cholesterol

[Marina46]

Hello,

I’ve been told I need to be on medication to control my cholesterol. The levels are Tri’s 720,Total 370,HDL 40 I also have several risk factors. I'm hoping you can answer a few questions for me.


What level is recommended for individuals with diabetes?  Do diabetics need to be on medication if their lipids are normal or below? What long-term affects do statins and niacin have on the liver? Can diet and exercise alone reduce cholesterol levels? If I begin taking the medication will I have to take it for the rest of my life?

Thanks!!

[CCF-M.D.-MJM]

Hi Marina,

These are very good questions.  I have to agree with you doctor, you need at least one cholesterol medication, more likely two, and agressive diet and exercise.  As a diabetic, you are consider a risk equivalent to a patient who has had a previous heart attack.  If you look at the charts for long term outcomes (risk of death or heart attach), the graph a diabetic is superimposable over that of someone who has had a previous heart attack.  The recommendation is for an LDL cholesterol less than 100 and most physicians at the Cleveland Clinic would try to reach a level less than 80.  This is usually achieved with "statin" medication like lipator, zocor, pravochol, etc.  Your triglycerides are too high for an estimated LDL, therefore your LDL should be measured directly and treated appropriately.

Your triglycerides are clearly a problem and it is very unlikely, probably impossible, for you to adequately treat them with diet and exercise.  You need a medication like tricor, although this even likely to not reach a goal level of less than 150.  Triglyceride levels as high as yours are usually from a genetic cause--i'll bet your family has a history of very high triglycerides.

Statins and niacin will sometimes raise liver enzymes.  I don't believe there is a reported cases of statin induced liver failure.  Certainly if your liver enzymes go to more 5 times normal, it should be switched, but you by far at greater risk of cardiovascular problems from your cholesterol than from medication related problems.....although you should still watch for them.

As a diabetic you will need medication for the rest of your life.  There is very good data to show the benefits of this.

If you are over weight, you should make every effort to reduce your weight and improve you fitness.  I would avoid diets like atkins as I think they are too extreme.  The south beach diet and ornish diet are a bit more reasonable and dietician consult would probably help you.

Please treat this problem aggressively...it will help you in the long term. Good luck and thanks for posting.

[knicks30]

You should really try to go on the Dean Ornish program. You can get a book from dean ornish called "Dean Ornish's program to reversing heart disease." This book is really great. My uncle used it since his cholesterol was 345 total and it went down to 157! Im not sure if he it really makes chest pain from ishemia better because my uncle doesn't have heart disease but this book is no joke.

This book is really good for those who have high cholesterol and are serious of getting it down without medications.

Give it a try they sell it for like 15 dollars at your local bookstore like borders or barnes and noble.

[Barbarella]

I never tried the Ornish diet, but I eat very healthy, exercise (walk real fast 3 miles every day in all kind of weather) am not overweighed etc.  I think if Cholesterol is from eating the wrong food it can be lowered with certain diets as in the Ornish diet, but if Cholesterol is inherited (the whole family high cholesterol) or if people are under a lot of stress at times and certain meds i.e. Lasix can raise peoples Cholesterol.  I tried everything including Policasonol which you can buy over the counter and nothing helped.  My Cholesterol is 280 LDL 211.  I saw two doctors and presented them with what I found out on the Internet that Lasix (which I have to take) can raise Cholesterol, both doctors brushed it off and said no, kind of got mad that I did that research and didn't even want to look at the paper I had printed out for them.  I have an HMO insurance and can only get one "second opinion".  I need a doctor to get my BP meds refilled.  Both doctors told me I was a "walking time bomb".  A friend of mine refused to take statins and her doctor walked out of the door and said "there is no need for me to see you again find yourself another doctor".  I have no choice but take the statins for nothing else helped me.  I HAVE to take the Lasix I was told.  I'm taking 20mg of Zocor for about a week now and so far no side effects, but they can come later I was told by friends who took Zocor and Lipitor.  I'll keep my fingers crossed that I wont get any side effects.  My son wants me to get a "heart scan" it cost $400,-- and if my arteries check out clean he said I should bring the report to my doctor/Cardiologist and tell them to take the statins and "shove them".  But to be honest with you I'm scared of the result of this "heart scan".  I know this sounds crazy, but I rather not know.

