Crazy high LDL number?

[myprivate]

My cholesterol has been under control for around 10 years on a very low dose of lipitor, 5ml per day. I then went on a health binge for a year, exercise, eating healthy, etc. and thought I'd try stopping the lipitor for 6 months to see if I still needed it considering the healthy living. I'd also experienced some muscle aches which I thought might be related to the lipitor (which went away when I stopped taking it). Big shock as I just got my results back and the LDL is 227! Full results attached. Anybody else here experienced such a high LDLnumber or any thoughts?

[tonray]

I believe there is a period of a snap back reaction because you have been artificially suppressing your liver's cholesterol production. I would test every 3 months for a year and see if it goes down, which I believe it will if your diet stays clean. These drugs were designed for one thing to suppress numbers on tests, yes they will reduce mortality for those with existing heart disease but there are no studies showing the same for healthy individuals.

A person can eat fatty pork, and cheeseburgers every day and keep numbers looking good on statins but is that really healthy ? looking at only the numbers means nothing because your diet can be crap on the drugs and still look good.

Keep doing what you are doing and you will see a drop. Other numbers look OK....

Edited January 24, 2016 by tonray

[partington]

I believe there is a period of a snap back reaction because you have been artificially suppressing your liver's cholesterol production. I would test every 3 months for a year and see if it goes down, which I believe it will if your diet stays clean. These drugs were designed for one thing to suppress numbers on tests, yes they will reduce mortality for those with existing heart disease but there are no studies showing the same for healthy individuals.

A person can eat fatty pork, and cheeseburgers every day and keep numbers looking good on statins but is that really healthy ? looking at only the numbers means nothing because your diet can be crap on the drugs and still look good.

Keep doing what you are doing and you will see a drop. Other numbers look OK....

The numbers that go down on statins are LDL cholesterol, and are the important numbers.

LDL is what circulates in the blood, and enters the arteries to form lesions which turn into atherosclerosis. Many studies on animals as well as humans have shown that LDL can enter the arteries by processes, for example leakage through damaged areas of endothelium (this cell layer forming the surface of the artery that contacts the blood) or bulk transport via cells ingesting a bubble of liquid (pinocytosis), that result in deposition of LDL in amounts proportional to its concentration in the blood.

This is why it is LDL numbers that are important and dangerous. As you were on statins you probably have a propensity for high cholesterol, and dietary changes alone though they should be tried first often are only successful in reducing LDL around 10-15%, unless the previous diet was abnormally unhealthy.

There must be a lab mistake here also, though small, because total blood cholesterol in these results is given as 274mg/dl.

Total blood cholesterol is made up of

HDL cholesterol, here given as 61mg/dl, and

LDL cholesterol, here given as 227mg/dl and

VLDL cholesterol, not measured separately but fasting is about 10% of total blood cholesterol, say 20mg/dl

Your HDL and LDL alone add up to more (288mg/dl) than the total stated here (274 mg/dl) and this is even without including whatever your VLDL cholesterol, which MUST be part of your total cholesterol number because it is detected by the total cholesterol test.

There may be a bit of a lab error here, perhaps reporting your LDL too high, but also perhaps reporting your total cholesterol too low, it's not possible to say .

Your LDL is still too high though and if it was me I would try a different statin to control it, as other versions can be better tolerated.

[chiang mai]

I've been taking Crestor for seven years, I started at 20mgs and then with changes to diet plus an exercise regime I managed to get down to 10mgs. Subsequently I tried to do what you did, I stopped statins completely for two months and my LDL numbers went from a very satisfactory 60/70 to a very unsatisfactory 175, needless to say I went back onto Crestor 10 mgs and normal service was resumed. I believe I have read somewhere previously that there is a rebound issue with statins.

EDIT to add: BTW you need to work on your HDL, <50 is recommended and 60 ish is good. I'm currently showing 64 and 65 respectively.

Edited January 24, 2016 by chiang mai

[gk10002000]

My cousin who by all outward appearances looks fine had a number of like 450. No weird diet. A heavy drinker for sure. So no idea these days among us billions of humans when some odd outliers occur

[partington]

My cousin who by all outward appearances looks fine had a number of like 450. No weird diet. A heavy drinker for sure. So no idea these days among us billions of humans when some odd outliers occur

There is a well known and quite common gene mutation (~1 in 500 people have it in the UK) called FH (familial hypercholesterolemia), that causes high LDL as its major symptom.

