Atorvastatin v Simvastatin

[cheeryble]

My LDL and total lipids are high 

My HDL and triglycerides are optimal.

 

Ive just been prescribed atorvastatin 10mg which I believe is something over 500bt/30

Wife's mum happens to take simvastatin (lipitor?) and can give me free don't ask how.

 

Is there enough benefit to buy the atorvastatin given my total meds are already about 5000/month?

 

Thanks

[VBF]

Difficult question to answer.

 https://www.singlecare.com/blog/atorvastatin-vs-simvastatin/

 

This implies that Atorvastatin is more effective https://www.ncbi.nlm.nih.gov/pubmed/10687671

I had events last year and was prescribed Atorvastatin - my NHS Cardiac Nurse said it's more effective.

 

https://www.nhs.uk/conditions/statins/

 

In my case it's a no-brainer as it's free.

You MIGHT be taking other meds that interact with one or the other although the links suggest that they're the same in that regard.

I would suggest you ask your prescriber (doctor or nurse) WHY they prescribed what they did.

[BigJ]

You may wish to do some research before taking any statins.  I think VBF was hinting at that too.  Many studies show that the triglyceride/HDL ratio is the strongest predictor of coronary artery disease and you say your levels are "optimal".  Take a few hours (we all have free time now) and do some research on the internet on the association of high LDL to CAD and the side effects of a statin drug before making your decision.

[tifino]

yeah, 'statins don't differentiate between HDLs and LDLs

 - they wholesale rip out both... 

 

Losing all that good HDL, alongside the actual LDLs that you did want to lose... means you have lost your last line of defence against LDLs fighting back

 

maybe you also could instead go down the COQ10 path? \

 - as it concentrates on the actual LDL, directly aiming at prevention of LDL Oxidation...

Edited April 10, 2020 by tifino

[Why Me]

OP:

Lipitor is atorvastatin. My notes from an old thread from way back say that atorvastatin can be replaced by (the much cheaper) simvastatin by doubling the dose. E.g., your 10mg/day atorvastatin (my dose too) equals  20mg/day simvastatin.

 

Another thing I picked up is that some brands of simvastatin 40mg tabs are particularly cheap (like 30b/10). Then use a pill cutter to get 20mgs.

[Puchaiyank]

Been taking Simvastatin for decades to control my cholesterol...eat what I want when I want...

 

I used the 40 mg once per day pill.

[Sheryl]

12 hours ago, BigJ said:

You may wish to do some research before taking any statins.  I think VBF was hinting at that too.  Many studies show that the triglyceride/HDL ratio is the strongest predictor of coronary artery disease and you say your levels are "optimal".  Take a few hours (we all have free time now) and do some research on the internet on the association of high LDL to CAD and the side effects of a statin drug before making your decision.

 

As above - there are other ratios also important but with low tricglycerie and high HDL yo uwill come out well on all of them.

 

As a first step you need to make sure the LL result is direct LL not indirect method. They usually do indirect and if your triglycerides are under 100 that method is not accurate.

 

Quite possible that a repeat LDL test that is direct will put you in or not much above normal range.

 

If it still shows high LDL (would help to know the actual numbers here) you should discuss with a specialist who is up to date on dyslipidemias as a favorable triglyceride/HDL ratio would suggest most of the LDL particles are of the "good" type.

 

See https://www.docsopinion.com/2014/07/17/triglyceride-hdl-ratio/

for a clear explanation

 

If it does turn out you need a statin (it may not) then simvastatin works as well as the more expensive atorvastatin in most patients.

 

[cheeryble]

Thanks to all.

Age 71

As Parkys makes typing v slow I will put the basics.

 

Total Cholesterol 218mg/dl

Triglyceride 85

HDL-C 59

LDL-C 142

Ive always avoided statins but have exercised daily and quite hard

This has changed now I have PArkys I move slow am not strong and exercise is modest, so I'm willing to go the statin route if necessary.

         

Edited April 11, 2020 by cheeryble

[Sheryl]

2 minutes ago, cheeryble said:

Thanks to all.

Age 71

As Parkys makes typing v slow I will put the basics.

 

Total Cholesterol 218mg/dl

Triglyceride 85

HDL-C 59

LDL-C 142

Ive always avoided statins but have exercised daily and quite hard

This has changed now I have PArkys and exercise is modest, so I'm willing to go the statin route if necessary.

         

 

You definitely need to get re-tested with a direct measure of LDL

 

Then as I said before consult a specialist up to date in these matters.

 

Quite possible stains not necessary. Don't rush into them

[cheeryble]

15 minutes ago, Sheryl said:

 

You definitely need to get re-tested with a direct measure of LDL

 

Then as I said before consult a specialist up to date in these matters.

 

Quite possible stains not necessary. Don't rush into them

Very interesting and sounds valid Sheryl especially knowing your critical eye has been over it.... and perfectly happy to follow this route.

I have a very good relationship with the GP and who oversaw the check up and guess I can "question" him with no problem. I had a bad experience with another doc here once.

 

[VBF]

@cheeryble  This is an interesting thread - I too avoided Statins for many years despite having what I thought was marginally high Cholesterol levels. After events last year, I now take the Atorvastatin 80mg daily and am supposed to be having a review in June this year.

 

Unfortunately the Covid outbreak has put a lot of appointments on hold here in UK. I've just logged a request for blood tests and hopefully a GP appointment (a telephone appointment would serve quite well here) so we shall see what we see. 

