Beta Blockers and Statins Anecdotal Discussion possible unrelated psa reveal (1 Viewer)

[Dezbelief]

I've read through some of the old threads and have read the arguments against especially on the statin side. I'm interested in if anyone has regrets taking these meds or if anyone is happy they are taking them, how have these meds helped and hurt individuals. I am interested in hearing from patients, friends and family of patients, nurses, doctors and pharmacists with first hand experience. I have read the scientific evidence. It's not a question of if I take them or not. I have had two doses so far. I have some blockage in a vein coming from the brain. My arteries are clear. As an aside my thyroid has dozens of spots. My thyroid levels were luckily normal in my blood work.

 

[Don Quixote]

Not on beta blockers, but on the statin side…. I’ve been on Crestor (generic version now) for >10 years. I’ve been really happy with it. I have really bad genes when it comes to cholesterol/heart — my dad passed away of a heart attack at 49, as did my mom’s father; so, I’ve got bad genes on both sides.

My LDL was around 200 when I first started taking it (my weight was in the 150-160 range then and I’m not a smoker, so not much that life improvement could do to help). My LDL is down to around 90-100 now, and I don’t have the blood pressure issues that my dad started having around my age yet (knock on wood).

 

[Scoresman]

I take atorvastatin due to family history of heart attacks. Dad passed away at 32, grandfather passed away at 44. I just turned 45.

Incredibly happy. Cholesterol has never been lower and I'm living life not on a hugely restrictive diet.

 

[jm192]

In general, if you have an indication for Statins, they're one of the greatest drugs we have.

They lower your LDL (bad cholesterol), they can raise your HDL (good cholesterol). They also help stabilize plaques.

The two "big" things to watch for: They can increase your liver enzymes. They can also cause muscle aches/cramps. Some people can't tolerate them for these reasons.

 

[notoriousbill]

In general, if you have an indication for Statins, they're one of the greatest drugs we have.

They lower your LDL (bad cholesterol), they can raise your HDL (good cholesterol). They also help stabilize plaques.

The two "big" things to watch for: They can increase your liver enzymes. They can also cause muscle aches/cramps. Some people can't tolerate them for these reasons.

I am on 20mg of atorvastatin as well (due to genetics - dad had his first heart attach at 56 and mom has high cholesterol). I was on 40 mg and had to reduce it to 20 due to aches. My cholesterol went down to 151 from 275 in April. Good cholesterol is on lower end of normal. Helps that I have lost 87 lbs (from 300 to 213) in the past year.

 

[Pip's Invitation]

I've been on a beta-blocker (atenolol) for high blood pressure for 21 years. I was diagnosed with high blood pressure at 30 (my dad was diagnosed with it at 15). They don't give beta-blockers as the first-line therapy for blood pressure anymore, but because it's worked for me, I've never been switched off it. My blood pressure is under control and I have never experienced any side effects from it.

I was on atorvastatin for about 7 years in the '00s, when they were giving statins to anyone with high "bad" cholesterol (LDL). I was taken off of it when my health insurance changed and it got more expensive (it wasn't generic yet) -- and I had a new doctor that didn't think just anyone with high LDL should be on it; my LDL hasn't returned to where it was in the early '00s. Later, I learned that my father was statin-intolerant, and I remembered that I had back pain much more frequently in the '00s than I do now. I had attributed that to bad posture and not enough physical activity, but now I wonder if I'm one of those people who gets muscle issues from statins. We'll find out if I ever get to the point where I need to go back on.

I write about cardiology for a living, so I could go on about the scientific evidence, but you said you're familiar with that already.

 

[shuke]

Why not both?!

I've been on atenolol (beta blocker) for about 8 years due to arrhythmia. Been on Lipitor (statin) for about a year after a routine neck x-ray alerted my doctor to some carotid artery sclerosis.

Neat.

Edit to add that I've had no side effects or issues with either.

 

[Phil Elliott]

On 20mg statin for over 20 years. Cholesterol and triglycerides very normal. No issues with muscle pains, liver enzymes, etc. keep HDL up with eating some avacado a couple times a week. Fish oil will raise my LDL slightly. Generally carb lite meals although love a great ice cream cone once or twice a week. Lots of salads. Typical protein at dinner is pork chop, steak, brats, fish on the grill with steamed green beans or broccoli.

 

[Phil Elliott]

FWIW - my understanding is that soluble fiber may help reduce/control cholesterol, triglycerides and minimize blood sugar spikes. Insoluble fiber is also beneficial for "staying regular" and reducing risk of colorectal cancer.

 

[PinkydaPimp]

Curious has anyone been put on statins due to increase in cholesterol from a ketogenic diet? Whenever i do keto my cholesterol goes up. I’ve read where that is normal when doing keto and that there is good cholesterol and bad. However my doctor sees this in the blood work and puts me on crestor. Obviously I’m not gonna take a chance so i take the statin. Are the risks that come with statins mostly long term? I’ve never had any side effects from the crestor but i have seen people say it’s “bad.”

 

[Dezbelief]

Curious has anyone been put on statins due to increase in cholesterol from a ketogenic diet? Whenever i do keto my cholesterol goes up. I’ve read where that is normal when doing keto and that there is good cholesterol and bad. However my doctor sees this in the blood work and puts me on crestor. Obviously I’m not gonna take a chance so i take the statin. Are the risks that come with statins mostly long term? I’ve never had any side effects from the crestor but i have seen people say it’s “bad.”

@Pip's Invitation please feel free to chime in.

