Cholesterol

[FM001]

Got my fasting cholesterol results today, HDL was 1.6 LDL 2.2 Triglycerides 0.7 and total was 4.1

My consultants wants me to start a low-dose statin to protect my heart and is writing to my doctor to recommend this, my doctor isn't a fan of handing out statins needlessly and has said before that he wouldn't prescribe statins to someone like myself with no major cholesterol issues. Checking on the Diabetes UK website my LDL is 0.2 above the 2 mmol/l threshold so maybe the statin would reduce this to a safer level and just might be worth taking.

Any thoughts?

 

[Natalie123]

Um, those don't seem too bad to me. Have you had any previous cholesterol tests? I would be tempted to get a second cholesterol test and see if you are consitently over the 2 mmol limit for the LDL. These things can vary slightly. On the other hand I am by no means an expert so discuss with your consultant and doctor and get reasons behind their opinions

 

[FM001]

Um, those don't seem too bad to me. Have you had any previous cholesterol tests? I would be tempted to get a second cholesterol test and see if you are consitently over the 2 mmol limit for the LDL. These things can vary slightly. On the other hand I am by no means an expert so discuss with your consultant and doctor and get reasons behind their opinions

Believe it or not but this is my first fasting cholesterol check last test my total cholesterol was 3.8 and those before are usually around 4.

 

[Natalie123]

It does seem a little odd that they want to put you on meds with those results. My total is 5.1 but apparently the ratio of good to bad cholesterol is very good so my doctors don't want to do anything about it. It is the ratio that is most important but I don't know what that ratio should be. Does it say on the diabetes uk website? Hopefully someone with more experience of statins will be able to give you some more information about it.

 

[Pumper_Sue]

Got my fasting cholesterol results today, HDL was 1.6 LDL 2.2 Triglycerides 0.7 and total was 4.1

My consultants wants me to start a low-dose statin to protect my heart and is writing to my doctor to recommend this, my doctor isn't a fan of handing out statins needlessly and has said before that he wouldn't prescribe statins to someone like myself with no major cholesterol issues. Checking on the Diabetes UK website my LDL is 0.2 above the 2 mmol/l threshold so maybe the statin would reduce this to a safer level and just might be worth taking.

Any thoughts?

Any thoughts? yep go have a good read on the pros and cons then make your own mind up. Read esp the side effects.

 

[Robster65]

Definitely read up on it but bear in mind there's also a lot of misinformation about them so be careful about propaganda from either camp.

I've been on them for about 18 months I should think and had suspected probs with simvastatin so changed to atorvastatin and all seems well at the mo. My chol has come way down which may be lifestyle or may be the pills. But I'm still on them for the added benefits.

The evidence at the moment shows they do good. That's all the doctors can go on. If proper scientific evidence shows otherwise there'll be a change.

Rob

 

[Northerner]

My own personal thoughts would be that, if my cholesterol was so close to what was considered ideal, I wouldn't want to start taking what is after all a very powerful drug. Do you have any other risk factors for cardiovascular disease, apart from diabetes? I would consider the risk of taking the statin to be at least equal to the risk of not taking it, so would not take it.

 

[Flutterby]

I am with Northerner on this. It has to be your decision but with results like yours I wouldn't contemplate such a powerful drug. I've had bad experiences with statins so am biased but I've also had a stroke so am now considered high risk, but guess what - such is my distrust of statins that I am still not taking them. I wish you well whatever you decide and you may prefer to take them, do ensure though that you get regular blood tests throughout to determine any side effects before they do damage. I was never offered the blood tests and so make sure you ask for them.

 

[trophywench]

Toby - the test you should have, on statins is a liver function test.

I can say my own GP was excellent on this, when I first went on em, insisted I came back in a month for a Liver Function test. I'd gone on Statins (Atorvastatin) and a BP lowering one (an ACE) at the recommendation of my Diabetes consultant. The laterr was swapped for an ARB when I got the ACE cough. GP insisted it wasn't the ACE, said he'd had a cough for 6 months himself ..... strange then when I said 'Well, whatever you've got Doc - I want to see if it makes a difference to ME, please!' - and it did.

