Should I take statins or not?

[bamboozled]

I'm 55 and my latest total cholesterol is 248. It's been over 220 (at least) for about 7 years (I know from looking at some older test result). LDL is 174 and HDL 78. So they're ALL high: the good, the bad, and the ugly. The Dr., when I asked about statins, said she would recommend it. I'm not super keen on taking a drug every day. Then again, I'm not keen on having a heart attack, either. I'm quite fit and exercise frequently. My blood pressure is fine. I don't smoke. I eat healthy food, very little fried, lots of fruits and veggies. I do eat full fat yogurt and eggs, all sorts of meats (not processed), some cheese, olive oil, etc... Sure, some sweets and baked goods but not regularly. I do drink a fair bit of alcohol but my latest test was after 6 weeks of abstaining and it has gone up since my last test, not down, thus I don't feel that was a big contributing factor. I am feeling a lot of stress and generally that is my personality type. Stress is supposed to increase your cholesterol levels so perhaps that is the root cause. Yes, I'm working on lowering stress. So far, to little avail. Lastly, it could just be my fate/genetics.

 

Other doctors that viewed my test results did not push me to take statins and ultimately it is a personal decision I must make. Any people here have any anecdotes to add based on the above info? My sister who is on them complained of initial achy muscles but that cleared up.

Thank you!

[NoDisplayName]

I've been taking statins (simvistatin) for 'bout 20 years.  Originally had all high numbers, with total cholesterol around 300+.  I was running marathons, cycling cross country, eating healthy, so not much lifestyle changes I could have made.

 

I believe it's mostly genetic.  With statins (20mg/day) all my numbers are normal.  My current diet consists mainly of pizza, KFC, tater chips, donuts and soda.  Hardly exercise any more, jog/cycle/weights a few times a week.  I get a blood test every 3-4 months and adjust dosage accordingly.

 

Statins are cheap, blood tests are cheap.  Why not start with your doctor's recommended dosage for 3 months and see how you respond?  Have a lipid panel done every 30 days.

[SiamAndy]

Do an online search and you will see that one side effect is decreased libido. Anyway as they say in TL, up to you.

[bignok]

High cholesterol people live longer. Google it. Id sack the drug pushing doctor.

 

 

 

 

Edited November 15, 2023 by bignok

[bignok]

Here you go. Pay me 1000 baht and sack the doctor

 

https://www.sciencedaily.com/releases/2016/06/160627095006.htm

[KhunLA]

I AM NOT A DOCTOR ...

 

Take in as much good cholesterol as you can.  Eating healthy doesn't mean cutting all fats & cholesterol from your diet.   

 

Whatever cholesterol you don't eat, your liver will compensate for and make.  Liver makes bad cholesterol.  Statin is a drug that slows, prevents the liver from doing this.

 

When I was younger and ate everything & anything, my cholesterol was excellent.  Enter 'eat healthy',...  lower fats & cholesterol intake, and my numbers were completely reversed.  On statin now, liver 'controlled', and numbers instantly back to excellent.

 

I'm weening myself back on all the fats & good cholesterol I used to eat, and will be weening myself off the statins.

 

It's almost like they tell you to 'eat healthy', to sell drugs ... shh

Edited November 15, 2023 by KhunLA

[mstevens]

To answer your question, no, I would not take statins - at least, not before trying and if necessary, exhausting, all lifestyle factors first. I am a big proponent of trying lifestyle adjustments and natural medicine first - and only using pharmaceuticals if absolutely necessary. The reason for this is that pharmaceuticals have a lot of side effects. Yes, sometimes they may be necessary, but it's very much worth trying lifestyle choices first.

 

My understanding is that the key number with your cholesterol is the ratio of good (HFL) to bad (LDL). That's how my doctor explained it to me. Not the total, but the ratio.