[Marina46]

Knicks,
Thanks for the information,I will look in to it.

Marina

[Lexicon154]

I have been on Zocor 20 mg for over two years.  No side effects that I know of, but it has done absolute wonders for my cholesterol count.  I went from 258 to 160, and my HDL is 65.  I don't think I could ever have achieved this with diet and exercise alone.  As for Lasix, I never heard that it raises cholesterol, but there's no reason you couldn't switch to some other BP lowering medication.  Lasix was doing nothing for me, and my doctor has just switched me to Cozaar, which is a newer type of drug for hypertension. I'll be starting it tomorrow.

Statins are a modern miracle.  I recommend you give them a chance.

[Healthyself2]

Although eating well is very important, with cholesterol levels like yours you need multiple drugs.

I would say that HDL levels are the most important predictor of coronary artery disease and yours is just the mininum, but your HDL/LDL ratio is extremely poor.

Hopefully you have a good liver and haven't had hepatitis or other liver disease, which would prevent you from taking a statin.

You need to take a statin in at least a mid level dosage to bring down LDL and tris.  And you probably need Niaspan to increase HDL levels.  You could also use a third LDL lowering drug like Zetia or Welchol which work in a different way than the statins.

Also, you need to exercise daily.  Drugs alone won't save you.  Also exercise helps with diabetes.  Additionaly diet, weight control, and stress relief are very important.

The body is built to be used.  Diseases like coronary artery disease and type 2 diabetes are mainly lifestyle diseases.  Although I have heridity goig against me, I could have averted my severe coronary artery disease if I had ate proberly, exercised daily, watched my weight, and closely controlled my cholesterol and BP with drugs.

Good Luck.

[Marina46]

Healthyself2

I’m still considering my option on the medications I ‘ve heard that garlic lowers cholesterol, thought about possible trying that until I see the doctor in three months. And I just recently started an exercise class I think I’m trying to start out a little to fast not sure if it was related to the virus I had a few week back. Third of the way through the class I got a really bad headache, dizziness, heart feeling like it was flipping out went to step up on the step and everything went black for a few minute luckily I was able to catch myself. I’m thinking I may need to go back to just using the treadmill. Also, do you happen to know of any herbal supplements that lower cholesterol, blood pressure ,etc..?


Marina

[Barbarella]

Thank you so much for your advise.  How long did it take for your  cholesterol to go down while on Zocor?

As for the Lasix, I've to take it "to prevent fluid buildup" because I'm taking a small dose (5mg) of Minoxidil for high BP and Minoxidil can cause fluid retention my Cardiologist said. I'm also on a BP patch. I suggested to switch me to  something else, but both the Cardiologist and my doctor said "Lasix does not cause high Cholesterol".  In their opinion we should not pay any attention what we find on the Internet i.e. side effects etc.

I've no side effects from the BP meds, but the statins scare the hell out of me.  I've two friends who got very sick from statins I will not go into the details how sick they got.  Then I read this book by Dr. Uffe "The Cholesterol Myths", he is totally against statin drugs, and I read another book by a Cardiologist, Dr. Howard Wayne who is also against statin drugs.  Then I had the bright idea and logged on to the "Zocor side effects" chat room.  No wonder I'm scared to take it :)

Thanks again for your input.  I'll keep on taking the Zocor, so far I feel no side effect whatsoever.

[Barbarella]

Marina,

I fully understand you wanting to try a herbal/natural method first.  I too did all that.  Garlic pills, Policosonol, Apple Cider Vinegar, and the list goes on, and my Cholesterol went up instead of down.  Like my son told me "I either have my heart and brain scanned once a year to see if my arteries are clear or go on the statin drugs, but I have to do something".

I finally made up my mind to at least give the statins a try.  Should I get side effects I will stop.