A while after that, Doc said he couldn't prescribe Ator any more and prescribed Simvastatin.

When I then had the memory probs, I had absolutely no idea that Statins did this that or the other, 'allegedly' according to 'hearsay' LOL I just wondered; if an ACE caused a cough, could either of these tabs cause memory problems? Which one should I try dropping first? Didn't discuss it with anyone, just dropped one of them first, if not, I'd drop the other for a bit ..... dropped the Statin first. And 3 weeks later, memory probs subsided .....

It scared the bejazers out of me and still does.

Am still taking the ARB. If I have a stroke, at least I'll have all my marbles .....

Have also been told anecdotally and not officially I stress by a certain someone in the medical profession who I trust 110% that they worked in one of the centres where the 'Simvastatin versus other (more expensive!) statins' comparison took place (when it first came 'off licence') and though yes, they did occasionally get probs previously with some patients on virtually any previous brand statin, the problems were exceptionally rare. They increased hugely (comparatively) on Sim. But not enough apparently for that partic PCT to spend the extra dosh .......

I therefore have a complete and utter fear of the things.

 

[Northerner]

You might want to look at this, it's what made things hit home with me when debating whether to take the statin (click on 'Draw Cates Plot':

http://www.nntonline.net/visualrx/examples/statins/

You can see from this that, out of 100 people taking statins, for 95% it will make no difference whatsoever - 80% would have been OK anyway, 15% would have a problem despite the statins, and 5% would be better off. For me, with near normal cholesterol and good HDL, the potential risks of taking the statin outweighed the advantages of taking them. But obviously, this was my personal decision and I suspect you are more likely to read accounts from people who have decided against them than are happy with them on forums.

 

[mcdonagh47]

You might want to look at this, it's what made things hit home with me when debating whether to take the statin (click on 'Draw Cates Plot':

http://www.nntonline.net/visualrx/examples/statins/

You can see from this that, out of 100 people taking statins, for 95% it will make no difference whatsoever - forums.

That's a calculation based on the general population taking statins, so its not specifically relevant to diabetics, for whom a different calculator would be needed.
Toby is a diabetic and (presumably) a man over 45 , giving two high risk factors for heart disease, his consultant ( knowing from experience and research how many diabetics with Toby's type of figures develop heart disease ) probably thinks a low dose statin now is a necessary insurance policy.

You can't say it made no difference to the 95% just because they didn't die of heart attack, Statins have other benefits they could have enjoyed ( stabilisation of plaques, reduction of inflamation etc), plus the calculator limits the period under review to just ten years. In fact the statin group showed a 25% reduction on heart attack etc which looks like a result to me.

Plus that calculator seems to be based on the research result that came out last year which was just about individauls with JUST raised cholesterol and no other risk factors. That makes it really irrelevant to diabetics,since diabetes itself is a high risk factor for heart disease.

Toby's lipid panel isn't all that sparkling, and certainly not "near ideal" at 4.1 TC, hunter gatherers have TCs of 2.5 and no evidence of heart disease even in to their 80s. That tells us what a "natural" Total Cholesterol should be like.

As is usual with medical targets the hurdles for lipids are set low enough so that most people can scramble over them ( under 5 for the general population, under 4 for diabetics). Setting tight targets would mean a great deal more effort from the individual and more expense from the NHS.

 

[FM001]

Thanks everyone for the advice and comments on the pros and con's. It's not a decision I'll take lightly so will discuss this once again with my doctor about how it could possibly benefit me in the long run. As I said he's not one for dishing out pills that are unnecessary and I suspect he may still stick with this view depending on how he views my cholesterol results.

I don't have any risk factors apart from diabetes and had a heart check last year prior to a small operation on my back which turned out fine, the side effects of statins are well documented and this is something that is swaying me to decline them when offered.

Since being made redundant I have increased my fitness by exercising 3 times a day, never felt fitter for a long time and intend on keeping this up when I eventually find work again - time allowing, so could well do without any side-effects of medication be them statins or any other drug. Thanks again for the feedback🙂

 

[Northerner]

...Plus that calculator seems to be based on the research result that came out last year which was just about individauls with JUST raised cholesterol and no other risk factors. That makes it really irrelevant to diabetics,since diabetes itself is a high risk factor for heart disease....