 

Personally, I eat a high fat diet including eggs (minimum 3 per day), nuts (macadamias and pecans), seeds (pumpkin, flaxseed, sunflower), more red meat than is "recommended" with 4 or 5 red meat meals per week, avocados, olive oil, avocado oil, butter and a little cheese - and my cholesterol ratio is "outstanding" according to my doctor. To be clear, I do not eat a keto diet per se, but I do aim for high fat / and moderate to low carbs. I get a full blood panel and check in with my doctor every year and no concerns whatsoever from Doc.

 

I know those with experience in the medical industry will blast me for saying this but I am of the belief that a diet high in healthy fats (and low in carbs) is a key to good health.

 

 

 

Edited November 15, 2023 by mstevens

[bignok]

7 minutes ago, mstevens said:

know those with experience in the medical industry will blast me for saying this but I am of the belief that a diet high in healthy fats (and low in carbs) is a key to good health.

 

Doctors get rich off people eating carbs. Fats are essential. Carbs are not. Humans can go without carbs but can't go without fat.

 

Most doctors have less than 20 hours training in nutrition. They are drug pushers. They live 5 to 10 years younger on average.

[JackGats]

My cholesterol, including my "bad" cholesterol, has been sky-high for over a decade now. Nothing to do with diet, same as my mother. I'm skinny and eat little. I tried out statins and got cramps in my legs from day one.  Apparently statins hinder muscle build-up. I am not naturally muscular. I need to work out to gain some muscle definition. If I take statins I'll be scrawny like a grasshopper. I also read the literature about the link between statins and diabetes. So statins are the meds I've decided to pass on, come what may.

[bamboozled]

Thanks all. A lot of good stuff here and my thoughts are echoed in pretty much all the comments. I have indeed read that they now think diet is much less a cause of high cholesterol. And the negatives on carbs. To this end, I eat less carbs and more full-fat proteins. Who knows...these ideas on how to eat will prob. change yet again as the pendulum swings. So hard to know. I have looked for research debunking the high cholesterol being bad idea but did not find any. Thanks bignok for ur input on that. Still, the consensus in the med community seems to be pretty neg. on high cholesterol. Yes, one doctor a few years back did tell me not to worry about my high total C as my HDL was also high. I'm annoyed that my total C is going UP even after the exercise, no alcohol, and eating what I think is healthy.

 

I have not read that statins lower libido but will check that out. I'd love to just take a little bit everyday, get the benefit, and go on my merry way. But as some of you have pointed out, it's usually never that simple. There are usually side-effect and indeed I do not want to become another supplicant to big Pharma.

 

Any more input, please, bring it on.

 

By the way, the doc did not indicate how much or what I should take. We didn't get that far into the conversation. I was actually there for a thyroid check but got the lipid test at the same time since it was convenient.

Cheers!

[Sheryl]

total cholesterol is irrelevant.

 

Your LDL is definitely too high (optimal is under 100; anything above 160 is dangerously high). So you need to get that down.  If as it sounds from your post you are not going to be able to do that with lifestyle modifications then medication is advisable.  A statin would normally be tried first but if it does not suit there are other drugs that can be used instead e.g. niacin, fibrates, ezetimibe etc.

 

What is your triglyceride level? And what is your Hb1Ac?

 

You cannot assume good cardiac health just because you are physically active. A cardiac calcium test or stress test would be advisable and results could help inform target LDL levels and medication decision.s

[Uttaradit farang]

I had heart attack 7 years ago and I’m on 80mg statins. Was back in the uk and had my 6 monthly MOT test and my cholesterol was a little on the high side. 
I was given a newish treatment, 2 injections a year. And continue to take my statins. 
https://www.heartuk.org.uk/getting-treatment/inclisiran

[bamboozled]

5 minutes ago, Sheryl said:

total cholesterol is irrelevant.

 

Your LDL is definitely too high (optimal is under 100; anything above 160 is dangerously high). So you need to get that down.  If as it sounds from your post you are not going to be able to do that with lifestyle modifications then medication is advisable.  A statin would normally be tried first but if it does not suit there are other drugs that can be used instead e.g. niacin, fibrates, ezetimibe etc.

