just had fasting cholesteral test - total 226 hdl 63 ldl147 on zetia 10mgs. dr wants to start me on zocor 20 mg. i execise 6 days a week cario 50 mins a day. no family of heart disease unless you consider father had first heart problem at age 87. i do all the right things etc. oatmeal. metamucil, flaxseed, plant sterols. no eggs .butter cheese etc. mother is 81 with no heart problems, what do you think.
Your LDL is high, so it would be a good idea to take a low dose statin to improve it. Your LDL should be 100 or lower. You can, however, lower LDL by eliminating red meat. In one year time, you should see a considerable drop in LDL level. Also, salmon, nuts, omega 3 is good for the heart. Eat lots of fresh vegetables (not canned) and fruit, brown rice. What are your triglycerides? Your HDL is good. If you start the statin, make sure that your liver enzymes are checked at least every 6 months. If it were to start affecting your liver, the doctor can either cut back on the statin or stop it for awhile to allow the liver to heal itself. All the doctors that I know, are on a low dose statin (some lower than the recommended starting dose) and some of them do not even have high cholesterol. They take the statin for prevention of heart disease. If you cannot improve the LDL levels with diet, a statin would be helpful to prevent blockage buildup. Also, an 81mg (low dose) aspirin helps to prevent inflammation which is a cause of heart disease. If there is inflammation, then the cholesterol has a place to stick. Ask your doctor if you can add a low dose aspirin a day. Also, Lecithin is a good supplement to take to keep the arteries healthy and slippery.
thats all i eat is what you suggested. i take 81mg aspirin, my triglicerides (triglycerides) are 98, do not eat red meat and eat 4-5 fresh friuts and veggies, salmon sardines almonds and fish oil daily with a vigorous cardio workout six times a week . i read that less than 130 ldl was good for no other risks . i am only 17 points above. What about my ratio that appears good ??? again for this borderline levels would you have started off at a lower dose of stains ?
As far as statins go, I have been on them for years and had no side effects with great results. However, as with any cholesterol medications, you have to do your part which includes a heart healthy diet and exercise, don't depend on your meds alone. I dropped my cholesterol number considerably and have been vert happy with the results. But to be objective, you need to see both sides. Here's what the Mayo Clinic says about the side effects of statins;
"Muscle pain The most common statin side effect is muscle pain. You may feel this pain as a soreness, tiredness or weakness in your muscles. The pain can be a mild discomfort, or it can be severe enough to make your daily activities difficult. For example, you might find climbing stairs or walking to be uncomfortable or tiring.
Very rarely, statins can cause life-threatening muscle damage called rhabdomyolysis (about one case for every 15 million prescriptions). Rhabdomyolysis can cause liver damage, kidney failure and death. Rhabdomyolysis can occur when statins are used in combination with certain other drugs.
Liver damage Occasionally, statin use could cause your liver to increase its production of enzymes. If the increase is only mild, you can continue to take the drug. If the increase is severe, you may need to stop taking the drug, which usually reverses the problem. Your doctor might suggest a different statin. If left unchecked, increased liver enzymes may lead to permanent liver damage. Certain other cholesterol-lowering drugs, such as gemfibrozil (Lopid) and niacin, increase the risk of liver problems even more in people who take statins. Because liver problems may develop without symptoms, people who take statins should have their liver function tested about six weeks after they start taking a statin, and then again every three to six months for the first year of treatment, particularly if their statin dose is increased.
Digestive problems Some people taking a statin may develop nausea, diarrhea or constipation after taking a statin. These side effects are rare. Most people who have these side effects already have other problems with their digestive system. Taking your statin medication in the evening with a meal can reduce digestive side effects.
Neurological side effects Some researchers have studied whether statins could be linked to memory loss or amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. Researchers have not found a link between statin use and either condition." Having said that, I will continue to use stains gladly as they have done a great job for me, but everyone is different.
Having said all this, I still believe in statins and take them daily. As I said, they have worked great for me in conjunction to a heart healthy diet and exercise and my results have been nothing short of fantastic. Everyone is different and there are many options out there, you should discuss them with your doctor.
