Holy Cholesterol

[fireant911]

After receiving my reading (265 bad cholesterol) the doctor wanted to immediately put me on Crestor. I requested to wait three months and do the diet / evercise route - although I was already quite active, ate right, and generally in good health. The doctor said that he was doubtful of any notable improvement but if that was what I wanted to do...

My status was 42 years of age, 5'-8", and 178 pounds. I did my regime for three months - exercised and paid great attention to what I was eating (which included a bowl of oat meal everyday as we have all seen the commercials) and dropped a total of 10 points.

Beaten by the high cholestrol I then opted to go on the drug. I stayed on the Crestor less than one week as I developed massive headaches (not your ordinary run-of-the-mill headaches but headaches that knocked me off of my feet). I went to the doctor's office four times that week and saw the neurologist several times thereafter. A link was never established between the cholesterol drug and the headaches but I have not taken any since and I haven't had a headache.

My wife has always cooked in a very health conscious manner including an ample supply of fish (baked or grilled - not fried). Fish seems to always be recommended but the doctor said to stay away from shrimp as it is very high in cholestrol? My understanding that some of our bodies naturally produce higher levels of cholestrol regardless of our diet / exercise.

Has anyone else had a bad reaction to Crestor?

[artplumber]

Originally posted by notfarnow

When I got tested 5 months ago, I was ~ 180ldl. Sweet! Plus, I dropped 25lbs and I feel better than I have in years.

Jake,
Goal LDL is somewhat dependent on number of risk factors. However, for someone without atherosclerosis we'd prefer 100-130. If you have atherosclerosis, you want to be sub-100 and even sub-80.

[Nathans_Dad]

I'm wondering if many of you aren't confusing LDL with total cholesterol. The currently accepted guidelines are:

Total Cholesterol < 200
HDL > 40 (>60 is ideal)
LDL < 160 for all adults, <100 for those with heart disease, <70 for high risk heart disease patients
Triglycerides: Controversial, most would agree <250 at least.

It is certainly possible to have an LDL of 180, but I would be considering statin therapy for you if I were your doc. I like to see all my patients at 130 or less unless they are very young (which I have zero of...most of my patients are older).

[on-ramp]

crazy theory but here goes...

maybe 300 is normal for cholesterol .. perhaps the drug companies have conspired to set the normal at 200 so they can push their drugs.

any thoughts?

[artplumber]

Originally posted by on-ramp
crazy theory but here goes...

maybe 300 is normal for cholesterol .. perhaps the drug companies have conspired to set the normal at 200 so they can push their drugs.

any thoughts?

Actually based on actuarial data from Framingham study (a longitudinal study of patients/risks and the development of various diseases). Obviously, mostly applies to white males (where's that racist thread...), but it's what we've got.

[Dennis Kalma]

Just FYI...I have had a negative reaction to every statin....Crestor, Lipitor, Effexor, Lipidil Micro and a few others. Always the same, joint pain, muscle pain....severe discomfort.

While I do not agree that it is a plot by drug companies to sell drugs...they certainly are not adverse to painting a picture that you will only be healthy if you take all these medicines to control your body.

I think drugs have a place, but I also think that we all need to get our head around the fact that all of us are going to die, and we will die of something. In some cases it will be a car accident, others will be cancer, old age, heart failure whatever. You can't avoid it at all.

In my mind, the medical profession ought to combine the goals of providing assists to make life meaningful and enjoyable with living longer. I have a friend who is a nurse in teh old folks placement business....her assessment is that medical science is making the bodies live longer than the brains or desire of the patient. Good grandma with Alzheimers...her body is fine, but her brain left us in 1996 and we are all getting sick of changing her diaper.

So, do what you want...of course. I work out and watch diet as it is good for me on a few dimensions, makes me feel better as well. If a drug can reduce a risk without undue side effects...I'll give it a try. But if my quality of life suffers too much...I'll take the risk back thank you very much.

I just get really ticked off when insurance companies refuse to cover me as my cholesterol is too high and I refuse to take their choice of drugs....one nut case said that my risk was assessed similar to someone who is suicidal.

Sigh...

Dennis

[Nathans_Dad]

Originally posted by on-ramp
crazy theory but here goes...

maybe 300 is normal for cholesterol .. perhaps the drug companies have conspired to set the normal at 200 so they can push their drugs.

any thoughts?

Well, if you accept an average life expectancy in the 60-65 range, then 300 is probably perfectly fine.

[Dennis Kalma]

Rick....that statement is humorous but irresponsible.

Many, many people have ridiculously high cholesterol and live quite a bit beyond 65....as a matter of fact, the averages are only a couple of years apart, something like 78 versus 76, low versus high cholesterol, with many other contributory factors.

Dennis

[artplumber]

Dennis,
Perhaps you are referring to some of the confounders in the Framingham study (then again maybe not). If so, this is one representative article suggesting that high levels at advanced ages still represent increased risks of events (death or heart attack).

http://eurheartj.oxfordjournals.org/cgi/content/abstract/23/4/286

And yes, some smokers live to be George Burns age. But most don't.

[Nathans_Dad]

Actually I don't believe it is irresponsible at all. Of course some people have ridiculously high cholesterol and may live to be 100. They are not the norm. You cannot make statements about a population using the ends of the bell curve as examples.

I will tell you that if you take a population of Americans and give them all total cholesterols of 300 at the age of 30, many if not most of them will have significant CAD by the time they hit age 60. A significant number will have had cardiac events and some will be dead.

Now, my selection of the age of 65 was a bit tongue in cheek, but the answer to the question is correct. Lowering cholesterol improves morbidity and mortality across the board.

[Dennis Kalma]

Yeah Rick, I guess a background in physics leaves me woefully prepared for statistics.

There is an improvement, but my point is that it is a multivariable problem, no hard cause/effect just increased risk factors seemingly correlated with some specific and measureable factors like cholesterol levels, blood pressure etc etc.

Point that I want to make is that high cholesterol is by no means a guarantee of an early heart attack, but it is one risk factor. If one has several risk factors, most notably family history of heart problems, then I would suggest chasing the cholesterol bandwagon with all your heart (PI). If it is the only factor you have, then it may be worthwhile not taking drugs that give you quality of life issues.

I wish I could dig up the documents, but my recollection is that it is a 60% increase in heart related fatalities, but it was from a pretty small base so undue worry isn't really appropriate.

Take care....and keep in mind I really DO NOT want to live much beyond my mid-70's anyway....too bloody old for me.

Dennis

[JavaBrewer]

Well I got the results and they are not pretty.

LDL = 205
HDL = 93

I was on 1000mg of Niaspan and the doc bumped it to 1500mg. I started taking a 325mg Asprin at night and it seems to greatly reduce the flushing I was getting ~ 2:00 am.

To further muddy the water my blood pressure has jumped signifigantly and was 150/90. I re-checked it at the pharmacy the other day with the same result.

Finally, my weight has increased to a rather portly 209. I'm 43 and freaking dying here...

Work has/is been pretty stressfull lately and I haven't slept well in many months. I have not kept up with the exercise routine and feel wasted most of the time.

Wife and I sat down and started to draw up a game plan. Red meat once a week, cut/limit fats where possible, develop a real-world plan for solid and consistent exercise, reduce weight to 190, drink way way more water, and reduce stress.

My new life kicked in over the Holiday break. Not much has changed yet but my attitude is getting better. Went on a great solo mtn. bike ride on Saturday, epic really, and then had a great run on Sunday. Monday is my *off* day but I can't wait for Tuesday.

[artplumber]

David,
Not the end of the world with that HDL.

3-5 grams of niacin is where most people who really need the drug end up.

Consider an alternative to lipitor for LDL reduction

[Z-man]

Originally posted by Dennis Kalma
Just FYI...I have had a negative reaction to every statin....Crestor, Lipitor, Effexor, Lipidil Micro and a few others. Always the same, joint pain, muscle pain....severe discomfort.