 

What is your triglyceride level? And what is your Hb1Ac?

 

You cannot assume good cardiac health just because you are physically active. A cardiac calcium test or stress test would be advisable and results could help inform target LDL levels and medication decision.s

Hi Sheryl,

 

Triglyceride is 66. VLDL is 13. I did the full package health checkup at Rajavej in August including an EKG. Not what you intend? The test does indicate, "borderline ECG". No idea what that is. They checked "OK" for heart. I have a BPM of 55. A bit slow.

 

Hb1Ac...that's the type 2 diabetes, right? I asked the doc about getting that test and she said based on my August FBS test (86) there was no need for the Hb1Ac test.

 

Thank you!

[bamboozled]

11 hours ago, NoDisplayName said:

I've been taking statins (simvistatin) for 'bout 20 years.  Originally had all high numbers, with total cholesterol around 300+.  I was running marathons, cycling cross country, eating healthy, so not much lifestyle changes I could have made.

 

I believe it's mostly genetic.  With statins (20mg/day) all my numbers are normal.  My current diet consists mainly of pizza, KFC, tater chips, donuts and soda.  Hardly exercise any more, jog/cycle/weights a few times a week.  I get a blood test every 3-4 months and adjust dosage accordingly.

 

Statins are cheap, blood tests are cheap.  Why not start with your doctor's recommended dosage for 3 months and see how you respond?  Have a lipid panel done every 30 days.

NoDisplay...did you experience any side-effects of note?

[save the frogs]

11 hours ago, NoDisplayName said:

My current diet consists mainly of pizza, KFC, tater chips, donuts and soda. 

Jesus man.

Some people really like to tempt fate. 

 

 

[save the frogs]

Study: statin-associated memory loss

 

 

 

[Mike Lister]

1 minute ago, save the frogs said:

Study: statin-associated memory loss

 

 

 

Ah well, if Youtube says it does, it must be so! 

[Mike Lister]

On 11/16/2023 at 9:34 AM, bamboozled said:

Hi Sheryl,

 

Triglyceride is 66. VLDL is 13. I did the full package health checkup at Rajavej in August including an EKG. Not what you intend? The test does indicate, "borderline ECG". No idea what that is. They checked "OK" for heart. I have a BPM of 55. A bit slow.

 

Hb1Ac...that's the type 2 diabetes, right? I asked the doc about getting that test and she said based on my August FBS test (86) there was no need for the Hb1Ac test.

 

Thank you!

FWIW I think, from experience, is that a FBS is unreliable, simply because it is a single snap shot in time. Blood sugar levels rise and fall constantly throughout the day, even a FBS first thing in the morning on an empty stomach is unreliable because of various syndromes and false readings such as dawn phenomena. It's not a big deal but if you want a reliable blood sugar test, get an HbA1C because it measures glycated red blood cells that have a life of around 90 days hence the reading is a much more accurate measurement of you blood sugar levels over three months, rather than one day. The cost of an A1C is very low.

[save the frogs]

15 minutes ago, Mike Lister said:

Ah well, if Youtube says it does, it must be so! 

People think Youtube is a joke. There are silly cat videos on Youtube, but also serious stuff. It runs the whole gamut and is not to be dismissed as a complete joke. 

 

I think he has a medical degree.

Still doesn't mean he's right, though.

But he is quoting a study, not just stating an opinion. 

 

[Mike Lister]

1 minute ago, save the frogs said:

People think Youtube is a joke. There are silly cat videos on Youtube, but also serious stuff. It runs the whole gamut and is not to be dismissed as a complete joke. 

 

I think he has a medical degree.

Still doesn't mean he's right, though.

But he is quoting a study, not just stating an opinion. 

 

I understand, it's just that I think that something as important and serious as medical treatment and issues should only use first hand information and data from acknowledged and highly regarded sources. Personally, if I want information on anything medical I go to the Mayo or Cleveland Clinic as a starting point, that leaves me feeling like I've got an accurate answer without me having to try and interpret messages that I'm not equipped to do.