FH is a mutation of the receptor on the liver (called the LDL receptor) that removes LDL from the blood. The receptors are protein molecules on the outside of the liver that stick onto LDL and carry it inside the liver where its cholesterol can be removed from the body. When you have FH the receptor doesn't work, so your LDL is very high.

Most affected people (1 in 500), so your cousin may be one, have a single faulty gene and one normal one, so their LDL is very high but not gigantic. When two people with this mutation marry and have a child with two faulty genes LDL can reach 1500mg/dl or more, and these people, if untreated, can die of heart disease in their teens. This disease is one major piece of evidence that high LDL alone can cause heart disease.

Statins don't work at all on these people because statins work by increasing the number of these receptors on the liver. If you have both genes faulty the receptors don't work so increasing their number has no effect. Statins do work on people with only one faulty gene because they raise the number of the receptors that work, produced by the normal gene, so hopefully your cousin is on them...

Edited January 24, 2016 by partington

[myprivate]

I believe there is a period of a snap back reaction because you have been artificially suppressing your liver's cholesterol production. I would test every 3 months for a year and see if it goes down, which I believe it will if your diet stays clean. These drugs were designed for one thing to suppress numbers on tests, yes they will reduce mortality for those with existing heart disease but there are no studies showing the same for healthy individuals.

A person can eat fatty pork, and cheeseburgers every day and keep numbers looking good on statins but is that really healthy ? looking at only the numbers means nothing because your diet can be crap on the drugs and still look good.

Keep doing what you are doing and you will see a drop. Other numbers look OK....

The numbers that go down on statins are LDL cholesterol, and are the important numbers.

LDL is what circulates in the blood, and enters the arteries to form lesions which turn into atherosclerosis. Many studies on animals as well as humans have shown that LDL can enter the arteries by processes, for example leakage through damaged areas of endothelium (this cell layer forming the surface of the artery that contacts the blood) or bulk transport via cells ingesting a bubble of liquid (pinocytosis), that result in deposition of LDL in amounts proportional to its concentration in the blood.

This is why it is LDL numbers that are important and dangerous. As you were on statins you probably have a propensity for high cholesterol, and dietary changes alone though they should be tried first often are only successful in reducing LDL around 10-15%, unless the previous diet was abnormally unhealthy.

There must be a lab mistake here also, though small, because total blood cholesterol in these results is given as 274mg/dl.

Total blood cholesterol is made up of

HDL cholesterol, here given as 61mg/dl, and

LDL cholesterol, here given as 227mg/dl and

VLDL cholesterol, not measured separately but fasting is about 10% of total blood cholesterol, say 20mg/dl

Your HDL and LDL alone add up to more (288mg/dl) than the total stated here (274 mg/dl) and this is even without including whatever your VLDL cholesterol, which MUST be part of your total cholesterol number because it is detected by the total cholesterol test.

There may be a bit of a lab error here, perhaps reporting your LDL too high, but also perhaps reporting your total cholesterol too low, it's not possible to say .

Your LDL is still too high though and if it was me I would try a different statin to control it, as other versions can be better tolerated.

I was also wondering if it was a lab mistake, especially as most other numbers are quite good. I previously had borderline metabolic syndrome with raised FBS to 110, Liver Function test abnormal, Fatty Liver on ultrasound, high Cholesterol but most of those things seem fixed with the health binge, except for this really high LDL. Edited January 24, 2016 by myprivate

[myprivate]

BTW my LDL has never been this high, only maybe 15-20% high on previous occasions. It's really strange that it's so high.

[Sheryl]

Lab error is certainly possible, but so is rebound effect from stopping the statin.

Since the triglycerides are fine and HDL also good , and assuming you do not have known vascular disease, cardiac problems or history of stroke, I agree with Tonray that you could for now just maintain healthy diet and exercise and repeat the labs periodically...say initially in another 6 weeks just to be sure the levels aren't continuing to soar upwards and then (assuming result is not significantly higher than this) every 3 months.

If you have a history of vascular disease, stroke etc that is a whole other matter and for such people statin rebound effects can be very dangerous.

[myprivate]

Thanks all. Even though I don't have any known heart trouble I think I'll go back on the statins as that LDL number is scary, classed as 'very high risk' on several medical websites I've seen, and there is a history of heart disease is in the family so I'm concerned to do a 'watch and wait'. In fact my brother had a heart attack at 54 a couple of years ago (and I'm in my early 50's now). So I've decided to try 10mg of lipitor a day for a few weeks and take another test.

