My blood test shows high Cholesterol – Looking for advice - Drugs / Diet .

[tomgreen]

So over time I have had 3 blood tests all at the same Thai hospital ( different doctors ) 

 

1. Blood test was on 12th December 2022       ( A ) 
2. Blood test was on 19th of September 2023  ( B ) 
3. Blood test was on 5th of March 2024           ( C ) 

 

The first blood test done on 12th December 2022 ( A ) showed that I had high numbers in several areas , so the hospital doctor prescribed 20 mg of Atorvastatin , once a day and made a new blood test appointment for the 19th of September 2023 ( B ) .

 

The second Blood test was done on the 19th of September 2023 ( B ) , and the results from that blood test showed that my previous high numbers had now come down , due to me taking 20 mg of Atorvastatin , once a day . On seeing the reduced numbers in that blood test the hospital doctor said to me that I could stop taking the Atorvastatin if I wanted to , so I made the decision to completely stop taking the Atorvastatin. The hospital doctor then made a new appointment for a blood test for 5th of March 2024 ( C ) 

 

The Third blood test was recently done on the 5th of March 2024 ( C ) and the test results showed that my numbers had gone way back up. On seeing those blood test results the doctor prescribed 40 mg of Atorvastatin , once a day . And a new blood test appointment was made for the coming 28th of May 2024 .

 

The blood test results are shown as screen shots – A / B / C .

 

So it seems that I may have made a mistake by accepting the hospital doctors choice to stop taking the Atorvastatin on the 19th of September 2023 ( B ) when in reality I should have just continued to take the 20 mg of Atorvastatin on a daily basis . 

 

During all the previous times I was taking the 20 mg of Atorvastatin I did not alter my diet or life style, but the doctor who looked at my recent blood test results on the 5th of March 2024 ( C )  did say that I should look at altering my diet .I’m 74 years old , Five feet Seven inches tall , my weight is 79.1 Kg , my blood pressure is 117 / 71 / 65 , a non smoker / non alcohol drinker . I am not really physically active . ( Lazy ) 

 

So looking back at my past blood test results , there could now be a possibility that I may have to take the prescribed drug Atorvastatin for the rest of my life . 

 

I’m now wondering if any one here has had a blood test done and the results showed a high level of LDL cholesterol , and if so did you rely on drugs to lower the high  LDL cholesterol number or a combination of diet + drugs .

 

Any advice , suggestions or recommendations very welcome. 

 

 

Thanks - Tom 

 

.

 

 

 

[proton]

Had high test twice in the past at Thai Hospitals, when checked in the UK no problem!

[pub2022]

Most of the time, diet + exercise alone won't be enough. You'll need drugs as well.

But I'm not a doctor.

[NoDisplayName]

My understanding, having this high cholesterol thing for 30 years, is that it's mostly genetic, accounting for 75% of the high numbers.  Changes in diet and exercise can result in minor changes, but to get numbers down to the recommended ranges requires medication.

 

Jogging 70 miles per week, running marathons, cycling over the Alps, trying any number of dietary changes, had little effect. 

20mg/daily Simvistatin worked for me.

 

That's been my experience, and I too, am not a doctor.

[Sheryl]

It made no sense at all to stop the atorvastatin when it was clearly having the desired effect. Naturally your numbers went right back up. That's what happens. These are long term medications, not ones taken just until the labs improve and then stopped -- that is completely crazy and it is incredible that a doctor would advise it.  I would definitely stop going to that doctor. 

 

The only reason to stop would be if you had intolerable side effects (and even then, a different medication might be advised in its place). 

 

Countless people take statins long term and 20mg is a low dose of atorvastatin (but appeared adequate for you). 

 

I am surprised nothing was said about your HDL which is too low. You should eat more oily fish (mackeral, tuna etc) and/or take fish oil capsules to get that number up.

 

Beyond that I cannot advise re your diet without knowing what you currently eat. 

