My Recent Calcium CT Scan

Trooper said:
That's great info, thanks. Did you make any dietary changes or was the LDL reduction solely due to the statins? I plan on also monitoring AST and ALT if I decide on statins (Rosuvastatin is what has been prescribed for me). But first I will get a lipid panel, liver levels, and A1C/Glucose test.
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Prior to taking Rosuvastatin my ALT bounced between 25 and 37. My AST was between 22 and 25. When taking 40 mg of Rosuvastatin my highest ALT was 122 and highest AST was 92. My latest blood test showed an ALT of 33 and an AST of 28.


During the evaluation phase of my elevated ALT and AST I suggested to my gastro doc that we check it every week or so. He said two weeks was more standard but thought it wouldn't hurt to do it more frequently. The results were interesting. I've included some earlier data as a baseline and later data as a followup.


********* ALT AST
May 04 2020 25 24
Nov 11 2020 27 22
Feb 03 2021 33 25
Jun 02 2021 26 25
Jul 21 2021 Started 40 MG Rosuvastatin
Sep 07 2021 88 56
Nov 04 2021 122 92
Nov 05 2021 Changed to 20 MG Rosuvastatin
Nov 30 2021 53 37
Jan 10 2022 100 63
Jan 12 2022 113 72
Jan 19 2022 101 54
Jan 26 2022 63 36
Feb 02 2022 96 60
Feb 03 2022 Stopped Rosuvastatin
Feb 17 2022 64 37
Feb 24 2022 75 51
Mar 03 2022 52 31
Mar 15 2022 Started Praluent

Jun 25 2022 27 21
Oct 04 2022 29 24
Dec 27 2022 56 35
Feb 24 2023 41 28
Mar 01 2024 33 28


Question: Were elevated levels on Dec 27 2022 the result of eating Christmas dinner with friends? If so it's a sacrifice I'm willing to make to eat Honey Baked Ham.

When I plotted the data in Excel it was obvious how much ALT and AST bounced around between Jan 2022 and March 2022. Was this an effect of the statin or is it normal behavior? Does this happen in most people all the time or am I an outlier in this respect? If anyone has similar data feel free to post it.
 
RS53576GG said:
You'll be pleased to hear that I have all this data on a spreadsheet. I had 3 stents in July, 2021. Here's the data.


Nov 2020 - LDL is 96
Dec 2020 - Cardiac calcium test, score is 21

Jan 2021 - Started 5 MG Rosuvastatin
Feb 2021 - LDL is 75
Apr 2021 - Stopped Rosuvastatin
Jun 2021 - LDL is 87
Jul 2021 - 3 stents, started 40 MG Rosuvastatin
Sep 2021 - LDL is 37 ALT and AST liver enzymes climbing
Nov 2021 - Changed to 20 MG Rosuvastatin due to high ALT and AST
Late Nov 2021 - LDL is 35 ALT and AST decreased a bit

Jan 2022 - ALT and AST increasing to dangerous levels
Feb 2022 - Stopped taking Rosuvastatin
Late Feb 2022 - LDL is now 81
Mar 2022 - Start taking Praluent to reduce LDL
Jun 2022 - LDL is 41 ALT and AST are back to normal low levels
Dec 2022 - LDL is 36

Feb 2023 - LDL is 37

Mar 2024 - LDL is 40

It's pretty interesting how my LDL and AST - ALT liver enzymes bounced around. Turns out Praluent works pretty well for me. Not cheap but the price of liver problems is too high to ignore.

Interesting Side Story: About 11 weeks after stopping Rosuvastatin I was hiking in the nearby hills and noticed that my thinking processes seemed more defined. For lack of a better description my thinking seemed to be sharper. I wasn't looking for it, I just happened to notice it. For the next few days I paid close attention to my thinking abilities. They were definitely sharper. No question. I looked into it and discovered that "mental fuzziness" is known side effect of statins. It doesn't happen to everyone but it definitely happened to me. The thing that struck me about this is that I didn't notice it while it was happening. I only noticed it when my mental processes got back to normal. (Or at least what's normal for me!) If I hadn't had the liver enzyme problem I could have spent the rest of my life being somewhat less sharp than I used to be and never realized it. That's pretty scary.
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I have known a few people that took statins and it definitely affected their cognitive abilities. It was obvious because their card playing skills declined.
 
Thank you Trooper for posting this possible heart disease issue.

I am now very much interested and appreciate the information that all our members provide.
Before my recent Calcium score result of ~200, I was not concerned with heart disease. Now it is front and center for me.
 
RS53576GG said:
A low score doesn't always mean you're in the clear and a high score doesn't always mean you're going to die tomorrow.
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Which is likely why insurance doesn't cover it, I would imagine.

RS53576GG said:
I think exercise and eating certain foods probably contributed to lowering my LDL. I'm a pretty plain eater so it's easy for me to eat the same rotating schedule of 3 or 4 meals for a long period of time. I like salmon and chicken so I tend to eat them fairly often.