I don't think it's possible for it to be based on results from last year, since I first came across it in 2008...

If, as you suggest, this isn't pertinent to people with diabetes, I'd be interested to see something similar that does take diabetes into account (including a breakdown of how well-controlled the participants are).

 

[FM001]

Toby is a diabetic and (presumably) a man over 45 , giving two high risk factors for heart disease, his consultant ( knowing from experience and research how many diabetics with Toby's type of figures develop heart disease ) probably thinks a low dose statin now is a necessary insurance policy.

Sorry I must have been typing my reply when you posted yours. Yes the consultant did say it was to prevent problems not now but in the future when I was in my late 50's and 60's, he said heart disease in type 1's often showed at this age in longer term diabetics so it probably is similar to an insurance policy taking preventative measures now.

 

[AlisonM]

Your consultant has a point but, seeing as you've no other risk factors on your list, could you not try to lower your reading with diet changes first? Or have you already done that?

I'm having the same debate with my consultant at the moment as my cholesterol was 4.7 at the last test with the LDL being around 0.3 above optimum. So far I've refused them and am trying to bring it down without the pills. I've more or less decided that if this doesn't work, then I'll reconsider but I don't want to take pills I don't need if I don't have to.

 

[mcdonagh47]

If, as you suggest, this isn't pertinent to people with diabetes, I'd be interested to see something similar that does take diabetes into account (including a breakdown of how well-controlled the participants are).

You might like to try the Qrisk2 calculator ( perhaps Toby should too) which researchers seem to be using to calculate cvd risks ....it takes account of diabetes but not control ....if your score is over 20% on things like this then statins are recommended ....

http://qrisk.org/

 

[Northerner]

You might like to try the Qrisk2 calculator ( perhaps Toby should too) which researchers seem to be using to calculate cvd risks ....it takes account of diabetes but not control ....if your score is over 20% on things like this then statins are recommended ....

http://qrisk.org/

Thank you. According to this I have a 10.1% risk as opposed to a 7.8% risk for someone my age etc., but without diabetes. Given that this doesn't take into account my control, the fact that I am very fit, and the length of time since my diagnosis then I'm quite firmly below the 20%. I suppose it's a bit like that Flora heart age calculator that instantly docks 10 years or more off your lifespan as soon as you admit to having diabetes.

 

[mcdonagh47]

Thank you. According to this I have a 10.1% risk as opposed to a 7.8% risk for someone my age etc., but without diabetes. Given that this doesn't take into account my control, the fact that I am very fit, and the length of time since my diagnosis then I'm quite firmly below the 20%. I suppose it's a bit like that Flora heart age calculator that instantly docks 10 years or more off your lifespan as soon as you admit to having diabetes.

so your risk of heart problems in the next 10 years is increased by 29% as compared to a non diabetic with the same figures.
It would be interesting to recalculate your figures for when you were on a statin with a total cholesterol of 2.8 - would your percentage figure drop even further to vanishingly small ?

 

[Northerner]

so your risk of heart problems in the next 10 years is increased by 29% as compared to a non diabetic with the same figures.
It would be interesting to recalculate your figures for when you were on a statin with a total cholesterol of 2.8 - would your percentage figure drop even further to vanishingly small ?

You see, I think this is where statistics appear to overstate the case. What constitutes 'a diabetic'? It's not clear, just some fixed constant included in the calculation, no doubt. Actually, my cardiologist told me that he considered me low risk, so as an individual rather than a statistic I'm happy with my balance of risks, which is what we are talking about here - understanding and accepting a level of risk, whether that risk is to take statins, or not to take statins.

 

[Andy HB]

I just want to know how many hunter gatherers make it to 80 as a proportion of their population?

I'd suggest their risk of being eaten by something toothy and large is greater than them having a heart attack and that those susceptable to heart disease will already have been weeded out by such creatures anyway.

So, to clear western societies of heart disease, I propose that we release all the lions and tigers and other such predators from every zoo/safari park into the countryside. 😉

Oh, by the way, I don't want to take statins either.