[Skipalongcassidy]

Just choose which way you want to kill yourself... poor eating habits or statins... I chose poor eating habits because it's lots more fun than taking pills and am still going strong at 76... 555

[bamboozled]

I will get some more testing done. I'm not convinced of anything yet with the info I have so far. Yes, the A1C is on the list. Did someone mention a blood testing facility here in Chiang Mai?

[Sheryl]

On 11/16/2023 at 9:34 AM, bamboozled said:

Hi Sheryl,

 

Triglyceride is 66. VLDL is 13. I did the full package health checkup at Rajavej in August including an EKG. Not what you intend? The test does indicate, "borderline ECG". No idea what that is. They checked "OK" for heart. I have a BPM of 55. A bit slow.

 

Hb1Ac...that's the type 2 diabetes, right? I asked the doc about getting that test and she said based on my August FBS test (86) there was no need for the Hb1Ac test.

 

Thank you!

Triglycerides are fine then. In fact  lower than average -- which is good but also means that   if your LDL measure was indirect it may not be accurate. So I suggest you make sure in future to get only direct LDL measurements.

 

An EKG is not what I meant. Rather,  I meant either an Exercise Stress Test or a Coronary Artery Scan. The latter can be of special value in deciding whether or not to take statins.

 

An EKG tells whether or you are having or have had a heart attack or are in a chronic abnormal heart rhythm, or are currently experiencing lack of adequate blood flow to the heart., It does not tell you anything else about the state of your coronary arteries nor what blood flow to the heart and heart rhythm are like when not at rest.

[bamboozled]

2 hours ago, Sheryl said:

Triglycerides are fine then. In fact  lower than average -- which is good but also means that   if your LDL measure was indirect it may not be accurate. So I suggest you make sure in future to get only direct LDL measurements.

 

An EKG is not what I meant. Rather,  I meant either an Exercise Stress Test or a Coronary Artery Scan. The latter can be of special value in deciding whether or not to take statins.

 

An EKG tells whether or you are having or have had a heart attack or are in a chronic abnormal heart rhythm, or are currently experiencing lack of adequate blood flow to the heart., It does not tell you anything else about the state of your coronary arteries nor what blood flow to the heart and heart rhythm are like when not at rest.

Hi Sheryl,

 

Are those pricey tests to get, the stress test and the artery scan? Seems like it indeed would give a good indicator for taking statins or not. Do you favor one test over the other for my issue?

 

My cholesterol for the last 7 or 8 years, on 4 different tests, has shown LDL always above 220. I don't know if it was indirect or direct. How might I know that? HDL was always higher than normal, as well.

 

Strangely, my past thyroid tests, 3 I think, all showed my TSH over 3 and one I had in August showed 3.92, the highest ever. 2 weeks ago I got another and TSH had dropped to 1. The only life-style change I've made is I haven't been drinking any alcohol 6 weeks prior to that latest test (the one showing TSH dropping to 1). Would that account for such a huge difference? It seems like such a drastic change to me.

 

Hypothyroidism would account for a lot of my symptoms including the high cholesterol, from what I understand.

 

Thanks to Sheryl and to everyone for not dropping the ball on this with the site outage!

[Sheryl]

9 minutes ago, bamboozled said:

Hi Sheryl,

 

Are those pricey tests to get, the stress test and the artery scan? Seems like it indeed would give a good indicator for taking statins or not. Do you favor one test over the other for my issue?

 

My cholesterol for the last 7 or 8 years, on 4 different tests, has shown LDL always above 220. I don't know if it was indirect or direct. How might I know that? HDL was always higher than normal, as well.

 

Strangely, my past thyroid tests, 3 I think, all showed my TSH over 3 and one I had in August showed 3.92, the highest ever. 2 weeks ago I got another and TSH had dropped to 1. The only life-style change I've made is I haven't been drinking any alcohol 6 weeks prior to that latest test (the one showing TSH dropping to 1). Would that account for such a huge difference? It seems like such a drastic change to me.