 

Cholesterol aside,  your abnormally high creatnine is worrying and suggestive of kidney disease. You need to see a nephrologist. Sooner rather than later. 

 

Where in Thailand are you?  And where have you been going for health care? (You need to change it, for sure.) 

 

 

 

[KhunLA]

👍

 

 

[tomgreen]

52 minutes ago, Sheryl said:

It made no sense at all to stop the atorvastatin when it was clearly having the desired effect. Naturally your numbers went right back up. That's what happens. These are long term medications, not ones taken just until the labs improve and then stopped -- that is completely crazy and it is incredible that a doctor would advise it.  I would definitely stop going to that doctor. 

 

The only reason to stop would be if you had intolerable side effects (and even then, a different medication might be advised in its place). 

 

Countless people take statins long term and 20mg is a low dose of atorvastatin (but appeared adequate for you). 

 

I am surprised nothing was said about your HDL which is too low. You should eat more oily fish (mackeral, tuna etc) and/or take fish oil capsules to get that number up.

 

Beyond that I cannot advise re your diet without knowing what you currently eat. 

 

Cholesterol aside,  your abnormally high creatnine is worrying and suggestive of kidney disease. You need to see a nephrologist. Sooner rather than later. 

 

Where in Thailand are you?  And where have you been going for health care? (You need to change it, for sure.) 

 

 

 

 

Thanks Sheryl

 

The hospital where I had all my blood tested done was the Suranaree University of Technology (SUT) Hospital in Korat. ( I've all ways use this hospital for general health care )

 

 

I thought it was a bit strange when the doctor asked me if I wanted to stop the Atorvastatin drug , I have had no adverse side effects from taking Atorvastatin , so carrying on with that drug seems to be ok. 

 

When I was given my last blood test results on the 5th of March 2024 , the hospital doctor went over the high LDL cholesterol number ( take 40 mg of Atorvastatin ), but made no comment about the Low HDL number at all . As for the high creatnine number , the hospital doctor did comment about it being a high number and only recommended that I should drink more water . So now just looking at the abnormally high creatnine number , I wonder why the hospital doctor made no real / urgent comment about it . Now Ive become worried that I may have a problem related to my kidneys . My next blood test will be on the 28th of May 2024 ( see screen shot of the requested blood teat requirements )

 

My options now seem to be 

 

A. Wait until my next scheduled blood test appointment on the 28th of May 2024 , and see what the blood test results reveal + talk to the doctor about the Low HDL number and the High creatnine number. 

 

B. Go straight away and have another blood test done at a different hospital ( may be / Bangkok hospital Korat / St Mary's hospital Korat ) 

 

C. Go stright away to a private clinic and request a blood test .

 

Thanks 

 

Tom 

 

 

 

 

 

 

 

 

 

 

[mstevens]

I'm not a doctor, but am reasonably well read on cholesterol and diet.

 

It sounds like you're carrying some extra weight. Do what you can to lose some weight. The best way to do this is through diet. Exercise is helpful, but diet is a much more effective way to lose weight.

 

If you're willing to try a ketogenic diet (high fat, very low carb / max 20 grams of carbs per day), I imagine the weight will fall off you and your cholesterol profile will improve markedly with HDL increasing and Triglycerides decreasing. Your A1C will also improve.

 

A ketogenic diet essentially means half your plate is meat / animal products like eggs, and the other half is non-starchy vegetables. This approach would see you lose weight, your cholesterol profile improve - and you would not need to use drugs.

 

To be clear, this is not the approach which conventional doctors use although there is a growing number of doctors who recommend exactly this approach in preference to the prescribing of statins.

[scubascuba3]

Move to a better diet, it can improve cholesterol, of course people prefer drugs because they don't have self control

[Lorry]

Atorvastatin to "treat" high cholesterol should only be given if you have a high risk of cardiovascular disease.  We don't know your other risk factors so we cannot comment. 

No medication should be given to treat an isolated lab value.