 

[Pip's Invitation]

Curious has anyone been put on statins due to increase in cholesterol from a ketogenic diet? Whenever i do keto my cholesterol goes up. I’ve read where that is normal when doing keto and that there is good cholesterol and bad. However my doctor sees this in the blood work and puts me on crestor. Obviously I’m not gonna take a chance so i take the statin. Are the risks that come with statins mostly long term? I’ve never had any side effects from the crestor but i have seen people say it’s “bad.”

@Pip's Invitation please feel free to chime in.

The main issue is statin-associated muscle pain or weakness. However, various studies showed that must patients with suspected statin intolerance who were given statins and placebo at different times had the symptoms if they were on the statin AND if they were on the placebo.

In this study, researchers calculated that more than 90% of muscle symptoms reported by patients on statins were actually caused by something else: https://www.healio.com/news/cardiol...m-statins-small-does-not-outweigh-cv-benefits

Some studies have shown an increased risk for new-onset diabetes in patients on statins, but the body of evidence is inconsistent and the effect size, if any, is likely small.

By contrast, the evidence that cholesterol-lowering from statins reduces risk for heart attacks, strokes and other cardiovascular events is extremely strong.

 

[bcat01]

For you guys that have or have had high cholesterol what has worked for you to lower it without using statins? My cholesterol is 229mg. HDL 45mg, LDL 162mg and Triglycerides 108mg. I don't eat much red meat so it might not be related to diet. I am going to try the diet and exercise route for a couple months to see if that works. I started taking ground flax seed, olive leaf extract, fish oil and eating almonds every day. Any other suggestions?

 

[Scoresman]

For you guys that have or have had high cholesterol what has worked for you to lower it without using statins? My cholesterol is 229mg. HDL 45mg, LDL 162mg and Triglycerides 108mg. I don't eat much red meat so it might not be related to diet. I am going to try the diet and exercise route for a couple months to see if that works. I started taking ground flax seed, olive leaf extract, fish oil and eating almonds every day. Any other suggestions?

It's not just red meat. It's saturated fat. So like cheese, bacon, certain snacks, fries, etc. High saturated fat = high cholesterol.

Or you could be like me and have a condition called hypercholesterolemia where your body just naturally has high cholesterol.

 

[Terminalxylem]

Unless you’ve already had vascular problems (e.g. heart attack, stroke, etc.), or have a high risk condition like diabetes, use the pooled cohort equation to determine if you need cholesterol lowering medications. A 10-year risk greater than 7.5% is the cut-off for consideration of medical therapy.

Lifestyle modification is expected to drop cholesterol 20-30%, at best. Everyone should do what they can to optimize weight/diet/activity summarized here , but meds may be necessary regardless.

Sure, HMG CoA reductases inhibitors (“statins”) have potential side effects, but they are usually inconsequential relative to their benefits. And they are preferred first line therapy for most cholesterol problems. That being said, an argument can be made they’re simultaneously over- and under prescribed.

Beta blockers also have potential side effects, but most people tolerate them without much trouble. Depending on the indication, there is usually an alternative medication which can be substituted if you’re unable to take them.

 

[Judge Smails]

Well, I was on a statin for probably 10 years before I had my heart attack 3 years ago. Cholesterol hovered around 200 total, usually in the 190's. Not high compared to others but my PCP was one of those who really advocated for males my age to be on a statin for preventative purposes. I had a heart attack anyway...

I'm on a host of meds now. Take a Repatha shot once a month as that drastically reduces LDL #'s (my cardiologists wants me at 50). Still taking a statin, as well as 2 blood pressure meds. I'm off the blood thinner as of today but will be taking baby aspirin for life. I'm pretty lucky in that I never seem to get the side effects others mention with these drugs.

It's been an interesting journey. My #'s were always pretty good and I stayed in at least reasonable shape with plenty of cardio. I never had high blood pressure issues in my life until I had terrible pain from sciatica about 5 years ago. Took pain meds and had a couple epidurals and during that time my blood pressure spiked. Likely as a response to the pain. Couldn't get it regulated after that. I started taking blood pressure meds and then had the widowmaker following a Peleton ride. Really lucky I survived that. Time is tissue with these things and getting to the hospital in 3 minutes was a life saver.

BP was normal this morning during my checkup so going to stay the course with meds.

 

[ChiefD]

For you guys that have or have had high cholesterol what has worked for you to lower it without using statins? My cholesterol is 229mg. HDL 45mg, LDL 162mg and Triglycerides 108mg. I don't eat much red meat so it might not be related to diet. I am going to try the diet and exercise route for a couple months to see if that works. I started taking ground flax seed, olive leaf extract, fish oil and eating almonds every day. Any other suggestions?

I had high cholesterol, and my doc wanted to put me on a statin. I was just starting marathon training, so I asked that we wait to see if I could control it naturally. Trained for 18 weeks, ran the race, ate great, reduced fast food and alcohol….

Got tested about two weeks after my race and my numbers had moved down a little, but not enough to be in what they considered normal. Been on a statin since.

The point is: try diet and exercise. It definitely works for some people. But after all of that if you have to go on medication don’t consider it a failure on your part. Sometimes its just the way it is.

 

[Pip's Invitation]

Well, I was on a statin for probably 10 years before I had my heart attack 3 years ago. Cholesterol hovered around 200 total, usually in the 190's. Not high compared to others but my PCP was one of those who really advocated for males my age to be on a statin for preventative purposes. I had a heart attack anyway...

I'm on a host of meds now. Take a Repatha shot once a month as that drastically reduces LDL #'s (my cardiologists wants me at 50). Still taking a statin, as well as 2 blood pressure meds. I'm off the blood thinner as of today but will be taking baby aspirin for life. I'm pretty lucky in that I never seem to get the side effects others mention with these drugs.

It's been an interesting journey. My #'s were always pretty good and I stayed in at least reasonable shape with plenty of cardio. I never had high blood pressure issues in my life until I had terrible pain from sciatica about 5 years ago. Took pain meds and had a couple epidurals and during that time my blood pressure spiked. Likely as a response to the pain. Couldn't get it regulated after that. I started taking blood pressure meds and then had the widowmaker following a Peleton ride. Really lucky I survived that. Time is tissue with these things and getting to the hospital in 3 minutes was a life saver.

BP was normal this morning during my checkup so going to stay the course with meds.

Good luck! Did you ever have a genetic cardiovascular risk profile done?

 

[Judge Smails]

Well, I was on a statin for probably 10 years before I had my heart attack 3 years ago. Cholesterol hovered around 200 total, usually in the 190's. Not high compared to others but my PCP was one of those who really advocated for males my age to be on a statin for preventative purposes. I had a heart attack anyway...

I'm on a host of meds now. Take a Repatha shot once a month as that drastically reduces LDL #'s (my cardiologists wants me at 50). Still taking a statin, as well as 2 blood pressure meds. I'm off the blood thinner as of today but will be taking baby aspirin for life. I'm pretty lucky in that I never seem to get the side effects others mention with these drugs.

It's been an interesting journey. My #'s were always pretty good and I stayed in at least reasonable shape with plenty of cardio. I never had high blood pressure issues in my life until I had terrible pain from sciatica about 5 years ago. Took pain meds and had a couple epidurals and during that time my blood pressure spiked. Likely as a response to the pain. Couldn't get it regulated after that. I started taking blood pressure meds and then had the widowmaker following a Peleton ride. Really lucky I survived that. Time is tissue with these things and getting to the hospital in 3 minutes was a life saver.

BP was normal this morning during my checkup so going to stay the course with meds.

Good luck! Did you ever have a genetic cardiovascular risk profile done?

No, but family history is a mess. Dad had heart issues and was diabetic (though all due to poor lifestyle), both brothers raging diabetics, etc. Other cardiac issues in the family so I knew there were risks. And like others have said you can only do so much with lifestyle adjustments. Much is just the genetic hand we're dealt.

 

[bcat01]

For you guys that have or have had high cholesterol what has worked for you to lower it without using statins? My cholesterol is 229mg. HDL 45mg, LDL 162mg and Triglycerides 108mg. I don't eat much red meat so it might not be related to diet. I am going to try the diet and exercise route for a couple months to see if that works. I started taking ground flax seed, olive leaf extract, fish oil and eating almonds every day. Any other suggestions?

I had high cholesterol, and my doc wanted to put me on a statin. I was just starting marathon training, so I asked that we wait to see if I could control it naturally. Trained for 18 weeks, ran the race, ate great, reduced fast food and alcohol….

Got tested about two weeks after my race and my numbers had moved down a little, but not enough to be in what they considered normal. Been on a statin since.

The point is: try diet and exercise. It definitely works for some people. But after all of that if you have to go on medication don’t consider it a failure on your part. Sometimes its just the way it is.

Thanks. This is my plan.

 

[Steeler]

I guess this is as good of a place to ask this question as any... my LDL just came back at 130, my doctor prescribed statins but I really don't want to go on those. I was taking red yeast rice and fish oil and still registered @ 130. Maybe a weird question, but if I would go cold turkey on booze and eat a cholesterol friendly diet for 6 weeks would that be enough time to determine if the dietary changes would work? Or is that not long enought?

 

[The Dreaded Marco]

I guess this is as good of a place to ask this question as any... my LDL just came back at 130, my doctor prescribed statins but I really don't want to go on those. I was taking red yeast rice and fish oil and still registered @ 130. Maybe a weird question, but if I would go cold turkey on booze and eat a cholesterol friendly diet for 6 weeks would that be enough time to determine if the dietary changes would work? Or is that not long enought?

I would trust your doctor.

If you don’t trust your current doctor then get a second opinion from another physician rather than someone from this fantasy football message board.

 

[PinkydaPimp]

I guess this is as good of a place to ask this question as any... my LDL just came back at 130, my doctor prescribed statins but I really don't want to go on those. I was taking red yeast rice and fish oil and still registered @ 130. Maybe a weird question, but if I would go cold turkey on booze and eat a cholesterol friendly diet for 6 weeks would that be enough time to determine if the dietary changes would work? Or is that not long enought?

Try flax oil, lots of fiber and take the statin. I was able to get mine in check within flax oil and lots of fiber. Note that doing a ketogenic diet will increase your numbers though.

 

[Steeler]

I guess this is as good of a place to ask this question as any... my LDL just came back at 130, my doctor prescribed statins but I really don't want to go on those. I was taking red yeast rice and fish oil and still registered @ 130. Maybe a weird question, but if I would go cold turkey on booze and eat a cholesterol friendly diet for 6 weeks would that be enough time to determine if the dietary changes would work? Or is that not long enought?

I would trust your doctor.

If you don’t trust your current doctor then get a second opinion from another physician rather than someone from this fantasy football message board.

I hear that. However, my LDL was 115 (while on 1/2 a dose of fish oil and 1/2 dose of red yeast rice), then I upped to a full dose of both and my cholesterol went up after 2 months. In hindsight, I probably thought increasing those two supplements would allow me not to worry about dietary changes. I'm just curious if 6 weeks is enough time to see if no booze and a good diet would lower it. I want the statin to be the last resort and I haven't really tried the diet approach yet.