[thrilled]

Up your cholesterol,or get another medicine besides

[Tolley]

The LDL score can be very misleading and is not the best indicator of heart disease. Scientists recently discovered there were two types of LDL one which is large and fluffy and doesn't do much harm and the other which is small and dense and dangerous.

The best way to determine which type of LDL you have and your risk of heart problems is determine your ratio of HDL to Triglycerides. If your ratio is less than two then you have large fluffy LDL particles and so at low risk if you the ratio is greater than 4 then that spells trouble.

[tonray]

The LDL score can be very misleading and is not the best indicator of heart disease. Scientists recently discovered there were two types of LDL one which is large and fluffy and doesn't do much harm and the other which is small and dense and dangerous.

The best way to determine which type of LDL you have and your risk of heart problems is determine your ratio of HDL to Triglycerides. If your ratio is less than two then you have large fluffy LDL particles and so at low risk if you the ratio is greater than 4 then that spells trouble.

I think you mean Trigs/HDl ratio..... just for clarification.

[Sporting Dog]

I was sent to a lipid specialist for high cholesterol - I'd tried statins previously but couldn't tolerate them - sore muscles etc.

He tried every type and dosage of statins but they all produced the same effects.

I also had a coronary CT and carotid ultrasound done (both non-invasive) - and they showed next to no plaque buildup (?) - which was a great relief (I'm 52 years old). I take ezetrol (which isn't a statin?) and the doc keeps on my back about diet and exercise.

Maybe you could get these investigations done - just to see where you're at (internally).

(Just read your brother had a heart attack at 54 - I know famiiy history is an important indicator so I would go back onto lipitor if you can tolerate it. There are others that could be tried - vytorin, lipidil etc)

Edited January 26, 2016 by Sporting Dog

[Sheryl]

Ezetrol is a combination of two drugs" simvastatin (a stain) and ezetimibe (a non-statin). So you are in fact back on a statin.

Ezetimibe can also be used alone and would be an option for people with elevated LDL who cannot tolerate statins. Another option is nicotinic acid (Niaspan) - note that it needs to be a special sustained released prepation, cannot just take ordinary niacin supplement.

[tonray]

Ezetrol is a combination of two drugs" simvastatin (a stain) and ezetimibe (a non-statin). So you are in fact back on a statin.

Ezetimibe can also be used alone and would be an option for people with elevated LDL who cannot tolerate statins. Another option is nicotinic acid (Niaspan) - note that it needs to be a special sustained released prepation, cannot just take ordinary niacin supplement.

I took Niaspan for about 5 years but recent studies about its effectiveness at reducing mortality have caused most doctors to stop new scrips for it. Early studies showed it was the only agent that actually caused a regression in arterial plaques (meaning you can fix what your diet screwed up) but it seems that the statin Mafia has effectively killed the only real viable option to their monopoly. Doctors also did not like it because most patients cannot get past the initial few months of flushing and redness which abates significantly, but many patients get panic attacks even when they know the potential effects are just temporary for a few hours at most in the first few months.

I was sad to have discontinued it because it elevated HDL, lowered LDL and I believe had strong anti-inflammatory properties based upon research but later studies seemed to indicate that along with statins it had no added benefit so they just go with statins and drop the niacin but I would advise you do your own homework as it seems to have some real benefits and being a natural Vitamin certainly less dangerous than statins, which have already been shown to push many people into diabetes conditions.

[myprivate]

The LDL score can be very misleading and is not the best indicator of heart disease. Scientists recently discovered there were two types of LDL one which is large and fluffy and doesn't do much harm and the other which is small and dense and dangerous.

The best way to determine which type of LDL you have and your risk of heart problems is determine your ratio of HDL to Triglycerides. If your ratio is less than two then you have large fluffy LDL particles and so at low risk if you the ratio is greater than 4 then that spells trouble.

I think you mean Trigs/HDl ratio..... just for clarification.

Using this formula I'm seemingly very low risk at 1.29 ratio. But on the other hand an LDL of 227 is classified as horrendously high risk on several medical websites. So much conflicting info out there.

[myprivate]

Update: After a few months of taking only 5mg a day of Lipitor all of the numbers have returned to normal. I'm quite surprised considering it is a tiny dose and my LDL number was so high.

[myprivate]

And no muscle aches so far, I've been taking CoQ10 with the Lipitor as I read somewhere it helps with the side effects.