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Suggest medication for high cholesterol other than statins

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Posted on Thu, 12 May 2016
Question: Yes, I am allergic to statins and my total cholesterol is 268, HDL 59 and LDL 192 This is my first blood test without meds. I know ratios are important too. So my question is two fold: If my ratio is good is diet, weight loss and exercise enough? And is there a medicine for cholesterol that is not a statin that works? I just got this reading and go to my doctor tomorrow for an appointment. also my GFR is 54 and in the last year since the doctor increased my Simastatin to 40 mg is went from 78 to 54. is that from the statin? Thanks, XXXXXXX
doctor
Answered by Dr. Muhammad Sareer Khalil (1 hour later)
Brief Answer:
Need more information

Detailed Answer:
Hello and welcome

I appreciate your concern

Kindly answer the following to advise accordingly

which other statins have you tried other than simvastatin
There are other options for cholesterol lowering but the only one that lowers overall mortality rates are statins
what exact allergies do you experience with the statins.
Referring to the gfr values kindly specify the duration between the two readings.
what other medications are you currently using other than statins

let me know if you have any query

Wishing you best of health

Thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Muhammad Sareer Khalil (38 minutes later)
I tried LIPITOR and with both I had the muscle/joint problem plus I have had if ou have kidney disease you should take statins. Is that true?
Not taking any statins now and I am taking Losartan 50mg for blood pressure and Zolpidem 10mg (but I only take a third of the tablet to sleep). Also 81mg aspirin.
I do take several OTC: Multi Vitamin for seniors, B-12; CO-Q-10, fish oil, garlic, biotin, milk thistle, chromium picolinate, d-3, folic acid, calcium, 5-HTP, vitamin C, Magnesium, ad Glousamine. Cholestoff.

With regard to my GFR, 78 is the wrong number it is 67 and the tests were taken as follows with these readings;
5/15/15 - 67; 10/19/15 - 48; 12/11/15 - 55; 2/19/16 - 54;
Thank you for your prompt reply.
doctor
Answered by Dr. Muhammad Sareer Khalil (47 minutes later)
Brief Answer:
Explained

Detailed Answer:
Hello and welcome

Your concern is appreciated

Statins are drugs prescribed to lower cholesterol by inhibiting an enzyme that is needed to produce cholesterol in liver without this enzyme the consumed fat cant be transfirmed into cholesterol. There are high intensity statins and moderate intensity statins and the side effects include liver damage kindney damage muscle damage an increase in blood sugar level and neurologic side effects so yes the GFR can be affected.

If statins cant be given due to side effects then other drugs can be prescribed like cholesterol absorption inhibitor which is common alternative it prevent absorption if cholesterol from intestine ; another alternative is bile acid binding resins or sequestrants. this is oldest drug available not as effective as other drugs

People with high cholesterol also have high triglycerides some meds are given to lower it one these levels go down cholesterol level is often lowered, common prescription is niacin and B-3 niacin help increase good cholesterol and lower bad cholesterol its good for those who dont respond to other medication because its side effects are mild

Regarding lowering cholesterol life style changes should always intial treatment which include diet modification and exercise
There is no consensua as to what type of diet or what is the best diet for it but vegetarian diet or many people prefer mediterranean style diet but you should keep this in mind

Get your most calories from vegetables and fruits
Use olive oil as principle fat replacing all others
Limit processed foods
Stop alcohol
Eating fish couple of times per week
Avoid all trans fat
Whether medication is needed depends upon how you respond to life style change and risk for heart attack and stroke.

If all other risk factor are not there for heart attack and stroke like hypertention and diabetes then your cholesterol levels are not that bad it can be tried to control with life style changes

Regarding the GFR normal value is 90-120 ml/min
And eGFR less than 60 ml/min suggest that some kind of renal damage is there
If your gfr has decreased with statins then dose can be minimized or can be stopped altogether and alternative can be tried
Other thing is lowering your cholesterol your exercise and level of activity with diet will help you alot.

wishing you best of health

Thanks

Dr M.S Khalil
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Sareer Khalil (41 minutes later)
Thank you, Doctor. So in review of your answer to my questions in summary:

Statins can effect my kidneys and there are several strengthens. But as I have researched, my chronic kidney disease cannot be reversed and since I am in Stage 3 I feel that eliminating statins is the best option. Therefore diet, although I have been doing all the dietary suggestions you listed and exercise (which I am doing now but will increase it) are my
options and plus taking Niacin or B-3 Niacin. I go to my doctor tomorrow and we will discuss these options.

Although I feel that my cholesterol readings are hereditary and not diet related since I feel that I have always been aware of what not to eat. My daughter who is 5 foot tall and weights 105 pounds, plays tennis on a league, plus walks daily and very health conscience has recently had a cholesterol reading of 277, so it looks like I have passed it on.

Can you figure what my ratio is? Is that an important figure?
Thank you




doctor
Answered by Dr. Muhammad Sareer Khalil (22 hours later)
Brief Answer:
Explained

Detailed Answer:
Hello again.

The abnormality is called dyslipidemia classified on basis is of phenotype and etiology whether genetic or seconadary to any cause
In blood lipid are conjugated to specific protiens called lipoprotiens so either one part or both can be affected and can result in hyperlipidemia hypercholesterolemia hyperglyceridemia hyperlipoproteinemia or combined hyperlipidemia
The cause may be familial due to some specific genetic abnormalities they are futher classified into five subtypes your seems to be combined hyperlipidemia
Management include life style changes, fibrates drugs and statins . Dietry and excersize should be never underestimated it always help as compare to when you are not doing it. Alteration in diet is first step ig maximal diet therapy doesn't help drug therapy is added. The decesion to treat hyperlipidemia with drugs should be carefully based on weighing risks vs benefit for each patient. Because of rapid change in knowledge of both risks and benefitsof the therapy it must be reviewed at regular intervals

To calculate your ratio divide total cholesterol by HDL which comes out to be 4.5 it should be less than 3.5
Higher ratio shows higher risk for heart disease your hyperlipidemia may be of familial type. But it doesnt mean your life style changes are not helping it having comorbidities with it will make you more difficult for your as it will increase the chances of heart disease and stroke etc

Hope it helps

Thanks

Dr M.S Khalil
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

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Suggest medication for high cholesterol other than statins

Brief Answer: Need more information Detailed Answer: Hello and welcome I appreciate your concern Kindly answer the following to advise accordingly which other statins have you tried other than simvastatin There are other options for cholesterol lowering but the only one that lowers overall mortality rates are statins what exact allergies do you experience with the statins. Referring to the gfr values kindly specify the duration between the two readings. what other medications are you currently using other than statins let me know if you have any query Wishing you best of health Thanks