 

[The Dreaded Marco]

Definitely healthy dietary changes and exercise are good for you but I still recommend you listen to a physician that you trust. I’m certain that they would not recommend otherwise.

 

[Terminalxylem]

I guess this is as good of a place to ask this question as any... my LDL just came back at 130, my doctor prescribed statins but I really don't want to go on those. I was taking red yeast rice and fish oil and still registered @ 130. Maybe a weird question, but if I would go cold turkey on booze and eat a cholesterol friendly diet for 6 weeks would that be enough time to determine if the dietary changes would work? Or is that not long enought?

You can see changes with dietary modification in as little as 4 weeks. As I said above, the best you should expect is a 20-30% reduction in LDL with lifestyle changes.

Theoretically, your doctor determined your 10 year atherosclerotic disease risk exceeds 7.5% using the Pooled cohort equation - this assumes you don’t have diabetes, or have already had a vascular event. If that is the case, the goal is >30% reduction in LDL; if you have diabetes or vascular disease already, the goal is LDL < 70, or greater than 50% LDL reduction.

So you might be able to reduce your LDL to ~100 with the changes, and you’d probably have some idea if it’s working 6 weeks from now. Unless you have very high risk, that wait probably won’t be the tipping point for your widowmaker. Then again, it’s impossible to predict exactly when an atherosclerotic plaque will rupture.

I’d ask your doctor what LDL goal he‘s targeting. If it is 70 or less, start the meds today. Otherwise, ask if you can repeat fasting lipids in 6 weeks. But you should make the lifestyle changes regardless. And find a doctor you trust.

Curious why you prefer taking two supplements instead of the prescription medication?

ETA The other thing your doctor may suggest, if you’re really on the fence about starting lipid-lower medications, is a coronary calcium score. It’s a test that looks at calcification in the arteries of your heart, which is a surrogate for atherosclerotic plaque.

 

[Steeler]

I guess this is as good of a place to ask this question as any... my LDL just came back at 130, my doctor prescribed statins but I really don't want to go on those. I was taking red yeast rice and fish oil and still registered @ 130. Maybe a weird question, but if I would go cold turkey on booze and eat a cholesterol friendly diet for 6 weeks would that be enough time to determine if the dietary changes would work? Or is that not long enought?

You can see changes with dietary modification in as little as 4 weeks. As I said above, the best you should expect is a 20-30% reduction in LDL with lifestyle changes.

Theoretically, your doctor determined your 10 year atherosclerotic disease risk exceeds 7.5% using the Pooled cohort equation - this assumes you don’t have diabetes, or have already had a vascular event. If that is the case, the goal is >30% reduction in LDL; if you have diabetes or vascular disease already, the goal is LDL < 70, or greater than 50% LDL reduction.

So you might be able to reduce your LDL to ~100 with the changes, and you’d probably have some idea if it’s working 6 weeks from now. Unless you have very high risk, that wait probably won’t be the tipping point for your widowmaker. Then again, it’s impossible to predict exactly when an atherosclerotic plaque will rupture.

I’d ask your doctor what LDL goal he‘s targeting. If it is 70 or less, start the meds today. Otherwise, ask if you can repeat fasting lipids in 6 weeks. But you should make the lifestyle changes regardless. And find a doctor you trust.

Curious why you prefer taking two supplements instead of the prescription medication?

ETA The other thing your doctor may suggest, if you’re really on the fence about starting lipid-lower medications, is a coronary calcium score. It’s a test that looks at calcification in the arteries of your heart, which is a surrogate for atherosclerotic plaque.

I had the test and have a calcium score of 42. I'm 56 with great bloodwork (except for cholesterol) , great BP, slightly overweight based on BMI - so no other risk factors and pretty healthy compared to the average 56 year old I would guess. I take a few other supplements in addition to the ones I listed and those were all prescribed by my PCP. I don't currently take any medication and and never liked taking meds, even aspirin for a headache. So it's a bit of a mental block or something. I had the same resistance to starting the supplements.

Thanks for this detailed response. I'm pretty sure the target LDL is >70 so diet alone wont get me there. So looks like statins and dietary changes are in my future.

 

[ChiefD]

Anyone having any issues with atorvastatin?

I was on it for a long time - maybe 6-7 years. About 2 years ago my cardiologist wanted me to go from 10mg tabs to 20mg. The 10 was getting me into a safe zone but the 20 got me into what he considered a really safe zone.

But man, after awhile I was starting to feel exhausted at the end of the day. Sore, tired.....fatigued.....all of that. This went on for a few months and never felt like doing anything. So I finally started thinking about what has changed. So I stopped taking that atorvastatin for about 2 weeks to test the theory. And wouldn't you know.....started feeling better.

So I started taking it again to really test it see if that was the cause, and yep - after a few days back on atorvastatin I started feeling like crap again. So I've been cutting the pills in half (my pharmacist said I could do that), and that seems to help.

But back to the drawing board on what I can take again.

 

[skol asylum]

Anyone having any issues with avorstatin?

I was on it for a long time - maybe 6-7 years. About 2 years ago my cardiologist wanted me to go from 10mg tabs to 20mg. The 10 was getting me into a safe zone but the 20 got me into what he considered a really safe zone.

But man, after awhile I was starting to feel exhausted at the end of the day. Sore, tired.....fatigued.....all of that. This went on for a few months and never felt like doing anything. So I finally started thinking about what has changed. So I stopped taking that avorstatin for about 2 weeks to test the theory. And wouldn't you know.....started feeling better.