Lipitor gave me joint pain, and may have attributted to my 'frozen shoulder' condition (my speculation). I've since been switched to Crestor, and the joint/muscle pain has decreased, and the flexibility in my shoulders has increased. I wonder if I went off Crestor if I would get even better...

-Z-man.

[craigster59]

It's like the old joke, "I have a friend who abstained from alcohol, rich foods and fast women. He was the healthiest guy I knew before he killed himself.."

[madmmac]

I really think there is something about statins that increases problems with joints, ligaments or tendons.

I took Lipitor for over 6 years and in the last 2 years I have had to have wrist surgery due to a cyst that was created from synovial fluid leaking out of the wrist capsule and collecting in my hand. It still leaks at times and puffs up my hand but it is not in a central cyst and the body usually absorbs it. It's swelled up right now.

I also did a 3+ degree tear of my plantar fascia while coaching basketball, trotting up and down the floor reff'ing our scrimmage..not really doing any extreme exertion at all. I had never had a foot problem or pain till it just ripped. Its been 2 years since and I am still in pain. I have to golf with a cart, even for 9 holes, it sucks.

Took the kids bowling, after 2 games, with my own personal ball, my middle finger is killing me and stop bowling and get ice and an extra beer. Next day my finger is about the size of an overcooked Ball Park frank. Go to the DR and the tendons are torn. Told him all I had done was bowled a couple of games and he could not believe the internal damage.

Now my right thumb gets stuck when trying to bend it sometimes and my left index finger sounds like there is gravel in it and it hurts....other than that I am doing well...sheez.

The Dr took me off Lipitor and put me on Vytorin...190 was too high for him. Blood pressure 110/70, age 50 and should reduce the weight of my car by 30 to 40 lbs with me in it.

[artplumber]

Originally posted by madmmac
I really think there is something about statins that increases problems with joints, ligaments or tendons.

I took Lipitor for over 6 years and in the last 2 years .....

The Dr took me off Lipitor and put me on Vytorin...190 was too high for him. Blood pressure 110/70, age 50 and should reduce the weight of my car by 30 to 40 lbs with me in it.

Oy! It's called maturity (when I'm being nice).

Why don't you guys bring up the complaints about memory and vision loss while you're at it?

Muscle inflamation is a known complication of therapy and is incredibly rare. Many more ascribe their vague aches and pains (associated with no longer being 20y/o) to the drugs.

BTW Lipitor use was shown to be associated with a reduction in the development of Alzheimers and cataracts. And Vytorin contains a different statin + ezetimibe

[azasadny]

I take Welchol to lower my cholesterol and I'm going in this week to have my cholesterol retested. I was at 310 and that's eating a low cholesterol/low fat diet. Positive family history doesn't help... I'm 6'1" and 188lbs and the Welchol doesn't work in the liver, so it's better for me than the statins...

[JavaBrewer]

Originally posted by artplumber
Why don't you guys bring up the complaints about memory and vision loss while you're at it?

Art, I hear ya buddy, but the color was all wrong. I have this older brother who... do you like scones with your coffee.

[Nathans_Dad]

Agree with Art. Statins do have side effects, but I think people tend to blame everything on the statin. I guess it has to do with the number of statin commercials on the tube and all the warnings that come with them. Statins are really great drugs that do a lot of people a lot of good. I think they get a bad rap.

Welchol is a bile acid binding resin, they have been around since before statins. They work well, but many people get hellacious gas and irregular bowels with them. Basically you are delivering more fat to your colon and the bacteria there have a field day with it.

Vytorin is one I have started using recently, it is a combination of Zocor(simvastain) and Zetia (ezetimbe). The nice thing about Vytorin is that you can get comparable LDL lowering with a lower dose of the statin component than using Lipitor or Zocor alone. Cuts down on some of the side effects.