My only guideline for cooking is that the time I invest in preparing a meal can't be longer than the time it takes me to eat it. The cooking process can sometimes take 30-40 minutes but the time I actually spend preparing it can't be longer than 10-15 minutes.
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Well there goes my 15-hour brisket cooks! :)

Healthy Lifestyle said:
Thank you Trooper for posting this possible heart disease issue.

I am now very much interested and appreciate the information that all our members provide.
Before my recent Calcium score result of ~200, I was not concerned with heart disease. Now it is front and center for me.
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You're welcome. Ditto on the great information here and that it is now a priority for me also. DW would always say how healthy I ate and applaud me on my active lifestyle. I guess our DNA contributes something as to how our bodies process cholesterol and and create plaque? Dunno. I remain confused as ever, but at least I am more informed and on the hunt for more information. I just really don't want to be on a statin unless I have to. The only other drug I take is Flomax, which is also known for dizziness so I don't want to compound the risk. Next step for me is to get a baseline lipid, liver and A1C data and go from there.
 
Good discussion. I recently had a heart CT scan and my result was about the same as Trooper’s. I’m 63 and have always had cholesterol on the higher side that improved a bit when I changed my diet and lost 25 lbs a few years ago. Anyway, I tried several different statins over the years but couldn’t tolerate them due to getting pretty severe (leg) muscle cramps. But I tried again recently (Crestor 10 mg) and found that if I skip a dose 1 or 2 days per week I can tolerate it. I do 2 harder workouts each week so I skip the dose the night before those days. Statins work best taken at bedtime. As mentioned, statins stabilize the calcium (cholesterol ) deposits but won’t dissolve them. By lowering your cholesterol there should be less to clog your arteries, I’m guessing. If you know you have some coronary artery plaque, which the calcium score indicates, you should ask your doctor if you should be taking an aspirin each day. My doctor prescribed an enteric-coated 81 mg aspirin each day for me.
 
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I had borderline high cholesterol for probably a decade, then it jumped to 283. My calcium heart CT score was 198. I passed the treadmill EKG easily, but the doctor quadrupled my statin dose to 40mg and put me on 81mg aspirin daily, which I'm planning to start today. I'm not thrilled to be taking aspirin daily. Anyone's thoughts/experiences with taking low-dose aspirin? Thanks!
 
My CAC score was over 500! Cardiologist didn't seem to worry too much about it but put me on a statin with my LDL around 200+. 3 years later, I had chest pains and 3 stents put in. Not sure Cardiologist could have done much more, but his indifferent attitude was off-putting. He was on vacation when my stents were done so I had to use the hospital cardiologist - who just happened to be one of the few guys in the world at that time qualified to do valve replacements through veins or arteries (IOW without cracking the chest.) So I felt blessed.



I'm on max Atorvastin and LDL is around 35. Take 81mg ASA. Don't really do anything else (hey, none of us gets out of here alive.) YMMV
 
I was prescribed a statin (10 mg Atorvastatin) and it brought my cholesterol down to perfect.

But I started to have some muscle pain in my arms. At the same time I was having spine issues so I decided to take the statin every other day instead of every day.

My cholesterol went up a bit but nothing terrible. So that’s where I’m at with it. I just wish I could drink grapefruit juice in the morning. I miss it.
 
HI Bill said:
I had borderline high cholesterol for probably a decade, then it jumped to 283. My calcium heart CT score was 198. I passed the treadmill EKG easily, but the doctor quadrupled my statin dose to 40mg and put me on 81mg aspirin daily, which I'm planning to start today. I'm not thrilled to be taking aspirin daily. Anyone's thoughts/experiences with taking low-dose aspirin? Thanks!
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I took low dose aspirin for at least 10 years perhaps more, but stopped after more recent guidelines were murkier. At my CAC and cholesterol my physician is somewhat indifferent.

Now that Ive quit I noticed two things

- I was more likely to get nosebleeds if I tried something like Flonase. Now I don’t seem to, although I still don’t use it consistently
- for years I had GERD and took medicine, now I no longer have it. Losing 30 lbs probably helped, but the aspirin may have made it worse too. Not sure.
- more likely to occasionally have bleeding hemorrhoids (sorry if tmi)
 
HI Bill said:
I had borderline high cholesterol for probably a decade, then it jumped to 283. My calcium heart CT score was 198. I passed the treadmill EKG easily, but the doctor quadrupled my statin dose to 40mg and put me on 81mg aspirin daily, which I'm planning to start today. I'm not thrilled to be taking aspirin daily. Anyone's thoughts/experiences with taking low-dose aspirin? Thanks!
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I had that exact score of 198 last summer. And passed the EKG good as well. Bumped my Rosuvastatin to 40mg and began 81mg aspirin. So, identical to your story.
I’ve had no side effects or issues with the increased statin dosage or the low dose aspirin.
Sure wish I didn’t have the 198 CAC score and the heart disease it represents. I need to further modify my diet to assist my health, but that hasn’t much happened yet. I work out quite hard and feel fine. But that CAC score sometimes causes worry that it represents a ticking time bomb.
 