Do keep us in the picture please. 

 

[cheeryble]

56 minutes ago, VBF said:

@cheeryble  This is an interesting thread - I too avoided Statins for many years despite having what I thought was marginally high Cholesterol levels. After events last year, I now take the Atorvastatin 80mg daily and am supposed to be having a review in June this year.

 

Unfortunately the Covid outbreak has put a lot of appointments on hold here in UK. I've just logged a request for blood tests and hopefully a GP appointment (a telephone appointment would serve quite well here) so we shall see what we see. 

Do keep us in the picture please. 

 

May your events be little ones!!

 

ps interestingly the results give me a prediction of 15% odd of a CV event in the next ten years

Edited April 11, 2020 by cheeryble

[cheeryble]

.

Edited April 11, 2020 by cheeryble

[Sheryl]

2 hours ago, cheeryble said:

Very interesting and sounds valid Sheryl especially knowing your critical eye has been over it.... and perfectly happy to follow this route.

I have a very good relationship with the GP and who oversaw the check up and guess I can "question" him with no problem. I had a bad experience with another doc here once.

 

 

GP is highly unlikely to  know enough. A Western GP (if  keeping up with the literature) often will, but I haven't encountered a single GP in Thailand who has in depth, up to date knowledge on this. You need a specialist who is up to date on dyslipidemias or an up to date cardiologist.

 

But first get the direct LDL test. You can go direct to a lab for it and indeed that is better as GP may not even understand the difference.

[cheeryble]

6 hours ago, Sheryl said:

 

GP is highly unlikely to  know enough. A Western GP (if  keeping up with the literature) often will, but I haven't encountered a single GP in Thailand who has in depth, up to date knowledge on this. You need a specialist who is up to date on dyslipidemias or an up to date cardiologist.

 

But first get the direct LDL test. You can go direct to a lab for it and indeed that is better as GP may not even understand the difference.

Did I see a notice for a lab off the Mahidol Road anyone?

I live south of town

Edited April 11, 2020 by cheeryble

[myprivate]

Similar dilemma for me. I've been taking statins for nearly 20 years as I was diagnosed with high cholesterol in the old days when they only looked at the "total" number. I get aches and fatigue from the statins after a while, and so I have a statin holiday every year or so for about 1-2 months. During my last statin holiday I had a blood test to see what my natural levels are, as below;

 

Total Chol 283 <200

Trigly 96 <150

HDL-C 71 >55

LDL-C 214 <130

 

(Exercise stress test and other blood tests normal)

 

So I also have this mix of "very good" Triglyceride and HDL levels, but "very bad" Total Chol and LDL levels.

[Why Me]

On 4/11/2020 at 3:06 PM, Sheryl said:

You need a specialist who is up to date on dyslipidemias or an up to date cardiologist.

Hi Sheryl:

Is there someone you would recommend in Bkk (Bumrungrud maybe)?

Thanks.

[Sheryl]

21 minutes ago, Why Me said:

Hi Sheryl:

Is there someone you would recommend in Bkk (Bumrungrud maybe)?

Thanks.

 

https://www.bch.in.th/find-doctor/doctor-profile/?smid=4730

very good, up to date cardiologist

 

also at Rhamkamheng Hosp

 

https://translate.googleusercontent.com/translate_c?depth=1&hl=en&prev=search&rurl=translate.google.com&sl=th&sp=nmt4&u=https://www.ram-hosp.co.th/searchdoctor1%3Fmajor_id%3D%26doctor%3D336&usg=ALkJrhi8rLA0hmmzWcLw4N-c0Yx_dK1yMQ

 

 

[cheeryble]

Hi Sheryl

i went to a reputable medical lab.

My DIRECT LDL came out at 190, a higher figure than the indirect (148).

I might add when he saw my figures with HDL of 59 he questioned needing a test.

How to interpret the whole thing?

 

Thanks

Edited April 14, 2020 by cheeryble

[Sheryl]

20 hours ago, cheeryble said:

Hi Sheryl

i went to a reputable medical lab.

My DIRECT LDL came out at 190, a higher figure than the indirect (148).

I might add when he saw my figures with HDL of 59 he questioned needing a test.

How to interpret the whole thing?

 

Thanks

190 is pretty high. High enough that most doctors would agree with treating with a statin.

 

 

[VocalNeal]

On 4/13/2020 at 12:22 PM, Sheryl said:

 

https://www.bch.in.th/find-doctor/doctor-profile/?smid=4730

very good, up to date cardiologist

 

also at Rhamkamheng Hosp

 

https://translate.googleusercontent.com/translate_c?depth=1&hl=en&prev=search&rurl=translate.google.com&sl=th&sp=nmt4&u=https://www.ram-hosp.co.th/searchdoctor1%3Fmajor_id%3D%26doctor%3D336&usg=ALkJrhi8rLA0hmmzWcLw4N-c0Yx_dK1yMQ

 

 

Cheers,

 

I was wondering where to go > i will return to BCH next week and see him.

[cheeryble]

On 4/15/2020 at 4:33 PM, Sheryl said:

190 is pretty high. High enough that most doctors would agree with treating with a statin.

 

 

Thanks Sheryl

 

A shame would have liked to avoid as the Parky's already gives me fatigue and discomfort.

Hmmm...