So I started taking it again to really test it see if that was the cause, and yep - after a few days back on avorstatin I started feeling like crap again. So I've been cutting the pills in half (my pharmacist said I could do that), and that seems to help.

But back to the drawing board on what I can take again.

Interesting. I'm on Atorvastatin. Started me out at 10 and recently upped to 20. No issues so far.

 

[ChiefD]

Anyone having any issues with avorstatin?

I was on it for a long time - maybe 6-7 years. About 2 years ago my cardiologist wanted me to go from 10mg tabs to 20mg. The 10 was getting me into a safe zone but the 20 got me into what he considered a really safe zone.

But man, after awhile I was starting to feel exhausted at the end of the day. Sore, tired.....fatigued.....all of that. This went on for a few months and never felt like doing anything. So I finally started thinking about what has changed. So I stopped taking that avorstatin for about 2 weeks to test the theory. And wouldn't you know.....started feeling better.

So I started taking it again to really test it see if that was the cause, and yep - after a few days back on avorstatin I started feeling like crap again. So I've been cutting the pills in half (my pharmacist said I could do that), and that seems to help.

But back to the drawing board on what I can take again.

Interesting. I'm on Atorvastatin. Started me out at 10 and recently upped to 20. No issues so far.

That's good.

Not sure what happened, but something has changed for me. But then again, I'm getting older (54) and **** hurts in new and mysterious ways every week it seems. So who knows.

Oh, and thanks for the proper spelling. I always get that one wrong.

 

[Terminalxylem]

I guess this is as good of a place to ask this question as any... my LDL just came back at 130, my doctor prescribed statins but I really don't want to go on those. I was taking red yeast rice and fish oil and still registered @ 130. Maybe a weird question, but if I would go cold turkey on booze and eat a cholesterol friendly diet for 6 weeks would that be enough time to determine if the dietary changes would work? Or is that not long enought?

You can see changes with dietary modification in as little as 4 weeks. As I said above, the best you should expect is a 20-30% reduction in LDL with lifestyle changes.

Theoretically, your doctor determined your 10 year atherosclerotic disease risk exceeds 7.5% using the Pooled cohort equation - this assumes you don’t have diabetes, or have already had a vascular event. If that is the case, the goal is >30% reduction in LDL; if you have diabetes or vascular disease already, the goal is LDL < 70, or greater than 50% LDL reduction.

So you might be able to reduce your LDL to ~100 with the changes, and you’d probably have some idea if it’s working 6 weeks from now. Unless you have very high risk, that wait probably won’t be the tipping point for your widowmaker. Then again, it’s impossible to predict exactly when an atherosclerotic plaque will rupture.

I’d ask your doctor what LDL goal he‘s targeting. If it is 70 or less, start the meds today. Otherwise, ask if you can repeat fasting lipids in 6 weeks. But you should make the lifestyle changes regardless. And find a doctor you trust.

Curious why you prefer taking two supplements instead of the prescription medication?

ETA The other thing your doctor may suggest, if you’re really on the fence about starting lipid-lower medications, is a coronary calcium score. It’s a test that looks at calcification in the arteries of your heart, which is a surrogate for atherosclerotic plaque.

I had the test and have a calcium score of 42. I'm 56 with great bloodwork (except for cholesterol) , great BP, slightly overweight based on BMI - so no other risk factors and pretty healthy compared to the average 56 year old I would guess. I take a few other supplements in addition to the ones I listed and those were all prescribed by my PCP. I don't currently take any medication and and never liked taking meds, even aspirin for a headache. So it's a bit of a mental block or something. I had the same resistance to starting the supplements.

Thanks for this detailed response. I'm pretty sure the target LDL is >70 so diet alone wont get me there. So looks like statins and dietary changes are in my future.

Yeah, your estimated 10-year risk for atherosclerotic disease is right at the cut-off of 7.5%, but the calcium score shows you already have some coronary artery disease. From the 2018 cholesterol guidelines:

1. In adults 40 to 75 years of age without diabetes mellitus and with LDL-C levels ≥70 mg/dL to 189 mg/dL (≥1.8-4.9 mmol/L), at a 10-year ASCVD risk of ≥7.5% to 19.9%, if a decision about statin therapy is uncertain, consider measuring CAC. If CAC is zero, treatment with statin therapy may be withheld or delayed, except in cigarette smokers, those with diabetes mellitus, and those with a strong family history of premature ASCVD. A CAC score of 1 to 99 favors statin therapy, especially in those ≥55 years of age. For any patient, if the CAC score is ≥100 Agatston units or ≥75th percentile, statin therapy is indicated unless otherwise deferred by the outcome of clinician–patient risk discussion.

And I wouldn’t set the bar so low. You don’t want to target being like the average middle aged guy (especially in the US) - you should want excellent health, period.

 

[Terminalxylem]

Anyone having any issues with atorvastatin?

I was on it for a long time - maybe 6-7 years. About 2 years ago my cardiologist wanted me to go from 10mg tabs to 20mg. The 10 was getting me into a safe zone but the 20 got me into what he considered a really safe zone.

But man, after awhile I was starting to feel exhausted at the end of the day. Sore, tired.....fatigued.....all of that. This went on for a few months and never felt like doing anything. So I finally started thinking about what has changed. So I stopped taking that atorvastatin for about 2 weeks to test the theory. And wouldn't you know.....started feeling better.

So I started taking it again to really test it see if that was the cause, and yep - after a few days back on atorvastatin I started feeling like crap again. So I've been cutting the pills in half (my pharmacist said I could do that), and that seems to help.