 

Creatinine 1.45 is too high.  Hopefully,  you are just dehydrated from the summer heat.  Drink a lot (your urine should have the color of white wine,  not of beer) for a week or two and check creatinine again. 

[tomgreen]

8 hours ago, proton said:

Had high test twice in the past at Thai Hospitals, when checked in the UK no problem!

 

Ive wondered about the quality of blood tests , it does make you think .

 

.

[tomgreen]

8 hours ago, NoDisplayName said:

My understanding, having this high cholesterol thing for 30 years, is that it's mostly genetic, accounting for 75% of the high numbers.  Changes in diet and exercise can result in minor changes, but to get numbers down to the recommended ranges requires medication.

 

Jogging 70 miles per week, running marathons, cycling over the Alps, trying any number of dietary changes, had little effect. 

20mg/daily Simvistatin worked for me.

 

That's been my experience, and I too, am not a doctor.

 

Genetic , thats some thing I had not thought about.

 

.

[Dolf]

Why is high cholestrol bad?

 

https://reason.com/2018/09/22/new-research-confirms-we-got-cholesterol/

[KannikaP]

9 hours ago, tomgreen said:

my blood pressure is 117 / 71 / 65

Is that all day, every day, or on waking up. Is it the same every day?

[gargamon]

9 hours ago, pub2022 said:

Most of the time, diet + exercise alone won't be enough. You'll need drugs as well.

But I'm not a doctor.

Diet and exercise will provide up to a 5% decrease in the numbers. A statin will reduce the numbers around 50%. Don't forget you need to take a co-q-10 supplement if you take a statin. 

[tomgreen]

28 minutes ago, KannikaP said:

Is that all day, every day, or on waking up. Is it the same every day?

 

I normally take my blood pressure at random times every other day ( see screen shot )

 

 

.

[tomgreen]

18 minutes ago, gargamon said:

Diet and exercise will provide up to a 5% decrease in the numbers. A statin will reduce the numbers around 50%. Don't forget you need to take a co-q-10 supplement if you take a statin. 

 

Thanks, Ive not heard about ....  co-q-10 supplement . So I'm going to google it 

 

.

[tomgreen]

48 minutes ago, Dolf said:

Why is high cholestrol bad?

 

https://reason.com/2018/09/22/new-research-confirms-we-got-cholesterol/

 

Thanks for the article link , I wonder why that study is not more commonly known ?

 

.

[Dolf]

1 minute ago, tomgreen said:

 

Thanks for the article link , I wonder why that study is not more commonly known ?

 

.

People have tried to criticise the study. I'd say the drug companies want more money don't you?

[Henryford]

8 minutes ago, tomgreen said:

 

Thanks for the article link , I wonder why that study is not more commonly known ?

 

.

 

Because Big Pharma don't want it known.

[KannikaP]

49 minutes ago, tomgreen said:

 

I normally take my blood pressure at random times every other day ( see screen shot )

 

 

.

I wish mine were like that!

[Sheryl]

1 hour ago, tomgreen said:

 

Thanks for the article link , I wonder why that study is not more commonly known ?

 

.

Because this is not a reputable site and it quotes not a scientific journal but another unreliable site (Daily Mail)'s out of context version of same.  

 

Regarding last visit recommendation to take 40 mg atorvastatin: if I understand correcty you previously took 20 mg and it was effective. No reason therefore to take 40. Should always take the lowest dose necessary.

 

It is sounding like the doctors you see are not really looking at your history when making recommendations. You may need to be more proactive in drawing their atrention to it (prior lab results  prior med dosages etc).

 

Get another creatnine and BUN  test and I would slso suggest electrolytes  (sodiun  potassium). -- only these tests not others so   no need to fast before hand which should remove any effect due to dehydration. For a few days prior make sure to drink enough that you urinate with normal frequency and amount and your urine is light in color (light yellow not completely water-like)  but don't overdo it beyond that point.

