Get a 2nd opinion on re-starting statin cholesterol drugs?

huango

Hola,
I know you are not medical doctors with knowledge in cholesterol, but some of you have gone through this process.

I just got my fasted cholesterol test on 1/25/17.
I'm trying to see if I should go back on statin drugs.
--> From your experience/knowledge, if you were me with my cholesterol numbers, would you go back on statin?


I was on it, as you can see from the table: yr2010 to yr2012.
I stopped because:
1. I researched and learn that my ratio is pretty good, since my HDL is pretty high, and
2. I was hoping to be able to improve my cholesterol with improved eating and exercise habits.

I've been "working" on improving my cholesterol numbers without drugs for many years now, so I think these numbers are staying.
It would take some weird miracle for my LDL to go down, w/out the assistance of drugs.
I've drank sour sop leaves tea: that may be the reason why it went down on 9/2014, or maybe some other fluke, because I drank a lot of that tea before this recent test.

---> Would you go back on statin?



I have high cholesterol, since I found out in college.
It's not hereditary, my parents' cholesterol are normal.
I just seem to make extra.

I'm 44yrs old.
Short: 4'11".
116#
BMI = 23.7
My diet is mainly lean protein and veggies and fruit, lower carbs (on/off Dukan Diet since September 2016).
I'm basically pretty healthy, normal weight, eat well, and exercise 2-5times a week.

My ratio is fine = 3.18 (should be <4.4)
HDL = great = 107 (>40)
Triglycerides = great = 68 (<150)

But my LDL = 219, almost double of the recommended 129.
Making my Total cholesterol = 340 (<200).


Appreciate your feedback.
Thanks,
Amanda

KnitOrMiss

When your trigs are low and HDL is high, the standard calculation for LDL is often WAY HIGH and wrong. Find another calculator that adjust for the healthier other numbers to get a better idea of your ACCURATE results. But now, with this and no other risk factors, I [personally] wouldn't worry about this at all. LDL is actually a protection for your brain as you age...so just with age, it will naturally increase.

The body will make cholesterol to transport fuel to the brain...even if you eat NONE, so restricting fats out of your diet is counter-intuitive without other reasons. Carbs are are what cause triglyceride and LDL increases, generally... My LDL is higher, but my trigs and HDL are in a good ratio.

tcunbeliever

Things I would consider:

1 - cholesterol testing is highly inaccurate if you have lost weight (the fat metabolism process totally skews the numbers) - you didn't specify, so not sure if this applies

2 - there is no evidence that lowering cholesterol improves cardiovascular health - it actually doesn't change your risk of stroke or heart attack to have a lower number

3 - statins have a lot of side effects

For me, I would never choose to take them, but I'm very comfortable ignoring medical professionals and making my own health decisions. Not everyone is ok with that, and you will get supported here no matter what you choose to do, so do whatever you think is right.

cstehansen

I am not a doctor. I just look at the research. Rather than give an opinion, here are some links I found useful:

http://www.medpagetoday.com/cardiology/prevention/20948
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824152/
http://www.zoeharcombe.com/2010/11/cholesterol-heart-disease-there-is-a-relationship-but-its-not-what-you-think/
http://www.myhealthwire.com/news/breakthroughs/859
https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2016-06-13-study-says-theres-no-link-between-cholesterol-and-heart-disease/

I have more, but they get a bit repetitive. These are a combination of articles and actual research studies.

I would also add that you have to be very careful when you hear claims about benefits of statins or any drugs. What they tout is "relative risk reduction." When they say it reduces risk by 30%, what they mean is that instead of having a 1% chance of death by heart attack, your risk is now 0.7%. In reality your total risk was reduced by 0.3%. However, when they say that "only 20% have negative side effects," they are talking about 20% of total. This means you can reduce your total risk by 0.3% but have a 20% chance of harmful side effects. At least for me, that math makes no sense.

Finally, here is a podcast from this week which has Dr. Cate Shanahan really explaining the REAL causes of CHD in relation to cholesterol.

http://www.thelivinlowcarbshow.com/shownotes/15644/1212-dr-cate-shanahan-low-carb-vail/

RalfLott

IMHO, it would make a difference whether you have diabetes, whether you have a lot of risk factors for heart disease, whether you're still losing weight or have been stable for a while, and what the breakdown of your LDLs looks like.

You might see if your doctor would order Apo-A1 and ApoB tests for the latter purpose.

Also, LDL is calculated from other numbers - your doctor might be able to order a "direct" LDL count.

Nice HDL/Trig ratio - I would pay good money for it!

FYI, my leg cramps from Lipitor pretty much vanished overnight when I switched to Crestor. Alas, that was a side effect I could actually feel....

dasher602014

It is tough because I think statin medication will be reduced in the next 10 years when a greater understanding and/or acceptance of what really is a risk for CVD filters through the main stream medical world. I guess I think of it like HRT. It was so accepted, then it was a no-no, now it is back but less.

I can offer no advice. I think this is a very personal choice.

And the standard advice of low fat diet and exercise, just does not work for some of us.

Like you, my HDL is high and my triglycerides are very low. Unfortunately, my LDL is in a one to one relationship with my HDL. Low fat diet simply lowered both a little. Low carb diet raised both a little. The only thing that "broke the tie" was Crestor. With heart disease in my family, I decided to take it.