Herbal stuff in my opinion is good if your condition is mild, but in our case with our high Cholesterol numbers the herbs wont cut it for me anymore I'm way beyond that.

[Mantels]

Does it help with water retention?I take Toprol xl and I am looking to decrease water retention, maybe this could work. I watch what I eat but can't lose any weight.

[~*CaMeO*~]

I'm a Type2 diabetic (diet controlled), have high BP (reasonably controlled by Lisinopril) and DID have screamingly high Lipid readings 4 years ago (cholesterol - 315 / tri's - 648) and my Doctor put me on a low cholesterol/low fat diet for 1 month to see if it would help.  I was 62, 5'2" and 120# and moderately active.  At the end of that month my readings were: cholesterol -414 / tri's - 1235 (no, that's NOT a typo).  Started on Zocor and only took it for 4 days as it knocked me for a loop, then tried Pravachol which I stayed on for 3 days as the sides were horrendous.  Third try was with Baycol and I managed that for 5 days and dumped them down the toilet (mind you, all 3 drugs were the lowest dose possible and I cut them in half as I know I'm medication sensitive).  Was then put on Lopid (not a statin) and today my readings are: cholesterol - 231 / tri's - 200.  My high lipids are not genetic ......... I just happen to be one of those folks who manufactures a heck of a lot more then I need.  I have a liver profile done (along with the lipid check and A1C for the diabetes) every 3 months and so far all is good.  I do watch my diet (not excessively though), exercise 3 days per week and TRY to keep stress to a minimum (not really successful with that).  Sorry for such a long post .......... am just leading up to a very strong suggestion that you need to control those lipids!  Try the statins and hopefully one of them will work for you. If not, there are other meds out there (older ones) which you can try.  Yes, you will have to take them for the rest of your life and sometimes your body becomes immune to one or another of them, meaning you'll have to switch meds.  Be sure to have a blood work-up done as often as your Doctor suggests to keep tabs on what's going on.  GOOD LUCK!

[Barbarella]

Cameo,

I read your post to Marina, and the success you had with "Lopid".  Since I'm scared to death of statins I was ready to call my doctor to see if he will prescribe Lopid for me.  But I "googled" it first to see what side effects the Lopid has and found out that Lopid is "part of a statin" whatever that means.  So far I've no side effects from Zocor but only have been taking it for about a week.

Marina,

There is a "none statin" drug out there (not over the counter)called "Colestid".  I took it for 3 months and my Cholesterol only went down 22 points (from 302 to 280) and my doctor was not satisfied with only 22 points in three months. I wanted to keep on taking it and slowly but surely probably my Cholesterol would have gone down, but my doctor got very irritated when I said that :) But maybe it works better for you.  Everybody is different.

[Gaspipe]

Just wondering why are you so afraid of statins? At least the older statins have been shown to have very favorable risk -benefit ratios ..Especially at the lower doseages.

[Barbarella]

The reason I'm so afraid of any statins is because I know how rough they can be on your liver otherwise why does your liver get checked every 3 months while on statins?  My husband was on Zocor for about 3 months and got severe pains in his hip.  His doctor did not want to admit that the Zocor "might" could be the cause.  He had Xrays done even a bone scan and they found nothing wrong with his hip.  He kept on taking the Zocor and the pain got worse waking him up at night.  He stopped taking the Zocor and it got better  and it took him almost one year before the pains in his hip finally stopped.  He was put on two more statins and the same happened again.  He is not taking any statins anymore but his Cholesterol never was more than 206 before taking the statins believe it or not.

A very good friend of mine was on Lipitor.  She developed muscle pains, flu like symptoms and called her doctor right away but again he told her "she might be coming down with something" and told her to keep on taking the Lipitor.  The flu like symptoms stopped but her joints started to ache real bad, again she told her doctor and his reply was "at your age you probably have arthritis" but told her to keep on taking the Lipitor. She had decreased urination, and hardly went to the bathroom anymore, and right after that she ended up in the ER with her kidneys shutting down, she spend 3 weeks in the ICU on life support in a coma.  FINALLY the doctors at the hospital admitted that Lipitor was the cause of all that.  She almost died.  She doesn't know yet if she is going to sue.  Right now she is happy that she is alive.

