I guess I'll be taking a statin

[WhatNext]

Searching this forum for "statin" brings up 1000+ results. Searching through just a few of them isn't helping me with this decision. My primary reason for agreeing to go on a statin will be to preserve a pretty good relationship with my GP; I don't know it that's a good enough reason. About 3 months ago he ordered a test for cholesterol--3 numbers: TC, LDL, and HDL. My numbers were 224, 124, and 90. Last week the test was repeated and the new numbers were 213, 121, and 81. So he wants me to take a statin. I haven't told him about my APOE status (3/4) and I doubt it would make a difference. My brother and my son also have "above optimum" cholesterol, as did my mother and probably my father, who was overweight, a couch potato, and buttered everything. My father died of melanoma at the age of 81; my mother died after catching the flu at 92.
I'm female and I have a small frame, both of which increase my risk of side effects from a statin. Muscle weakness and soreness are side effects and I think it would be counter-productive if a statin interferred with my exercise routine (yoga and weight lifting), which I think is the best thing I'm doing for my health.
Tough decision: I would love some advice.

WhatNext
67 year old woman, APOE 3/4

[Julie G]

Do you know your triglycerides from 3 months ago and now? Any differences in diet in that interim? How's your hbA1c, fasting glucose and insulin?

[FL-RCD-PRCTNR]

Hi WhatsNext!
I'm going to conjecture as to WWDBS (What Would Dr. Bredesen Say). To further help you with your decision, you may want to consider having your LDL Particle Number (optimal <1000), Oxidized LDL (optimal < 60 U/I) and/or sdLDL-small density LDL (optimal < 20 mg/dl) . Cleveland Heart Lab offers these as NMR LipoProfile with Oxidized LDL as add-on. I think Dr. Bredesen has said repeatedly that these are much more important indicators of cardiovascular risk. Boston Heart does as well, and maybe other labs like Quest or LabCorp.

An HDL of 90 is superior! I rarely see that high.... would you please sell it to me, so I can give it to my husband for his birthday??

He has also mentioned that some people have had a Cardiac CT for Calcium Scoring, and that a low calcium score was enough to sway against statins. Good information to have anyway, and I don't think it's excessive given that you are being requested to commit indefinitely to a medication with significant potential for side effects.

If you do go with the statins, please please please take the UbiquinOL form of CoQ10, because our own body's production of it requires the same enzyme that is blocked by statins. The "party line" is that statins don't decrease CoQ10, but i call BS on that. Life Extension has a very good product. If you like to check these things out on your own ConsumerLabs.com is an excellent, exhaustive source of independent information about all things supplement.

Best of luck to you, whatever you decide. But I must say I cringe at the thought that we would feel we would have to do something we didn't think was in our best interest to get along with our Dr.....

Trust your heart!

[MarcR]

In my opinion, the science suggesting that micromanaging serum cholesterol is good for human health is highly suspect.

[Davida]

Hi WhatsNext!
I'm going to conjecture as to WWDBS (What Would Dr. Bredesen Say). To further help you with your decision, you may want to consider having your LDL Particle Number (optimal <1000), Oxidized LDL (optimal < 60 U/I) and/or sdLDL-small density LDL (optimal < 20 mg/dl) . Cleveland Heart Lab offers these as NMR LipoProfile with Oxidized LDL as add-on. I think Dr. Bredesen has said repeatedly that these are much more important indicators of cardiovascular risk. Boston Heart does as well, and maybe other labs like Quest or LabCorp.

Hi FL-RCD-PRCTNR!

Welcome to the Apoe4 community and thank you for posting. We all learn so much from each other. I certainly appreciate the information you shared and I'm sure others will as well. You probably have already reviewed some of what is on the site. If at any time you would like to share more of yourself and your work, posting on Our Stories is a wonderful thread.

Again, thanks for joining. I hope we hear more from you. Your wisdom and experiences are always welcomed.

My best, Davida

[WhatNext]

Tricky. Do you know your triglycerides from 3 months ago and now? Any differences in diet in that interim? How's your hbA1c, fasting glucose and insulin?

Hi Julie, thanks for responding. It turns out the test results did include 2 additional numbers. On the most recent test vldl was 11 and triglycerides were 54. I don't know what they were on the previous test. I'd need to order a test from LabCorps and pay out of pocket to get any other results, which I'm seriously considering doing. The last time I did was October 2017. My fasting glucose was 77. My test didn't include hbA1c unless it's called something else. My insulin Resistance score, LP-IR was <25. My diet hasn't changed.

I have an update. I spoke briefly with the nurse and told her I didn't want to take a statin. The doctor called me back and said "You don't have to take a statin--there are alternatives." This was news to me and I had no answer. He wrote a prescription for Zetia which I filled and I'll start taking it tomorrow *sigh*. I have to get another blood test in 6 weeks. I don't like the reviews! I read just a few and had to stop.