Additionally, the low fat diet was really, really difficult because I am also gluten and lactose intolerant so I found it too restrictive. Then came the news that the office had never seen a patient keep their LDL down through diet and exercise alone, although a few had tried. Not encouraging.

Unlike you, I am still overweight. So I am hoping it will "correct" some when I am smaller. But likely, no.

I would still get the additional tests to measure direct LDL if you can. That would make you decision clearer.

Good luck.

huango

Quick driveby:

REALLY appreciate your feedback.
Will be back for more later.


@RalfLottRalfLott: thanks for making me look into the HDL/Tri ratio.

What I found:

- HDL = great = 107 (>40)
- Triglycerides = great = 68 (<150)
----This gives me almost a 3:5 ratio for HDL to triglycerides, which is pretty good.


http://www.drsinatra.com/the-most-important-cholesterol-ra…/
"I've long said cholesterol isn’t the real culprit when it comes to heart health, inflammation is. That hasn’t changed. But there is one cholesterol ratio you want to watch—your ratio of triglycerides to HDL cholesterol levels. In fact, a study published in the American Heart Association journal Circulation found that
--->>>those people with the highest triglyceride-to-HDL cholesterol ratios had a sixteen times greater risk of heart disease than those with the lowest ratios.

What should your triglycerides-to-HDL cholesterol ratio be? Ideally, you want no more than a 2:1 ratio of triglycerides to HDL cholesterol. So, if your triglycerides are 100 mg/dl, your HDL cholesterol should be 50 mg/dl. Anything under 3:5 is considered a good ratio, but I don’t like to see a blood lipids ratio that’s over 5:1"

cstehansen

@huango - one reason that ratio is looked at (HDL/Tri) is it is a proxy for insulin levels. Elevated insulin (hyperinsulinemia) is almost always a factor in determining risk for heart disease. Dr. Joseph Kraft, who is now 95 years old, recently said he has never seen an instance of death by heart disease where the person did not have elevated insulin and would love for someone to show him a single incident of it.

ellevin11

There is a test to determine how much plaque build up you may have in your heart, which some say is the most reliable way of detecting risk of heart disease. It is called the coronary calcium scan and it is a CT scan of your heart.
Unfortunately a lot of people in the medical community don't know about it and many insurances don't cover it. But from my basic research it isn't super expensive and would probably give you a clearer picture of if you are at risk.

RalfLott

ellevin11 wrote: »

There is a test to determine how much plaque build up you may have in your heart, which some say is the most reliable way of detecting risk of heart disease. It is called the coronary calcium scan and it is a CT scan of your heart.
Unfortunately a lot of people in the medical community don't know about it and many insurances don't cover it. But from my basic research it isn't super expensive and would probably give you a clearer picture of if you are at risk.

Great point. I got a CT scan and CAC score for $99. You also get a view of the lungs, which the reviewing radiologist will also see.

ETA: Getting a low - but positive - result from this test is what persuaded me to take Crestor.

I plan to repeat the test it in a couple years to see if eating VLC has improved what LF left behind... If so, I would drop the Crestor (and check again a few years later).

retirehappy

RalfLott wrote: »

ellevin11 wrote: »

There is a test to determine how much plaque build up you may have in your heart, which some say is the most reliable way of detecting risk of heart disease. It is called the coronary calcium scan and it is a CT scan of your heart.
Unfortunately a lot of people in the medical community don't know about it and many insurances don't cover it. But from my basic research it isn't super expensive and would probably give you a clearer picture of if you are at risk.

Great point. I got a CT scan and CAC score for $99. You also get a view of the lungs, which the reviewing radiologist will also see.

ETA: Getting a low - but positive - result from this test is what persuaded me to take Crestor.

I plan to repeat the test it in a couple years to see if eating VLC has improved what LF left behind... If so, I would drop the Crestor (and check again a few years later).

My husband just got one of these also. There is also an ultrasound test that will let your doctor observe the blood flow through your heart. From what I have read the formula is tri/hdl so your number is even better using. And getting the Apo-A1 and ApoB tests is also a good idea.

Only you can decide what is best for you. If you had any side effects, you have to weigh the risks for you. My husband had too much muscle pain from statins, he has a high total number but everything else is ok.

RalfLott

retirehappy wrote: »

RalfLott wrote: »

ellevin11 wrote: »

There is a test to determine how much plaque build up you may have in your heart, which some say is the most reliable way of detecting risk of heart disease. It is called the coronary calcium scan and it is a CT scan of your heart.
Unfortunately a lot of people in the medical community don't know about it and many insurances don't cover it. But from my basic research it isn't super expensive and would probably give you a clearer picture of if you are at risk.

Great point. I got a CT scan and CAC score for $99. You also get a view of the lungs, which the reviewing radiologist will also see.

ETA: Getting a low - but positive - result from this test is what persuaded me to take Crestor.

I plan to repeat the test it in a couple years to see if eating VLC has improved what LF left behind... If so, I would drop the Crestor (and check again a few years later).

My husband just got one of these also. There is also an ultrasound test that will let your doctor observe the blood flow through your heart. From what I have read the formula is tri/hdl so your number is even better using. And getting the Apo-A1 and ApoB tests is also a good idea.

Only you can decide what is best for you. If you had any side effects, you have to weigh the risks for you. My husband had too much muscle pain from statins, he has a high total number but everything else is ok.

If only our bodies would talk to us - or we could understand them better! I thought I made a wise, mature, and laudable decision to follow LF diets..... Oops!

Thanks for the tip on the ultrasound.