High Calcium Score

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pharmacydoc
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High Calcium Score

Postby pharmacydoc » Fri Nov 08, 2019 12:10 pm

I just received a calcium artery score of 255! I am shocked because my cholesterol numbers were very good in September:

HDL 78
VLDL 9
LDL 105
total cholesterol: 192
Triglycerides: 46
Total Chol/HDL: 2.5

Is it reasonable that cholesterol could be so good but the calcium score so high? Does this mean I need a statin? My internist is heavily pushing a statin, but I am waiting for an opinion from my functional medicine doctor. If a statin is indicated, which one has the fewest side effects and the greatest effect on mortality?

My father died of a heart attack at the age of 59 and had his first heart attack at the age of 52. I am a 69-year-old woman. I thought my good diet and exercise programs were protecting me, but maybe not as much as I thought. I am also APOE 3/4.

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Julie G
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Re: High Calcium Score

Postby Julie G » Fri Nov 08, 2019 3:00 pm

Sorry, pharmacydoc. From what I understand cholesterol alone isn't really correlated with heart disease. Are you also tracking glycemic markers: fasting glucose, insulin, hbA1c? How are your inflammatory markers, hsCRP and homocysteine? Are you taking Vitamin D? If so, are you also taking K2? While your number may seem high, it's most important to stabilize progression. We've had many talks on the site about that. Maybe our search function would help. I hope some others weigh in with ideas. -xo

donbob
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Re: High Calcium Score

Postby donbob » Fri Nov 08, 2019 3:29 pm

pharmacydoc wrote:I just received a calcium artery score of 255! I am shocked because my cholesterol numbers were very good in September:

HDL 78
VLDL 9
LDL 105
total cholesterol: 192
Triglycerides: 46
Total Chol/HDL: 2.5

Is it reasonable that cholesterol could be so good but the calcium score so high? Does this mean I need a statin? My internist is heavily pushing a statin, but I am waiting for an opinion from my functional medicine doctor. If a statin is indicated, which one has the fewest side effects and the greatest effect on mortality?

My father died of a heart attack at the age of 59 and had his first heart attack at the age of 52. I am a 69-year-old woman. I thought my good diet and exercise programs were protecting me, but maybe not as much as I thought. I am also APOE 3/4.


MESA-nhlbi.org. Has an online risk calculator.

NF52
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Re: High Calcium Score

Postby NF52 » Fri Nov 08, 2019 3:47 pm

pharmacydoc wrote:I just received a calcium artery score of 255! ...
My father died of a heart attack at the age of 59 and had his first heart attack at the age of 52. I am a 69-year-old woman. I thought my good diet and exercise programs were protecting me, but maybe not as much as I thought. I am also APOE 3/4.
Hi Doc!
With a heart attack at age 52 and death from a second one at age 59, your dad would have been considered to have "early" heart disease, which probably was silently stalking him for years. This is from Harvard Heaalth:
if a parent or sibling had a premature heart attack, that's an even stronger signal to be more proactive in monitoring and lowering your risk, he adds. A premature or early heart attack is one that occurs before age 55 in a man or before age 65 in a woman.
https://www.health.harvard.edu/heart-attack/do-premature-heart-attacks-run-in-your-family

So it's actually possible that your diet and exercise HAVE been protecting you from a heart attack, but not enough to keep your arteries calcium free.

One other causal factor, besides those Julie G mentioned, may be your lipoprotein(a), also referred to as Lp(a). I had a very high Lp(a) level of 178 when tested at age 65, since anything above 75 is considered high. As a 67 year old woman whose dad died of cardiac arrest at age 67, with a history of aortic stenosis, a "silent" heart attack and quadruple bypass before his death, I too wondered about my coronary calcium score. Luckily mine calcium score was at zero two years ago; although that doesn't mean it can't change

Here's an excerpt from the Lipoprotein(a) Foundation, a website I have found helpful:
Lipoprotein(a) is a particle in your blood which carries cholesterol, fats and proteins. The amount your body makes is inherited from one or both parents and is determined by the genes passed on from your parent(s) when you are born. It does not change very much during your lifetime except if you are a woman, levels increase as the natural estrogen level declines with menopause. Diet and exercise seems to have little to no impact on the lipoprotein(a) level....Lipoprotein(a) is a type of lipoprotein/cholesterol and high levels increase your risk for atherosclerosis (build up of fatty deposits in the wall of the artery, also called atherosclerotic cardiovascular disease or CVD) including coronary heart disease (blockages in your heart arteries) or heart attack, peripheral vascular disease (PAD, blockages in the leg arteries), aortic stenosis (damage to the aortic valve of the heart), thrombosis (blood clots) and stroke (blockages in the neck arteries).
https://www.lipoproteinafoundation.org/

Another option would be to get a referral to a cardiologist that your doctor recommends--or your friends, if you trust their judgement! A good cardiologist has seen hundreds of patients like you, and may have recommendations for further testing just as NMR cardiac stress testing that would show whether that calcium is likely to cause problems. The test is painless and covered by insurance with a referral.

Best of luck in finding out what's going on--keep us posted!
Last edited by NF52 on Fri Nov 08, 2019 3:52 pm, edited 1 time in total.
4/4 and still an optimist!

PeterM
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Re: High Calcium Score

Postby PeterM » Fri Nov 08, 2019 3:48 pm

Don’t despair, pharmacydoc. If you are controlling for all that Julie has wisely cited (and glancing at your previous posts it appears you are going in that direction) that calcium score could easily be old plaque that formed years ago that has long since stabilized. While the 255 number seems alarming on the face of it your actual cardiovascular risk may be far lower. And your numbers don’t look bad at all. By any lipid measure you are pretty much in the middle of the lowest quartile for risk. Perhaps get an advanced lipid panel and look at your oxidized cholesterol and LDL-p numbers. And if you continue to address all that Julie mentions (plus some thyroid numbers) you will likely see no increase in that calcium score if you repeat the test next year. In any case, a statin at this point seem like hammer when it’s pliers (or nothing at all) that is actually called for.

pharmacydoc
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Re: High Calcium Score

Postby pharmacydoc » Fri Nov 08, 2019 5:37 pm

Thanks to all of you for the input! I'm less worried now. I'm due to have comprehensive labs done next week and that will help me put the pieces together better. These labs will include the LDL-p number and homocysteine. My Vitamin D was 63.7 in January. I take 5,000 units of D3 and 100 mg of K2 daily. Two years ago my A1C was 5.2. My fasting glucose usually runs in the 90's.
NF52, thank you for the info about the NMR stress test. I'll ask my doctor about that.
I'll certainly keep you posted after I get the results of my labs next week. Thanks again!

LeeRodriguez
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Re: High Calcium Score

Postby LeeRodriguez » Mon Nov 11, 2019 6:53 pm

Try reducing carbs try to get FBS under 90, mid-80s. I’m in a program that allows 15 gm net carbs per meal. Had labs drawn last week, results pending


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