But back to the drawing board on what I can take again.

Up to 30% of people have muscle symptoms on HMG CoA reductase inhibitors (aka “statins”). Most are annoying, but not dangerous.

The general strategy is exclude other causes of muscle problems first (thyroid disease and excess alcohol consumption are common culprits), then stop the drug and rechallenge. If symptoms come back, consider another statin. In your case, that would likely be rosuvastatin (Crestor), though there are other choices. If symptoms return, find the highest tolerated dose and consider adding a second drug, ezetimibe (Zetia), if your cholesterol goal hasn’t been achieved.

Some people also like to throw in coenzyme Q10 and/or vitamin D supplements, but the data isn’t great supporting their use.

 

[Scoresman]

I’m on 80 mg of atorvastatin. My doctor said it was up to me to go that high but it would be the most conservative approach considering my family history. He said the goal there would be to get the ldl < 55.

I decided to go up to 80 mg because I did not have any side effects to date.

That said, since going up to 80 I’ve been having some digestion issues, bloating, cramping,etc. I read this could be a side effect so I’m wondering if I should bump back down to 40. Gonna talk to the doc.

My family history is related to lipoprotein(a). Normal range for this is less than 29. Mine is about 140. This is apparently the protein in your body that causes plaque to build up in your arteries.

 

[Terminalxylem]

I’m on 80 mg of atorvastatin. My doctor said it was up to me to go that high but it would be the most conservative approach considering my family history. He said the goal there would be to get the ldl < 55.

I decided to go up to 80 mg because I did not have any side effects to date.

That said, since going up to 80 I’ve been having some digestion issues, bloating, cramping,etc. I read this could be a side effect so I’m wondering if I should bump back down to 40. Gonna talk to the doc.

My family history is related to lipoprotein(a). Normal range for this is less than 29. Mine is about 140. This is apparently the protein in your body that causes plaque to build up in your arteries.

Your doc should probably check liver tests, if it hasn’t been done already.

And statins don’t really impact lipoprotein a, TMK. There are newer, injectable drugs (PCSK9 inhibitors) which may work better for your specific cholesterol problem, though data is limited.

 

[Scoresman]

I’m on 80 mg of atorvastatin. My doctor said it was up to me to go that high but it would be the most conservative approach considering my family history. He said the goal there would be to get the ldl < 55.

I decided to go up to 80 mg because I did not have any side effects to date.

That said, since going up to 80 I’ve been having some digestion issues, bloating, cramping,etc. I read this could be a side effect so I’m wondering if I should bump back down to 40. Gonna talk to the doc.

My family history is related to lipoprotein(a). Normal range for this is less than 29. Mine is about 140. This is apparently the protein in your body that causes plaque to build up in your arteries.

Your doc should probably check liver tests, if it hasn’t been done already.

And statins don’t really impact lipoprotein a, TMK. There are newer, injectable drugs (PCSK9 inhibitors) which may work better for your specific cholesterol problem, though data is limited.

My liver tests were perfect on 40mg but haven’t tested on 80. Been at this dose for 3 months now I think.

They put me on really high doses of Niacin for the lipoprotein years ago, but I could not tolerate the side effects.

 

[Terminalxylem]

I’m on 80 mg of atorvastatin. My doctor said it was up to me to go that high but it would be the most conservative approach considering my family history. He said the goal there would be to get the ldl < 55.

I decided to go up to 80 mg because I did not have any side effects to date.

That said, since going up to 80 I’ve been having some digestion issues, bloating, cramping,etc. I read this could be a side effect so I’m wondering if I should bump back down to 40. Gonna talk to the doc.

My family history is related to lipoprotein(a). Normal range for this is less than 29. Mine is about 140. This is apparently the protein in your body that causes plaque to build up in your arteries.

Your doc should probably check liver tests, if it hasn’t been done already.

And statins don’t really impact lipoprotein a, TMK. There are newer, injectable drugs (PCSK9 inhibitors) which may work better for your specific cholesterol problem, though data is limited.

My liver tests were perfect on 40mg but haven’t tested on 80. Been at this dose for 3 months now I think.

They put me on really high doses of Niacin for the lipoprotein years ago, but I could not tolerate the side effects.

Liver toxicity is more common with higher mg, and can definitely present within 3 months of upping the dose. There’s a million other possible explanations for your symptoms, but the labs should be rechecked imo.

ETA Weren’t you the guy making light of the concept of “high” meat consumption, asking how many burgers a day you should eat?

Given this new information, for you specifically, the answer is zero. As Mr. Mackey would say, Lipoprotein a is bad, M’kay?

 

[Scoresman]

I’m on 80 mg of atorvastatin. My doctor said it was up to me to go that high but it would be the most conservative approach considering my family history. He said the goal there would be to get the ldl < 55.

I decided to go up to 80 mg because I did not have any side effects to date.

That said, since going up to 80 I’ve been having some digestion issues, bloating, cramping,etc. I read this could be a side effect so I’m wondering if I should bump back down to 40. Gonna talk to the doc.

My family history is related to lipoprotein(a). Normal range for this is less than 29. Mine is about 140. This is apparently the protein in your body that causes plaque to build up in your arteries.

Your doc should probably check liver tests, if it hasn’t been done already.

And statins don’t really impact lipoprotein a, TMK. There are newer, injectable drugs (PCSK9 inhibitors) which may work better for your specific cholesterol problem, though data is limited.

My liver tests were perfect on 40mg but haven’t tested on 80. Been at this dose for 3 months now I think.

They put me on really high doses of Niacin for the lipoprotein years ago, but I could not tolerate the side effects.