You need to weigh the risk of high cholesterol causing CAD to the very slight risk of these side effects. Before you decide, consider the following;
Side Effect #1: Liver Enzyme Elevation
All statin drugs have been shown to elevate liver enzymes to some degree. Liver enzymes include aspartate aminotransferase (AST) and alanine aminotransferase (ALT), which are monitored before beginning statin therapy, three months after beginning statins, and least every six months while on statin therapy. When your liver enzymes are elevated, may not experience any symptoms.
When standard doses are given, liver enzyme elevation occurs in about one percent of individuals taking statins. This liver enzyme elevation is usually seen within the first four months of therapy. The likelihood of this elevation increases in older people and in those taking other medications that might interact with statins and also raise liver enzymes. The risk of developing elevated liver enzymes while on statins is also dose-dependent, which means that the higher the dose of statins you are taking, the more likely you will experience an increase in your liver enzymes.
Although there have been reports of liver failure and hepatitis associated with statins and elevated liver enzymes, these occurrences are rare. Current studies have not been able to establish a definite link between statin use and liver disease. If for some reason your liver enzymes do become elevated, they are restored back to normal once the statin is stopped.
Side Effect #2: Muscle Pain and Weakness
Myopathies, or muscle symptoms such as weakness and pain, are also another reason many individuals shy away from statin therapy. Myopathies range from mild myalgias, or muscle pains, to a life-threatening condition known as rhabdomyolysis. It is currently estimated that the most common myopathy associated with statin use, myalgia, only occurs in about one person out of every 1,000 people taking statins.
The chance of experiencing myopathies while on statins increases as you get older, with higher doses and while taking other medications that may interact with statins. These symptoms will usually appear within four months of initiating statin therapy.
Rhabdomyolysis, another myopathy that can occur with statin use, is characterized by profound muscle pain, weakness, significantly increased amounts of creatinine phosphokinase in the body, and bloody urine (due to muscle breakdown and the release of myoglobin in body). Although this condition is deadly if not properly treated, it also extremely rare. Rhabdomyolysis occurs in one person out of 10,000 individuals taking statins.
The Benefits Outweigh The Risks
Although side effects are associated with statin use, these side effects are relatively uncommon when compared to the reduction in cholesterol and lowered risk of heart disease that can be gained in many individuals with statin therapy.
Again, I am very happy with my decsion to use statins, you need to weigh the risks against the benefits to decide for yourself. Ask your doctor about your options. Your benefit will be a reduction in LDL which at 167 puts you at risk.
There really isn't enough data yet to establish true long term effects of statins. It is only relatively recently that they have been dished out to the public like the miracle candy.
If you start statins, you will notice quickly if something isn't right. You simply stop taking them and report back to your GP. Statins will not kill you over night.
Statins have been on the market since 1987 so there is a 22 year history to go back on. Not terribly long but long enough to gather data on their effectiveness and safety. Ed is correct, if you start, watch for symptoms and have your blood checked after 30 - 60 days to see how your liver is responding. You can always quit taking them, but with a high LDL you will always be at risk for CAD.
If this is your first time with slightly elevated (altho your LDL is pretty high) then I don't think statins would be the first course of action. My doctor is not very quick with the Rx pad. I'd try some things to lower it on my own, such as krill oil, continuing to exercise, etc. first. There are even non-statin things that can be prescribed (there is a powder that you mix and drink daily, forget the name) first. I am not sure of your age, but your family history is good. Personally I would wait, test again in 6 months, and ask that your CRP be checked as well... which looks for inflammation in the vessels. That is as critical or more so than cholesterol. This is of course my opinion and how I would approach it and I am not a doctor.
I don't know what more this individual can do on their own. They are doing 50 mins of cardio 6 days a week, using supplements and taking Zetia and still has a high LDL. I don't think it would be unreasonable to start a statin if their lifestyle is not getting the desired results. I guess there could be some diet changes, but they don't give much more info.
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