Then I read articles on line and in magazine, and books written by doctors and cardiologists who are not in favor of statins, and if you log on to the Zocor side effects chatroom you get an eye full what these people went through.  Of course that does not mean that any of that will happen to me, but right now the statins drugs have the biggest horror stories when it comes to side effects.

[vegashermit]

scary stuff about the kidneys...I've been on lipitor since 9 dec 04 after 3rd mild attack...guess kidneys will be another test to get...is nice to be alive though

[~*CaMeO*~]

I think that what you may have read while "googling" is that Doctors sometimes prescribe a statin to compliment the Lopid.  Lopid is usually prescribed for those of us who have absolutely no luck whatsoever in lowering their triglycerides.  Very high tri's can lead to pancreatitis (think that's how it's spelled).  Could you provide the site that says it's "part of a statin"?  I know it's a medication that has been around a l-o-n-g time and I'm comfortable with that as I've been used as a lab rat too many times with the "new and improved" medications for varying problems.  If your not having any sides from the Zocor, by all means, stick with it -------- but DO have a liver profile work-up done as often as your Doctor wants you to.

[Barbarella]

Go to Google and type in their search box "lopid side effects" once the site comes up click on the very first link.  Once that comes up you will see when you read the second sentence where it says "its part of a statin drug".  I really don't understand that term, either it is or is not a statin drug.

[~*CaMeO*~]

(You can call it lopid statins, since it is part of statin drugs).

I think what they mean by that statement is that Lopid (gemfibrozol) is in fact a part of some statin drugs.  I pinned my Doctor to the wall before I agreed to try Lopid, given my nasty reactions to 3 different statins, and he told me that Lopid has been around quite a bit longer than any statin.  He said the sides (if I encountered any) would be totally different from the statins, and would be quite mild.  As I never believe anything I'm told (major fault of mine I guess), I cut the tabs in half and went that route for a couple of months before going the full dosage and so far, so good (4 years now).  There are periods of time when I feel funky so I take a few days off from all medications and when I'm back on an even keel I resume taking them.  He doesn't yell at me (frowns alot though) because he knows that I'm a believer of: life's too short to spend it not feeling well due to medication's side effects.

Thanks for steering me to that statement though and I will draw it to his attention on my next visit just to see what he has to say.  I hadn't found that particular comparison on any other Lopid site.  Take care .. God Bless!

[Barbarella]

I'm exactly like you when it comes to statins :) I started out cutting the 20mg Zocor in half for about 3 days.  Now I'm taking the whole 20mg "every other day".  Would you believe a doctor told this to one of my husband's co-workers.  The doc said "take it every other day that is what I do". As you can see even a doctor is careful about these statin drugs.

BTW, have you ever read the book "The Cholesterol Myths"? by Uffe Ravnskov, MD, PhD.  He himself got high Cholesterol (around 275) and he studied Cholesterol and people with high Cholesterol for over 15 yrs. You'd be blown away once you read his book.  A Cardiologist, Howard H. Wayne he also wrote a book agrees with Dr. Uffe. Uffe urges every person to show his book to their doctor.  Yeah right, I could see my doctor if I would present him with this book.  He gets mad when I tell him what I read on the Internet.

The book gives you lots of food for thought.  I'm skeptical otherwise I would NOT the Zocor would I believe Dr. Uffe 100%, but to be honest with you I am not as scared about Cholesterol anymore since I read his book and the book by Dr. Wayne.

Take care.  You've been 4 yrs on Lopid that looks like you got the green light.  Lets hope it will be the same for me :)

[~*CaMeO*~]

Yes, I have read passages from this book and couldn't agree more.  More people with borderline lipid numbers should delve into this one --------- makes one sit up and pay attention!

Post back and let me know how it goes with you and the Zocor - I certainly wish you the best!

[Barbarella]

You wanted me to post back and tell you how I'm doing with the Zocor.  Read my response to you on the "Hypertension" blog above on this site, my results threw me for a loop.