Koolau said:
My CAC score was over 500! Cardiologist didn't seem to worry too much about it but put me on a statin with my LDL around 200+. 3 years later, I had chest pains and 3 stents put in. Not sure Cardiologist could have done much more, but his indifferent attitude was off-putting. He was on vacation when my stents were done so I had to use the hospital cardiologist - who just happened to be one of the few guys in the world at that time qualified to do valve replacements through veins or arteries (IOW without cracking the chest.) So I felt blessed.



I'm on max Atorvastin and LDL is around 35. Take 81mg ASA. Don't really do anything else (hey, none of us gets out of here alive.) YMMV
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Luck was on your side Koolua :)

My CAC score in 2021 was about half yours at 262.

My LDL has never been over 100 give or take a few points. I don't take Cholesterol meds and don't plan to. Test showed my total Cholesterol in the ticker doc's office :) two weeks ago was 131.

This Friday I go back for a checkup after after the Heart cath last week. One blockage at 50 %. The rest were under 20 %. No stents and the Doc told my wife it could be treated with meds. Not sure what meds they are talking about but will see Friday. I take the 81 mg aspirin but didn't until a month ago. I was told to three years ago and decided I didn't want to. I think I might now. :) I have been taking blood pressure medicine for 25 years and its under control. 115/70 when they did the Heart thing last week.

I will be 77 soon and really not going to worry much about anything. I walk 2 miles a day and eat good so not much more I can do.
People who are much younger than me probably should worry a little. If they have these tests and show high CAC scores along with high cholesterol .
 
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When I turned 50 in addition to having a virtual colonoscopy I had a heart scan done (not covered by insurance) primarily because my friend did the same thing 4 years earlier when he turned 50 just because they offered it. Long story, short he had a quintuple bypass two weeks later as he was over 96% blocked across the board. A couple years earlier I had a stress test done due to pain in the left arm and easily passed it so no really need for concern on my end especially since I exercise a lot and have never had high cholesterol (LDL only tipped above 100 a couple times). I was surprised when my score came back at 220 (95% for my age/gender). I did not really want to go on a statin due to some of the side effects and also because lifestyle changes - eat healthy consistently, exercise, reduce stress - can make a significant difference. I did a lot of research and was fortunate to come across Peter Attia's podcast (The Drive) and website (www.peterattiamd.com). He has a plethora of speakers give a masterclass on cholesterol (Tom Dayspring), heart disease, calcium scores, etc. It is certainly worth the time and $150/yr if you want to have uninterrupted podcasts and access to the show notes. You can access some of the podcasts for free. I found this to be the best resource for heart disease along with longevity and wellness. ApoB and LP(a) are biomarkers to focus on to gauge your LONG-TERM risk for hear disease but the heart scan is a quick and relatively inexpensive way to see if you have heart disease. I frequently tell friends that are 40yrs old and up to get this done. Its worth the $100 out of pocket.

Statins - I did not want to take them but after researching decided it was another cheap form of insurance/risk management that I would be foolish not to engage. Yes - they can lower LDL (which is the number to focus on) but the other benefits are that they lower inflammation and harden the plaque. Ironically, your CAC score tends to go up with a statin but your plaque has hardened.

Stress - reducing this (along with weight) helped me reduce inflammation.

YMMV
 
I'm looking thru this thread and was wondering the out of pocket cost for the calcium CT scan. Guessing it's under $400 and maybe as low as $200. thanks
 
HI Bill said:
I had borderline high cholesterol for probably a decade, then it jumped to 283. My calcium heart CT score was 198. I passed the treadmill EKG easily, but the doctor quadrupled my statin dose to 40mg and put me on 81mg aspirin daily, which I'm planning to start today. I'm not thrilled to be taking aspirin daily. Anyone's thoughts/experiences with taking low-dose aspirin? Thanks!
Click to expand...

I take it daily and no issues other than I bleed easily when I cat myself!
 
JoPeter57 said:
I'm looking thru this thread and was wondering the out of pocket cost for the calcium CT scan. Guessing it's under $400 and maybe as low as $200. thanks
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I had one done circa 2007 or so. It was $400 then. I'm sure they're a bit cheaper nowadays and probably more refined too.
 
Unbelievably our local hospital does them for $50 2023.
 
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JoPeter57 said:
I'm looking thru this thread and was wondering the out of pocket cost for the calcium CT scan. Guessing it's under $400 and maybe as low as $200. thanks
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Mine was $49 in 2014.
 
By the way, all this talk of the various drugs that folks take - or refuse to take - we had a whole thread on statins. I've probably said this before: If you don't trust your doctor to prescribe meds for you - you should probably find a doctor you DO trust to prescribe for you. I agree we should all do our own research on such things, but why pay for advice you're not going to take. You could save a lot of money by skipping the doctor if you don't want to follow her/his advice. Just my thinking on the subject but YMMV.
 
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