back in April.

My first words to the initial guy when I come back in January will be, "you were right".
 
My experience with a statin, was that it caused brain issues. I refused them eventually. They then put me on Red Yeast Rice and CoQ10.

The brain is a heavy user of cholesterol and lowering it for me appeared to cause an effect that was very unpleasant. It sort of changed my personality/demeanor. In fact, I think it could have almost caused me to get fired at work.
 
I'm glad your doctor is on board with the Red Rice Yeast, because it isn't necessarily well-tolerated. I think it can have the same side-effects as a statin.
My understanding is that the ingredient it contains that reduces cholesterol is chemically a statin. If so, why not take the pill and know for certain what your dose is?
 
My PCP wanted me on a statin, but my Cardio said, nah. My raw cholesterol numbers support it, barely, but he said they look at several factors.

I'd be more concerned that a cardio doc didn't want to do a stress test, particularly if you haven't had one in 10 years or if you are new to that practice.
 
My understanding is that the ingredient it contains that reduces cholesterol is chemically a statin. If so, why not take the pill and know for certain what your dose is?
Yes. I think "natural" is a euphemism for "little quality control," too. There was a period where I was making my own beer and familiar with the ugly intermediate slurry that was part of the process. Live yeast, dead yeast, yeast food, yeast excreta, dead yeast sludge, etc. And how well does the vendor do in separating the active ingredient (whatever that is) from all the other ugly stuff? And then what quantity of the active ingredient goes into the consumer package? And who monitors this?
 
My PCP wanted me on a statin, but my Cardio said, nah. My raw cholesterol numbers support it, barely, but he said they look at several factors.

I'd be more concerned that a cardio doc didn't want to do a stress test, particularly if you haven't had one in 10 years or if you are new to that practice.
It seems that, in the absence of symptoms, stress tests aren't as useful as they were once thought to be. I was surprised that a stress test only shows when an artery has >70% blockage! See here
 
Not another statin thread...ugh. It's the medical equivalent of the "When to take Social Security" thread.
Since it is clearly labeled as such, it's easy to ignore and move on to something else - just like I do with the when to take SS threads!
 
Childlike, maybe, but I have this idea that decades in medicine, medical school, residency, ACP qualifications, continuing education, and QC by his large medical group might, just might, have resulted in his knowing more than I could learn from a little internet research, random anecdotes, and consultation with SGOTI. I don't need him to justify his opinions to me, though I do expect and get discussion of tradeoffs where I have questions or where significant tradeoffs exist.

WADR, sometimes you guys crack me up. :)
Well perhaps some people don't think one size fits all. That's our right,BTW ever looked at the annual reports of medical malpractice.Once a common medication goes mainstream people's bad reaction to them gets minimized IMHO..
 
Not sure I understand. Is the RRY somehow not medication? You seem to be treating it as medication. How do you know what is in the package? Certainly it has been subject to less quality control than the statin tablets that I take per Dr.'s orders. Does that make the RRY somehow superior?

This idea makes no sense to me.
Well my Dr. prescribed it as an alternative. I didn't even ask for an alternative it was put in my test details comments.

"I will prescribe Lipitor 10mg taken nightly, alternatively you can try red rice yeast 600mg 2X daily. Let me know which you prefer. Repeat labs in six months"
 
I’ve taken a statin for well over a decade now. Started with Lipitor and now simvastatin. No side effects that I’m aware of- I feel generally great.
 
I have a brain and I'm going to use it. I've also lived in this body 71+ years and know what's "normal" and some of its peculiarities.
Fair enough. I feel this way, as well, as I suspect most of us here do.

Rather than your airline comparison, I compare it to taking your car in for maintenance or to address a problem. They have superior expertise but they may be wrong and if they want to do something expensive I might get another opinion.
I'm not sure I fully agree with your auto mechanic analogy. Auto mechanics aren't required to undergo 7+ years of intensive, rigorous postgraduate education and training, followed by years of "automotive repair residency", followed by having to pass a licensing test from the "auto mechanics" board. From what I've seen, just about anyone who has a working knowledge of cars, car parts, and tools can be employed as a mechanic, even people without a high school diploma. There is, IMHO, a vast difference between the depth of expertise required to be a medical doctor—especially something like a cardiologist—and a car repair person. And this is not to say that just because someone is a doctor that they can't be wrong, or that you shouldn't ask questions. You absolutely should, up to and including seeking a second opinion for stuff that seems overly invasive, unorthodox, or life threatening, etc. Just don't seek that second opinion from sources that haven't undergone that same level of years-long, rigorous training and licensure as your own doctor... including yourself!
 
Fair enough. I feel this way, as well, as I suspect most of us here do.


I'm not sure I fully agree with your auto mechanic analogy. Auto mechanics aren't required to undergo 7+ years of intensive, rigorous postgraduate education and training, followed by years of "automotive repair residency", followed by having to pass a licensing test from the "auto mechanics" board. From what I've seen, just about anyone who has a working knowledge of cars, car parts, and tools can be employed as a mechanic, even people without a high school diploma. There is, IMHO, a vast difference between the depth of expertise required to be a medical doctor—especially something like a cardiologist—and a car repair person. And this is not to say that just because someone is a doctor that they can't be wrong, or that you shouldn't ask questions. You absolutely should, up to and including seeking a second opinion for stuff that seems overly invasive, unorthodox, or life threatening, etc. Just don't seek that second opinion from sources that haven't undergone that same level of years-long, rigorous training and licensure as your own doctor... including yourself!
++++
 
My experience with a statin, was that it caused brain issues. I refused them eventually. They then put me on Red Yeast Rice and CoQ10.

The brain is a heavy user of cholesterol and lowering it for me appeared to cause an effect that was very unpleasant. It sort of changed my personality/demeanor. In fact, I think it could have almost caused me to get fired at work.
In my case, it caused both my washer to over-suds and my toaster to burn English muffins, even when set to low. When I saw doc at my next visit, I brought along pics of the mess on the laundry room floor and a sample burnt muffin. He apologized and admitted not understanding the connection before this.
 
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