 

there are some stand alone labs in Korat such as https://www.rtlclab.com/?fbclid=IwAR096QM1ywmb97tvgqCfuq8SDmregTgojHgJulniPkvJRW-VYJb4yXgBLfw

I don't have any specfic info on their quality, maybe other Korat residents can advise.

 

If your creatnine  is still elevated consult a nephrologist.  I'd suggest Dr. Watanyu Parapiboon at Maharat (majn govetnment hospital in Korat, much bigger than Suranaree) going through their "after hours" clinic. 

 

Yes elevated LDL is often genetic and since you are not diabetic and your triglycerides are normal likely true in your case ...though it would help to know your weight/height, activity level and diet.

 

Don't forget the fish oil.  You want to get your HDL (which is protective) up preferrably to about 70. 

[Sheryl]

3 hours ago, Lorry said:

Atorvastatin to "treat" high cholesterol should only be given if you have a high risk of cardiovascular disease.  We don't know your other risk factors so we cannot comment. 

No medication should be given to treat an isolated lab value

Not an isolated value. 2 readings several months apart at a hospital lab.  With a normal reading in between after going on statin then going back up to prior level when statin discontinued.

 

His cholesterol ratio is 5.02. 

 

And there are indications of chronic kidney disease. Judging from both BUN and heat wave at the time, March value likely affected by dehydration but not the Dec reading.

 

Most clinicians would recommend statin in this case especially since he tolerated it well and showed good result at low dose.

 

 

[tomgreen]

1 hour ago, KannikaP said:

I wish mine were like that!

 

At home use an Omron HEM 1730 model blood pressure monitor . At my age ( 74 ) I'm amazed that my blood pressure numbers are always within the general '' Normal '' range.

 

Ive tested the same Omron HEM 1730 model blood pressure monitor on family members , and those results were all different ( which I expected ) . When I go to Hospital for a blood test , my blood pressure is always shown as a bit higher than taken at home. 

 

. 

[Dolf]

43 minutes ago, Sheryl said:

Because this is not a reputable site and it quotes not a scientific journal but another unreliable site (Daily Mail)'s out of context version of same.  

 

Regarding last visit recommendation to take 40 mg atorvastatin: if I understand correcty you previously took 20 mg and it was effective. No reason therefore to take 40. Should always take the lowest dose necessary.

 

It is sounding like the doctors you see are not really looking at your history when making recommendations. You may need to be more proactive in drawing their atrention to it (prior lab results  prior med dosages etc).

 

Get another creatnine and BUN  test and I would slso suggest electrolytes  (sodiun  potassium). -- only these tests not others so   no need to fast before hand which should remove any effect due to dehydration. For a few days prior make sure to drink enough that you urinate with normal frequency and amount and your urine is light in color (light yellow not completely water-like)  but don't overdo it beyond that point.

 

there are some stand alone labs in Korat such as https://www.rtlclab.com/?fbclid=IwAR096QM1ywmb97tvgqCfuq8SDmregTgojHgJulniPkvJRW-VYJb4yXgBLfw

I don't have any specfic info on their quality, maybe other Korat residents can advise.

 

If your creatnine  is still elevated consult a nephrologist.  I'd suggest Dr. Watanyu Parapiboon at Maharat (majn govetnment hospital in Korat, much bigger than Suranaree) going through their "after hours" clinic. 

 

Yes elevated LDL is often genetic and since you are not diabetic and your triglycerides are normal likely true in your case ...though it would help to know your weight/height, activity level and diet.

 

Don't forget the fish oil.  You want to get your HDL (which is protective) up preferrably to about 70. 

Here's a scientific website which places doubt on good cholesterol

 

https://www.nih.gov/news-events/news-releases/study-challenges-good-cholesterol-s-role-universally-predicting-heart-disease-risk

[BigStar]

12 hours ago, tomgreen said:

the doctor who looked at my recent blood test results on the 5th of March 2024 ( C )  did say that I should look at altering my diet .

