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What Is The Remedy For High Cholestrol?

Posted on Thu, 6 Mar 2014

Question: Hello, my name is XXXXXXX I am 39 years of age. A few years back I had a routine blood test and found out I had high cholesterol of around 6.8mmol (combined). Since then I had changed my diet and 3 months later went for another blood test and my cholesterol had increased to around 7.2mmol (combined). I have consulted various doctors and also seen a cardiologist, but they cannot figure out why my cholesterol is so high. I only weigh 53kg, have no family history of heart disease, no diabetes, no high bood pressure. Recently I had a genetic testing done and that has also come back normal. So here I am looking for advice on this mystery raised cholesterol. Ultimately I will have to start taking statins, but I am not very happy about this as they have many side effects. I am only 39 and feel stressed about taking a pill for the rest of my life. Can someone please help me out here, please let me know if you require further information. Many Thanks

Follow up: Dr. Lohit K (30 minutes later)

Sorry forgot to say my recent blood test showed cholesterol at 8.2mmol. LDL is 5.8mmol, HDL is normal, triglycerides is 2.66mmol

Answered by Dr. Lohit K (49 minutes later)

Brief Answer: Statins, life style modifications Detailed Answer: Hi XXXXXXX Thanks for using HCM. I had gone through your query and understand your concerns. The main reason for raised cholesterol level is life style changes, eating habits and genetic makeup but the treatment for all of them is same. You should be worried but not too much. You may easily get back to normal range with the prescribed medications (statins) and life style modifications. I see similar cases amongst young people who visit my clinic. In the first meeting, I advise my patients to go on lifestyle modifications for three months. I retest them again after three months and if they continue to be in high range then I advise them to take statin group of medicines like Atorvastatin, Rosuvastatin and Pravastatin and your doctor has done the same. Usually with treatment LDL and total cholesterol level will come down. Once it is in normal range then we can optimize the dose based on your activities. Rosuvastatin has better tolerability and good effect with low dose (high potency). So you can discuss with your doctor to choose that best suits you. A combination of medicines and lifestyle management is required to control it. For the next 2-3 months, try the following guidelines. Then get your cholesterol checked again. The lifestyle changes should include: Reduced intake of saturated fats to less than 7% and cholesterol to less than 200 mg/day. Cut down the processed food. White bread, doughnuts, white sugar, pizza should be completely avoided. High fibre diet, green leafy vegetables, fruit. Increase the soluble fiber in the diet. Sources of soluble fiber include oatmeal, oat cereal, lentils, apples, oranges, pears, oat,nuts, beans, dried peas, blueberries, psyllium, cucumbers, celery and carrots. A 30-40 minute physical activity every day like morning walk, evening walk or a visit to the gym or swimming pool. Smoking and Alcohol intake can increase the triglyceride levels so better to avoid them. Hope this information helps you and answered your queries. Feel free to ask if any related queries and I will be glad to answer them. Wish you good health. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Lohit K (53 minutes later)

Thank you for your reply, Dr Lohit. This has been going on for a couple years and despite diet changes etc, my cholesterol still does not come down. I have a few questions regarding statins, if you do not mind answering them. 1) What are the long term effects of taking statins, e.g does it lead to liver dysfunction and trigger type 2 diabetes and kidney problems. 2) Do I have to take COQ10 supplement as I believe the statin destroys this enzyme in the liver so i have to replace it. 3) Do Krill fish oil capsules help lowering cholesterol. 4) Can high cholesterol lead to increase in blood sugar and diabetes. 5) Would statins be safe for me to use for the rest of my life without triggering other illness. The doctors here prescribe simvostatin mostly, is this a good drug and tolerable to use. Many Thanks

Answered by Dr. Lohit K (21 hours later)

Brief Answer: Safe. Krill oil helpful. Detailed Answer: Hi, Thanks for writing back. 1. I have seen many of my patients taking statins for more than a decade without any side effects. Most people on statins tolerate them very well. But some people experience side effects like flushing of the skin, Muscle aches, tenderness, or weakness (myalgia) or gastric discomfort initially. This will be relieved in time. Some rare side effect like myositis or elevated CPK level may occur. But these are very rare. But they do not cause kidney, liver or diabetes problem. 2. COQ10 supplement not required. Your body will have adequate required enzymes. 3. Krill fish oil has some role in lowering cholesterol level, triglycerides. You can use it. 4. High sugar can cause high cholesterol level. The high cholesterol, glucose, hypertension all can be bassociated with each other and are individual risk factor for development of other disorder. So nee to be careful with regular followup and monitoring. 5. Yes. It is safer. But very few may get side effects as explained earlier. If no problem is seen in the initial months then no need to worry for its side effects. 6. Yes all statins are good. I usually prefer rosuvastatin and atorvastatin than any other statins. Hope this helps you. Feel free to ask if any related queries. Wish you good health. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Lohit K (22 hours later)

Thank you for your reply Dr Lohit. The common statins used here are simvastatin and atorvastatin, I believe rosuvastatin is a bit expensive so the doctors leave that for a last resort. As I have no other risk factors other than high cholesterol, I feel slightly uncomfortable taking the statin. My doctor had done a framingham online test and it says I have a 5% risk of heart attack or stroke. One cardiologist had also told me that high cholesterol itself does not cause heart attacks or strokes, its only when combined with high blood pressure and diabetes that the risks get larger. So I am still in 2 minds whether to start taking the medication as I will be on them for lifetime, or I can take a low dose statin and if my LDL goes back to normal I can stop taking the medication.

Answered by Dr. Lohit K (2 hours later)

Brief Answer: Life style modifications +/- statins Detailed Answer: Hi XXXXXXX As I told before based on the available studies the risk increases with age and also associated comorbidities. So high cholesterol level is a part of contributing factor. Since your cholesterol levels are high better is to start low dose statin for few months along life style modifications. This will help you to get back to normal level and also relieve your anxiety. Later on you can gradually reduce the drug. Other option is do strict life style modification for couple of months and check for the levels, if still you find higher values then you need to start drugs. Yes, rosuvastatin is bit expensive. If you are affordable you can take this or else other statins will also help you. So I hope this information helps you to make good decision. Feel free to ask if any queries. Regards

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar