Experiences with high cholesterol and meds?

[sf333]

I’ve had high cholesterol for years - as early as 2015 (maybe before but this is the earliest I can find bloodwork results from). I’ll post my current numbers below to give an idea of where I’m at. A few years ago, my doctor told me I had to lower my cholesterol or I’d need to start meds. With the pandemic and other craziness, I kind of forgot about the whole thing.

Recently, I started thinking about my health and I went back to my doctor’s office and met with a different doc in the practice (mine wasn’t available for a while). This doctor plugged my 2020 numbers into a risk calculator which said I have a 1% chance of an event happening in the next 10 years. She said my numbers are only mildly elevated (LDL of 159, for example). Because of these two things, she feels that I don’t need to be on meds. Very conflicting opinions between the two doctors.

I then had my blood drawn after my visit with her and my numbers are worse than they were 2 years ago. My dad has a long history of high cholesterol. I’m 46.

If you’ve gone on medication for cholesterol, what was the reasoning? Did you have side effects?

My current numbers:
Cholesterol: 262
HDL: 42
Triglycerides: 379
LDL: 156
Cholesterol/HDL: 6.2
nonHDLc: 220

[wencit]

FWIW, I recently had this discussion with my current doctor a couple weeks ago. Our numbers are pretty similar, right down to the fact that my cholesterol has been elevated for several years (and I was given the same warning by my previous doctor) and my doctor also calculated a 1% chance of an event happening. My total cholesterol is slightly below yours, but my doctor didn't necessarily recommend medication, although he said if I wanted to, he would prescribe it for me. In the end, we decided to wait and see if I could bring it down with lifestyle changes. I'll do another blood draw in 6 months and see where I am. In the meantime, I am trying to exercise more and be cognizant of what I eat. DH used to have really high cholesterol and was on meds for a little while, but he did a complete overhaul of his weight (lost 80 lbs) and diet (went vegan), and was taken off his cholesterol meds, so I know it can be done with lifestyle changes.

[KpbS]

I don't have experience with cholesterol and medication, but I know that making diet changes and exercise can lower your cholesterol. For instance eating oats can have a significantly lower your LDL levels in 4 weeks. https://www.eatthis.com/best-oatmeal...r-cholesterol/ https://www.mayoclinic.org/diseases-...l/art-20045192 https://www.health.harvard.edu/heart...er-cholesterol

[Snow mom]

DH has high cholesterol and it definitely runs in his family. He tried for many years to get it down with diet and exercise and it was never tragically high, although I don't have the numbers to compare to yours. They probably spent five or six years discussing it at his annual physical as he didn't want to take meds for it and his doctor didn't push it. Then about two years ago the doctor really encouraged DH to go on a low dose statin as the numbers really weren't changing with just diet and exercise. It's made a big difference and I think DH feels he's not sure why he resisted for so long. Of course the math might be different with him being male and therefore at higher risk for certain things. He has to now have blood testing twice a year, which we pay for out of pocket as our health system is all sorts of backwards. I'm not sure if the hope is to ever try getting off the statin, I'd have to ask him. I guess what I'd say is set a goal for changing your cholesterol numbers and see if you are able to do it on your own, but don't let it go like that indefinitely. I think having different opinions among doctors as to treatments and risk calculations is really common. To me a 1% chance, especially if you're talking about something really serious and life-altering, isn't a tiny probability. I'd strongly consider what the downsides of starting medication are.

[mmsmom]

If the reason for your high cholesterol is genetic, then no amount of dietary changes or exercise will help. My father had high cholesterol and was extremely strict with his diet for many years until the Drs finally determined it was genetic (this was in the 80’s before they knew as much as they know now). Now my kids and I also have high cholesterol. I started Lipitor a couple years ago. I’m on the lowest dose and it keeps my numbers in an acceptable range. I am a mostly healthy eater and workout 5 days a week. My DC are teens and I was told these years are hard to get accurate numbers due to their hormonal changes but their numbers are in an acceptable range now. They take fish oil and red yeast rice supplements which seem to help.

[ged]

My cholesterol is also higher than I prefer, but not at levels where my doctor suggest medication (and they are a tad lower than yours, I think). Doc thinks diet and exercise will reduce it. Idk - but I did start taking an OTC - Cholestoff ... off and on, though. i've also heard oatmeal is great, but I just don't really like it so I don't eat it enough. And also heard we need to add fiber - I've tried the whole metamucil thing but am very inconsistent with it. I am thinking to take some fiber capsules? I think my friend ate cheerios for a month and that helped?

[dogmom]

It’s a tough call. For years it was unclear whether women got as much benefits from satis (cholesterol meds) as men. Of course there were very few studies with women in them, especially women in child bearing years. It was also believed women didn’t suffer cardiac disease as much as men. Turns out people just weren’t really looking for it. After menopause things like hypertension are actually harder to control in women and women are much more likely to die after a heart attack. There has also been a move to use a risk calculator, like your doctor used, instead of just raw lab values to determine whether someone should take a statin. Long term statin use has also been studied more and we have a better handle on side effects. For me here are the key things to think about:

Satins have reduced mortality and morbidity from heart attacks, coronary artery disease and stroke. They really are remarkable drugs. Like all drugs they have side effects. Using a risk calculator is helpful for a provider in making recommendations.

Cholesterol is part diet and part genetics. Your body makes cholesterol, so it might be that you can do everything right and still have high numbers. Have reasonable expectations of diet & exercise.

Whatever you do now needs to be revisited, especially as you move towards menopause. So decided to wait a year and reevaluate is a solid plan.

Myalgia, muscle weakness, is the most common side effect from statins. It can lead to myopathy, which is longer lasting. Women seem to have a higher risk than men. But once again, less raw data on women.

Caveat: NONE of this applies to BP/Hypertension, “borderline” or not. People, understandable, link the two. However, I always counsel getting people on BP meds sooner than later. The data on even moderately elevated BP is convincing and continues to roll in from cardiac, to stroke to dementia. It causes long term damage to your body that cannot always be reversed. The side effects from most first line BP meds are minor and there are several families of medications to try. I think it makes much more sense of people to start a anti hypertension medication while they are making lifestyle changes and get off, then wait a year or two or three before starting. So over the years there was been a move to start BP meds early and wait on Cholesterol meds.

So, long way to say, if I were you I would wait and check the following year so you can have 2 years of back to back data.

[vludmilla]

Caveat: I am not a medical doctor but I do have an interest in cholesterol numbers, etc and I've read a lot on the topic. I would be concerned that your triglycerides are quite high. I would want to really overhaul my diet to get the triglycerides way down (like under 75!) and the way HDL up (add olive oil, eggs, avocado, not seed oils). You might find that if you do that, you won't have problematic LDL anymore. If you are inclined to wait a year before statins (which I would as well), that would be my approach, push that trigylcerides number way down and get HDL way up.

Eat a whole foods diet. Do NOT snack. 3 meals a day only. Increase lean protein (by a lot). Aim for 0.7 to 1.0 grams of lean protein per pound of body weight.--this is way above the RDA. If you eat that much lean protein (turkey, chicken breast, fish, eggs, low fat dairy, etc) and eat only whole foods while also completely avoiding snacking, I think your triglycerides number will drop and HDL will go up. Decent chance your LDL will come down as well.
Good luck!