Faint & Dizzy EVERYDAY

[MStarGirl]

Dear Professionals:
I am faint and dizzy on a "daily" basis.  I've been to the ER twice and the doctor's office five times.  I'm on Meclizine daily (I can take up to 150 mg daily, but I only take 25 to 50 mg daily) and 81 mg aspirin. I've had two EKG's, one Echo test, my MRI is on Monday, Jan 9th and a Bilateral Carotid Ultrasound, Jan 26th.

I am suppose to start Lipitor. My question is: Do you think it's safe to take Red Yeast Rice tablets from the health food store, instead of Lipitor?

And, are my doctors doing every test they need to do?  (I went to my primary care doctor yesterday and said, "how come these tests are not being ordered STAT?!) My doctor's reply was, "we don't have an MRI machine here - so you have to wait for the MRI on Monday."

This is my life and I cherish it.  Any advice would be graciously appreciated.

Thank you,

Mar

[CCFHeartMD11]

With regards to the red rice yeast, the reason that people talk about it when they talk about medications like Lipitor is because both inhibit an enzyme called HMG Co-Reductase, which helps produce cholesterol in the liver. There is data to suggest that Red Rice Yeast is effective in decreasing LDL (bad cholesterol). It also has fewer side effects than Lipitor. However, supplements are not regulated by the FDA, so it is harder to be sure what you are getting when you buy them. Before deciding to use Red Rice Yeast instead of Lipitor, it would be worthwhile to talk to your doctor to formulate a plan -- for example, set a time frame during which you will be taking Red Rice Yeast, after which a repeat cholesterol panel will be checked, and if not at goal, then Lipitor can be added or substituted. Also, you should investigate reputable locations to get quality supplements.

With regards to the workup, it sounds like the right things are being investigaged. The main concerns with dizziness are the brain and the heart. An echocardiogram and ECGs are good places to start with the heart, because abnormal heart function and abnormal heart rhythms could explain the symptoms. If those were normal, that is reassuring. If you are also having a sensation of abnormal heart beats or irregular heart beats, another possible test could be a Holter Monitor or an Event Monitor, which basically monitors your heart rhythm for a period of time to assess for any abnormalities that coincide with your symptoms. With a completely normal ECG and in the absence of funny heart beats, though, this probably isn't necessary. Looking at blood flow to the brain (via carotid ultrasound) and looking for structural abnormalities of the brain (via MRI) are also reasonable exams to do. Given that your symptoms have been ongoing for a long period of time and sound relatively stable, there is not a huge rush to get the tests. Obviously, a streamlined workup is preferable, but having the tests occur over the course of a few weeks will not be detrimental to the course. The difference in a few days at this point is likely negligible in terms of long-term outcome.

Another thing to consider as the etiology of dizziness is the inner ear. You should probably have your hearing checked and be assessed for Benign Paroxysmal Positional Vertigo, which is a condition in which some of the particles in the inner ear get lodged in small spaces, causing dizziness when you move around. This is easily fixed by something called an Epley Maneuver, which is a series of head turns and body position changes that are directed by a physician. It would be reasonable to ask your doctor about this.

If you haven't already, having your vision checked would also be a good idea, as even a suble visual abnormality (that may not be noticeable to you) could explain dizziness,

[MStarGirl]

Dear CCFheartMD11,

Thank you graciously for the response.  I appreciate the input in regards to the Red Yeast Rice.  I know this product is not regulated by the FDA, which is why I'm hestitant to get it. I was told by the local health food store owner, customers will go on Red Yeast Rice once diagnosed with high cholesterol-then take the product over a month, or until the bottle is finished, have blood work done and as she said, the bad cholesterol number is lower.

I do have a heart murmur.  I've been taking Atenenol for over ten years now, I've been told - since it's a beta-blocker, this is probably why I almost never feel my heart murmur.

Thank you for mentioning the tests you recommend, as well as what my dizziness and faint feeling could be.  

Most Respectfully,
   Mar