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High cholesterol: Are drugs the only real treatment?

By October 20, 2008 - 9:08am
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For most of my life, I have had cholesterol that has been under 200. Recently, however, after a routine cholesterol test (it did include fasting) as part of an annual exam, I learned my cholesterol is high (255).

I am surprised at this, since I never had high cholesterol before. I just had my 50th birthday and over the last two years have put on a lot of weight due to a depression that went undiagnosed for a while. That is now in the past, and I'm grateful, but I have to start working on the weight.

Here's my question. I have an appointment with my doctor later this week to talk about the results and what I should be doing about it. Are there people who are successful by lowering their cholesterol this much simply by diet and exercise? Or has the treatment of choice become drugs?

I hear so much about the statin drugs. Once you begin taking them, do you have to take them forever? I wouldn't mind medicine if it could be used on a short-term basis to get my cholesterol down while I lose the weight and get in better health, but I hate to think of starting a medicine that's a lifelong medicine if I might not need it.

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EmpowHER Guest

My only comment is that I feel better when I'm not taking my cholesterol medications, so I have cut back on them.

May 1, 2010 - 1:59am

Dr. Susan, thank you for bringing your blog to my attention. It's full of such good information. I'll print it out and read it again before my appointment on Thursday. Thank you!!

October 22, 2008 - 10:07am

Here is a brief blog I wrote on the subject of lowering cholesterol:

Monday, July 28, 2008
Cholesterol...Supplements vs. Statins

According to the American Heart Association an estimated 106.7 million adults in the United States have total blood cholesterol values of 200 mg/dL and higher, and of these about 37.2 million American adults have levels of 240 or above. Statin drugs remain the primary treatment for individuals diagnosed with high cholesterol levels, but they do come with numerous side effects and many of them are not benign.

For years well-meaning physicians have prescribed statins to lower cholesterol, because high levels have been thought to be a main predisposing factor to heart disease. Unfortunately, the body is not that simple. High cholesterol is not a direct link to heart disease, in fact we are not even sure if it is ONE of the links at this point. What we do know is that our bodies NEED cholesterol. It is vital in hormone development, nerve sheath development, brain health ect. If we are going to focus on the numbers game when in come to measuring cholesterol.....we should be equally as concerned about LOW levels of cholesterol as we are of high levels. The fact of the matter is if your levels are too high or too low it could suggest that your body is out of balance and may indicate that you make some lifestyle and/or dietary changes.

If your levels of cholesterol are significantly on the higher side and you and your physician wish to have them lower...there are other options aside from the statin drugs. Published in the Mayo Clinic Proceedings, a study conducted by cardiologist David Becker, MD of the University of Pennsylvania and his colleagues studied 74 people with high cholesterol.

Half took the statin drug Zocor and the other half took red yeast rice supplements. They were followed for 12 weeks.

The medication group took 40 milligrams of Zocor daily and received traditional counseling in the form of handouts on diet and exercise. The supplement group took three fish oil capsules twice daily. In addition, those with an LDL cholesterol higher than 160 mg/dL took 3.6 grams of red yeast rice daily, divided into two doses. If the initial LDL level was 160 or less, they took 2.4 grams of red yeast rice daily, divided into two doses.

The supplement group also attended weekly meetings and was taught about lifestyle changes by a cardiologist and a dietitian. The group was urged to follow a modified Mediterranean diet, limiting fat intake to less than 25% of daily total calories, and to exercise for 30 to 45 minutes five to six times a week.

"We followed them for a three-month period," Becker says. At the stuy's end, the levels of bad cholesterol had declined nearly the same amount in both groups. "The LDL declined 42% in the supplement group and 39% in the Zocor group," Becker says.
The supplement group also lost an average of 10 pounds in 12 weeks, but there was no significant weight loss in the medication group. Triglyceride levels, while on average normal in both groups at the start, decreased by 29% in the supplement group but just 9.3% in the medication group — a significant difference, Becker says.

Supplements and dietary/lifestyle changes can be a viable option in lowering cholesterol and triglyceride levels in many individuals and should be recommended prior to taking a statin drug.

If you have cholesterol levels above 240 mg/dL and more importantly have low levels of HDL (good cholesterol) or high triglycerides consider the following:

1. Modify your diet. Don't worry so much about the cholesterol levels in foods (cholesterol in food does not increase cholesterol systemically as we once thought) Focus on a diet low in processed foods, especially AVOID refined sugars, high fructose corn syrup, refined carbohydrates (white breads, pastas, sweets, juices). Focus more so on a diet with whole grains, fresh fruit/vegetables, lean proteins, legumes.

2. Exercise...walk, play, get active. REGULARLY.

3. Omega 3 fish oil...2000mg per day. Try Nordic Naturals.

4. Red Yeast Rice extract as prescribed by your physician.

Hope this helps!


October 21, 2008 - 2:18pm

Diet and exercised used to be recommended as first line treatment for high cholesterol. The problem is that it may take a while for this intervention to work. Meanwhile, while you are waiting you health is at risk.

I am a pharmacist but I feel that the best move is to start statins immediately as well as diet and exercise. Once your cholesterol is under control you can go back off of the medications and see is you can maintain the lower cholesterol levels.

October 20, 2008 - 5:04pm
EmpowHER Guest
Anonymous (reply to pharmacistmc)

Pharmacistmc, thank you so much for your opinion. I truly appreciate it. You're in the medical field and yet you see a different side of things than a doctor would, and certainly than a lay person would. Thank you again. If this is what my doctor recommends, I won't be as hesitant.

October 21, 2008 - 7:08am
(reply to Anonymous)

Annie, Thanks for the nice words. Best of luck getting your cholesterol down. It takes a lot of work and a lot of changes but you can do it.

October 21, 2008 - 8:14am

My doctor was baffled by how my cholesterol level increased over the course of a year, in spite of the fact that I'm a marathoner in almost year-round training. I hated the side effects I felt while on Lovastatin and eventually stopped taking it.

There are some interesting views against statins:

Dangers of Statin Drugs: What You Haven’t Been Told About Popular Cholesterol-Lowering Medicines By Sally Fallon and Mary G. Enig, PhD

Statins: Are these cholesterol-lowering drugs right for you?
, MayoClinic.com

Lowering cholesterol without statin drugs, L.A. Times

Statin Drugs:
A Critical Review of the Risk/Benefit Clinical Research
, RecoveryMedicine.com

As a former astronaut, aerospace medical research scientist, flight surgeon and family doctor, I was appalled by the lack of information in the medical community on the full range of side effects of the statin drugs. This book is a comprehensive reference source and summary of side effects of statin drugs.

Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor

Statin Drug Side Effects

October 20, 2008 - 4:44pm
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