 

Hypothyroidism would account for a lot of my symptoms including the high cholesterol, from what I understand.

 

Thanks to Sheryl and to everyone for not dropping the ball on this with the site outage!

 

LDL unless specified as direct is likely indirect measure and with a low triglyceride may not be accurate. 

 

Not all labs can do a direct LDL, you have to inquire.

 

Stress test is not very expensive (2-3,000 baht usually). Coronary Ct Calcium scan used to be 2-3 times as much but lately there have been promotions as low as 2,500 baht in the Bangkok area. I don 't know what price you will find in CM.

 

For purposes of aiding decision to treat or not treat elevated LDL, Calcium scan is best.

 

There is no upper iimit to HDL. Should be over 40, preferrably over 60 and  the higher the better. So yours is fine.

[bamboozled]

1 hour ago, Sheryl said:

 

LDL unless specified as direct is likely indirect measure and with a low triglyceride may not be accurate. 

 

Not all labs can do a direct LDL, you have to inquire.

 

Stress test is not very expensive (2-3,000 baht usually). Coronary Ct Calcium scan used to be 2-3 times as much but lately there have been promotions as low as 2,500 baht in the Bangkok area. I don 't know what price you will find in CM.

 

For purposes of aiding decision to treat or not treat elevated LDL, Calcium scan is best.

 

There is no upper iimit to HDL. Should be over 40, preferrably over 60 and  the higher the better. So yours is fine.

I'm going to look into that, thank you.

[mstevens]

If you are slim / have a low BMI and eat a low-carb diet (does not necessarily mean keto or carnivore), you may have what many medical professionals consider an "odd" cholesterol panel with total cholesterol high, LDL and HDL high but Triglycerides low. This describes me.

 

My total cholesterol is over 300, LDL over 200 and HDL touching on 100. Triglycerides are very low. My A51C is also very good. There is a greater awareness of these results which is referred to as a LMHR - lean mass hyper responder. There is a lot online about this WRITTEN BY DOCTORS who are increasingly aware of this.

 

High cholesterol numbers can be a worry and for sure, many doctors will freak out if they see a high total cholesterol number. But if you have a lean body mass and eat a very low-carb diet, you might be a LMHR. Google it (and check YouTube) for more information.

 

 

[ericthai]

@Sheryl  Have you heard anything about a new procedure where they user crisper to change the DNA to lower cholesterol?

if so, your thoughts about this?  My Cholesterol is under control with taking atorvastatin 20mg, but would like to stop taking this if possible.

 

 

 

[Mike Lister]

1 hour ago, ericthai said:

@Sheryl  Have you heard anything about a new procedure where they user crisper to change the DNA to lower cholesterol?

if so, your thoughts about this?  My Cholesterol is under control with taking atorvastatin 20mg, but would like to stop taking this if possible.

 

 

 

I've not thread of that Eric but I recently heard the UK is now offering an annual statins like shot which sounds interesting.

[bamboozled]

I also found this last night in my sleuthing:

 

A healthy diet
We know that an unhealthy diet can cause high triglycerides, while a healthy diet generally leads to low triglycerides.
One interesting note is that sometimes low triglyceride levels can occur with high LDL levels (which often indicate a higher heart disease risk). If low triglyceride levels lower heart disease risk, but high LDL levels increase it, what can cause this inconsistency?
There are two types of LDL particles that should be taken into account when calculating heart disease risk:
    •    LDL-A particles are larger, less dense, and lower your risk.
    •    LDL-B particles are smaller, denser, and increase your risk.
When you have low triglyceride levels but high LDL levels, it could indicateTrusted Source that you have a diet filled with healthy fats.
Healthy fats will not only cause an increase in good cholesterol (HDL) but can also change the type of the LDL particles in the blood. Therefore, those high LDL levels may not actually be a bad thing.
Instead, it is more likely that they are LDL particles that have become larger and less dense from the intake of healthy fat. Low triglycerides and high HDL levels in the blood will generally support this idea.