Liver toxicity is more common with higher mg, and can definitely present within 3 months of upping the dose. There’s a million other possible explanations for your symptoms, but the labs should be rechecked imo.

ETA Weren’t you the guy making light of the concept of “high” meat consumption, asking how many burgers a day you should eat?

Given this new information, for you specifically, the answer is zero. As Mr. Mackey would say, Lipoprotein a is bad, M’kay?

That was in the context of pizza vs burgers and was very tongue in cheek. Turkey burgers are usually ordered around our house these days.

 

[Willie Neslon]

I have done a lot of research into statins/high cholesterol over the last few years since I have not been able to physically tolerate statins. I tried to take 5 different medications but I can not take them. With three of them I felt like going to the ER. The other two I was able to take for a few days but felt like absolute crap. I really wanted to take these things because my LDL was high and I was told this number should be near or below 100. Mine has fluctuated between 130 and 220 over the last 7-8 years depending on my diet/exercise routine during the time of the test. Anyway, after really doing a deep dive here is what i discovered.

In the 1950's President Eisenhower was diagnosed with serious heart disease. He instructed his panel of medical advisors to find out why he and so many other Americans were suffering with heart disease which was on the rise in the US over the prior decade. His advisors came up with 2 hypothesis. One was the cholesterol hypothesis in which a diet high in saturated fat and cholesterol raises blood cholesterol and clogs your arteries. The other hypothesis was that sugar causes inflammation in the the blood vessels and causes your liver to send cholesterol to the damaged blood vessels. The panel decided to go with the first hypothesis and to this day our medical system treats patients based on that hypothesis.

In the 1970's drug companies came up with statins and by the 1980's they were widely prescribed. Today they are the most prescribed medicine in the country with something like 1 in 4 adults curently prescribed the medication. In 2003 one of the drug companies conducted a statin study called the Jupiter study. The takeway from the Jupiter study was that if you take a statin you had a 56% (don't quote me on the exact number) less chance of having a heart attack. Doctors around the world saw this headline and began prescribing statins to any of their patients who fell within the AMA guidlines to take one. The study had something like 18,000 participants. Half got the statin, half got a placebo. A very small amount of participants had a heart attack over the course of the study with something like 100 placebo participants and 72 statin participants having heart attacks. The take away from this was that if you take a statin your chances of having a heart attack were lowered by 56% (or whatever the exact number was). This is absurd on a number of levels mostly because the study fudges the result by swapping "absolute risk" vs. "relative risk". Drug companies have been known to swap relative risk and absolute risk depending on which shows their medication to have the greatest benefit. In actuality the absolute risk numbers from this study are close to 1% as opposed to 56%.

A rising number in the medical communtiy now say the greatest indicator of heart disease is not high LDL but a high Triglyceride to HDL ratio. The current belief is that your Tri to HDL ratio should be under 2. For example if your triglycerides are 120 and your HDL is 60 then that ratio is 2. Ideally you want to be under 2 or ever close to or under 1. When I was running about 8 years ago my tryglicerides were 63 and my HDL was 67 thus I had a ratio under 1. It closer to 1.8 now. The other huge indicator of potetial heart issues is a high A1C and blood sugar. Diabetics are far more likely to have heart disease than non-diabetics. Obesity is another potential heart risk.

LDL chosterol has long been called the "bad" cholesterol while HDL is called the "good" cholesertol. This just isn't true. Both are good! Your body needs both in order to work. The problem is that the LDL can get damaged and become small dense partical LDL and those small particals can clot in damaged areas of blood vessels. Healthy "fluffy" LDL particals cause no issue within your blood vessels and yet healthy LDL particles are exactly what statins remove from the body. The way a statin works is it makes the receptors on your liver that capture healthy LDL particles not be able work properly and instead of being sent into the bloodstream by the liver, the healthy LDL is evacuated from the body. Statins do nothing to evacuate the damaged small particle LDL from the body. Most doctors do not even test for LDL particle size or damage. They only see a high, potentially healthy LDL and write a script.

Some in the medical community believe that a doctor must prescribe statins to something like 200 patients in order to prevent a single heart attack. That means 199 patients take these medications for no reasons other than to suffer side effects and other ill-effects. Patients on statins have a higher risk for dimentia because it's LDL cholesterol that protects the brain. They have a higher risk of diabetes. They have a higher risk of liver injury as statins interfere with the processees of the liver. They also lower the amount of CoQ10 in the body which is why one of the side effects of statins is muscle aches. The absense of CoQ10 in the body can lead to muscle damage and make the most importnat muscle in your body, your heart, work harder. Doctors usually will never discuss the risks and downsides of statins, only that you need one if you want to avoid heart disease.

One study I forgot to mention (it's been done mulitple times) is a total choleserol vs. mortality study. Basically they took millions of people's total cholesterol and just checked 10 years later if they were alive or dead. They found people with the LOWEST total choleserol (around 140ish) had the highest 10 year death rate by a large margin, something like 8x normal. Whereas people on the high end (350+) carried only a modest elevated death rate. The study didn't check for anything else other than total cholesterol so it's plausible many on the high end who died likely had other factors with played into their death (obesity, diabetis, etc).

In our lifetimes it's doubtful that the Eisenhower era hypothesis regarding cholesterol will change in any significant way. There is too much money being made on statins. Doctors who have prescribed these medications for going on 40 years are not suddenly going to say no need to take this anymore, new information came out and it's doing you almost no good. Even patients will not stop taking them out of fear and having it drilled in their head for decades both on tv and in the doctor's office that they need to take these or else. Obviously, I am no doctor and certianly no expert so please don't take my word for it. Look into it on your own and talk with your doctor. There is a ton of information on the internet and some good resources on youtube (like this guy) to look into if you have the time.