[WhatNext]

Hi WhatsNext!
I'm going to conjecture as to WWDBS (What Would Dr. Bredesen Say). To further help you with your decision, you may want to consider having your LDL Particle Number (optimal <1000), Oxidized LDL (optimal < 60 U/I) and/or sdLDL-small density LDL (optimal < 20 mg/dl) . Cleveland Heart Lab offers these as NMR LipoProfile with Oxidized LDL as add-on. I think Dr. Bredesen has said repeatedly that these are much more important indicators of cardiovascular risk. Boston Heart does as well, and maybe other labs like Quest or LabCorp.
...

Best of luck to you, whatever you decide. But I must say I cringe at the thought that we would feel we would have to do something we didn't think was in our best interest to get along with our Dr.....

Trust your heart!

Hi FL-RCD-PRCTNR, thanks for your answer. I am considering getting the Extreme Heart Health panel again to check the LDL particle numbers. All of my tests have been done by LabCorp. I got just these two particle numbers from the test I had in October of 2017:
LDL-P = ll84 (moderate)
small LDL-p = 223 (reference interval < 527)

The trouble is I can't see myself walking in to my doctor's office and acting like I know more about this than he does. I can't see how it would come across any other way.

WhatNext

[WhatNext]

In my opinion, the science suggesting that micromanaging serum cholesterol is good for human health is highly suspect.

I agree!!! My doctor wrote a prescription for Zetia, which prevents the gut from absorbing LDL apparently. Anything that messes with my gut function sounds potentially catastrophic.

WhatNext

[jgilberAZ]

Get a coronary calcium scan.

If it shows you have heart disease, then consider taking a statin.
If it shows low risk, avoid the statin like the plague.

Lowering cholesterol increases all-cause mortality.

viewtopic.php?f=4&t=6274&p=68450&hilit=ldl#p68450
viewtopic.php?f=4&t=5212&p=58670&hilit=ldl#p58670
viewtopic.php?f=2&t=5064&p=57425&hilit=ldl#p57425
viewtopic.php?f=2&t=4981&p=56863&hilit=ldl#p56863


Really, your numbers look great to me.

https://cholesterolcode.com/report/


--===== CholesterolCode.com/Report v0.9.5.15 =====--
• Female • 67 • Coffee: <Unspecified Usage> •
• <Unspecified time and/or diet> •
• <Unspecified fasted time> • Cholesterol Rx: false •

Total Cholesterol: 213 mg/dL 5.51 mmol/L
LDL Cholesterol: 121 mg/dL 3.13mmol/L
HDL Cholesterol: 81 mg/dL 2.09mmol/L
TG Cholesterol: 54 mg/dL 0.61mmol/L

---------RISK REPORT---------
Atherogenic Index of Plasma: -0.535 mg/dL >>> Lowest Risk Third
----> Go to https://tinyurl.com/ycccmmnx for more on AIP

Framingham Offspring: 0.7 Odds Ratio >>> Low Risk
----> Go to https://tinyurl.com/y5fc5adl for more on this Framingham study

Jeppesen: >>> Lowest Risk Third
----> Go to https://tinyurl.com/y63xp7lj for more on the Jeppesen study

Cholesterol Remnants: 11 mg/dL >>> 0.12 mmol/L >>> Low Risk
----> Go to https://tinyurl.com/y84u92wm for more on Cholesterol Remnants

------CONVENTIONAL MARKERS AND RATIOS------
Friedewald LDL-C: 121 | Iranian LDL-C: 96
TC/HDL Ratio in mg/dL: 2.63
TG/HDL Ratio in mg/dL: 0.67 | TG/HDL Ratio in mmol/L: 0.29

[WhatNext]

Get a coronary calcium scan.

If it shows you have heart disease, then consider taking a statin.
If it shows low risk, avoid the statin like the plague.

Lowering cholesterol increases all-cause mortality.

viewtopic.php?f=4&t=6274&p=68450&hilit=ldl#p68450
viewtopic.php?f=4&t=5212&p=58670&hilit=ldl#p58670
viewtopic.php?f=2&t=5064&p=57425&hilit=ldl#p57425
viewtopic.php?f=2&t=4981&p=56863&hilit=ldl#p56863


Really, your numbers look great to me.

...

Wow thank you!! This is encouraging. I think if I have ANY side effects from the Zetia I'll print this out and take it to my doctor. I'll ask him about the coronary calcium scan and cross my fingers. I haven't told him that I'm APOE3/4, but I did tell him that my greatest concern is risk of AD. He knows my mother developed dementia although not until her mid to late 80s: she was 88 when I brought her to Virginia to live with me and took her to see him.

WhatNext