 

Sounds like a good idea. You're overweight; FBS indicates pre-diabetes. Consider a strict low carb diet. Stop being lazy and seriously exercise, put in your daily steps at minimum. You may be able to get your numbers into good ranges naturally.

[tomgreen]

37 minutes ago, Sheryl said:

Because this is not a reputable site and it quotes not a scientific journal but another unreliable site (Daily Mail)'s out of context version of same.  

 

Regarding last visit recommendation to take 40 mg atorvastatin: if I understand correcty you previously took 20 mg and it was effective. No reason therefore to take 40. Should always take the lowest dose necessary.

 

It is sounding like the doctors you see are not really looking at your history when making recommendations. You may need to be more proactive in drawing their atrention to it (prior lab results  prior med dosages etc).

 

Get another creatnine and BUN  test and I would slso suggest electrolytes  (sodiun  potassium). -- only these tests not others so   no need to fast before hand which should remove any effect due to dehydration. For a few days prior make sure to drink enough that you urinate with normal frequency and amount and your urine is light in color (light yellow not completely water-like)  but don't overdo it beyond that point.

 

there are some stand alone labs in Korat such as https://www.rtlclab.com/?fbclid=IwAR096QM1ywmb97tvgqCfuq8SDmregTgojHgJulniPkvJRW-VYJb4yXgBLfw

I don't have any specfic info on their quality, maybe other Korat residents can advise.

 

If your creatnine  is still elevated consult a nephrologist.  I'd suggest Dr. Watanyu Parapiboon at Maharat (majn govetnment hospital in Korat, much bigger than Suranaree) going through their "after hours" clinic. 

 

Yes elevated LDL is often genetic and since you are not diabetic and your triglycerides are normal likely true in your case ...though it would help to know your weight/height, activity level and diet.

 

Don't forget the fish oil.  You want to get your HDL (which is protective) up preferrably to about 70. 

 Thanks Sheryl

 

I'm going to get your recommended blood test done , before my next blood test appointment at the Suranaree University of Technology (SUT) Hospital in Korat on ( May 28th 2024 ) and see what the results are like . If the creatnine  is still shown as elevated I will go to see  Dr. Watanyu Parapiboon . 

 

My current weight is 79.1 Kg , I'm  Five Feet Seven inches tall , Blood pressure = 117 / 71 / 65 , Non smoker , Non Alcohol drinker , Not very active . For the past month Ive been trying to loose weight , and cut out all Sweets / Cakes / Biscuits / Potato crisps / Fried food / Fizzy drinks / Fast foods / chocolates / Eggs / Baked beans / Etc Etc .

 

Ive just ordered some fish oil capsules off Lazada.

 

Tom

 

.

 

 

[tomgreen]

9 minutes ago, BigStar said:

 

Sounds like a good idea. You're overweight; FBS indicates pre-diabetes. Consider a strict low carb diet. Stop being lazy and seriously exercise, put in your daily steps at minimum. You may be able to get your numbers into good ranges naturally.

Thanks for the encouragement , its appreciated 👍

 

Tom

 

.

[Sheryl]

47 minutes ago, tomgreen said:

 

At home use an Omron HEM 1730 model blood pressure monitor . At my age ( 74 ) I'm amazed that my blood pressure numbers are always within the general '' Normal '' range.

 

Ive tested the same Omron HEM 1730 model blood pressure monitor on family members , and those results were all different ( which I expected ) . When I go to Hospital for a blood test , my blood pressure is always shown as a bit higher than taken at home. 

 

. 

That is to be expected due to the stress of being at the hospital.

 

Omron is a good brand.

 

Your BP is perfectly normal. 

[PJ71]

12 hours ago, pub2022 said:

Most of the time, diet + exercise alone won't be enough. You'll need drugs as well.

But I'm not a doctor.

I'm not a doctor but you'd be surprised how much a strict diet and a reasonable amount of exercise can improve your health.

 

This is from personal experience.