 

[steelerfan1]

I guess this is as good of a place to ask this question as any... my LDL just came back at 130, my doctor prescribed statins but I really don't want to go on those. I was taking red yeast rice and fish oil and still registered @ 130. Maybe a weird question, but if I would go cold turkey on booze and eat a cholesterol friendly diet for 6 weeks would that be enough time to determine if the dietary changes would work? Or is that not long enought?

Mine was 304 a few years back. My PC doc for years told me it was a “little” high for years and to maybe up exercise and diet. If you tell me something is a little off I’m not going to do anything. When I figured out it wasn’t a little WTF high I switched to another PC who told me that I probably had Hypercholesterolemia and he was putting me on a statin. I told him to give me 6 months to try to get it down. After a radical diet change and routine it went down to 153.

I guess me not ever questioning my pc or looking at what the reading was it’s on me, but I’m a little untrust of the whole just listen to your dr thing.

 

[Terminalxylem]

I’m on 80 mg of atorvastatin. My doctor said it was up to me to go that high but it would be the most conservative approach considering my family history. He said the goal there would be to get the ldl < 55.

I decided to go up to 80 mg because I did not have any side effects to date.

That said, since going up to 80 I’ve been having some digestion issues, bloating, cramping,etc. I read this could be a side effect so I’m wondering if I should bump back down to 40. Gonna talk to the doc.

My family history is related to lipoprotein(a). Normal range for this is less than 29. Mine is about 140. This is apparently the protein in your body that causes plaque to build up in your arteries.

Your doc should probably check liver tests, if it hasn’t been done already.

And statins don’t really impact lipoprotein a, TMK. There are newer, injectable drugs (PCSK9 inhibitors) which may work better for your specific cholesterol problem, though data is limited.

My liver tests were perfect on 40mg but haven’t tested on 80. Been at this dose for 3 months now I think.

They put me on really high doses of Niacin for the lipoprotein years ago, but I could not tolerate the side effects.

Liver toxicity is more common with higher mg, and can definitely present within 3 months of upping the dose. There’s a million other possible explanations for your symptoms, but the labs should be rechecked imo.

ETA Weren’t you the guy making light of the concept of “high” meat consumption, asking how many burgers a day you should eat?

Given this new information, for you specifically, the answer is zero. As Mr. Mackey would say, Lipoprotein a is bad, M’kay?

That was in the context of pizza vs burgers and was very tongue in cheek. Turkey burgers are usually ordered around our house these days.

Keep your eyes out for two investigational drugs, olpasiran and pelacarsen, which look very promising for lowering lp a. If I were you, I’d ask for a prescription the second those get approved.

 

[Terminalxylem]

I guess me not ever questioning my pc or looking at what the reading was it’s on me, but I’m a little untrust of the whole just listen to your dr thing.

Doctors can be good or bad, just like members of every other occupation. They can be greedy, too.

Most are doing the best they can, and genuinely want to help you. I don’t have time to debunk the conspiratorial post above, but suffice it to say, doctors are human/make mistakes/get busy and overlook things/etc., so you need to advocate for your health to some extent.

Just please, don’t rely on YouTube, social media and/or fantasy football forums as your principle sources of medical information.

 

[steelerfan1]

Hi term. Wasn’t meant to be a post that all docs are bad, corrupt, etc. kind of meant to say what you said as far as you need to advocate for you. Don’t just blindly, like I did just assume what your doc tells you is always spot on. Get a second opinion like I did, even though it was like really late.

 

[Terminalxylem]

Hi term. Wasn’t meant to be a post that all docs are bad, corrupt, etc. kind of meant to say what you said as far as you need to advocate for you. Don’t just blindly, like I did just assume what your doc tells you is always spot on. Get a second opinion like I did, even though it was like really late.

Understood. I’ve seen multiple posts on the forum with objectively bad medical advice, so I definitely don’t think absolute trust in physicians is warranted. But the idea that doctors are mindless pill pushers, or worse, greedy shills enabled by a massive conspiracy is ludicrous.

It’s also ridiculous to believe a few YouTube videos are sufficient to understand complex subjects people spend years in training to comprehend.

Lastly, it’s worth noting, medicine is an imperfect science, and standards of care change over time.

 

[Scoresman]

Hi term. Wasn’t meant to be a post that all docs are bad, corrupt, etc. kind of meant to say what you said as far as you need to advocate for you. Don’t just blindly, like I did just assume what your doc tells you is always spot on. Get a second opinion like I did, even though it was like really late.

I’ve found you just need to be really really good at describing your issue/symptoms. Like, I’ll practice ahead of time or write down a list.

 

[steelerfan1]

Hi term. Wasn’t meant to be a post that all docs are bad, corrupt, etc. kind of meant to say what you said as far as you need to advocate for you. Don’t just blindly, like I did just assume what your doc tells you is always spot on. Get a second opinion like I did, even though it was like really late.

Understood. I’ve seen multiple posts on the forum with objectively bad medical advice, so I definitely don’t think absolute trust in physicians is warranted. But the idea that doctors are mindless pill pushers, or worse, greedy shills enabled by a massive conspiracy is ludicrous.

It’s also ridiculous to believe a few YouTube videos are sufficient to understand complex subjects people spend years in training to comprehend.

Lastly, it’s worth noting, medicine is an imperfect science, and standards of care change over time.

Agree with everything said