Cholesterol lowering presents a challenge
DEAR DR. GOTT: I am a 55-year-old, 5-foot-2, 137-pound female. I work full time at a busy office where I do little sitting. I have high blood pressure, sinus tachycardia, diabetes, hiatal hernia, asthma and moderate stenosis in my neck. I’ve had these problems for a long time and keep them under control with diet and medication that includes Verapamil, Digoxin, Actoplus, Singulair, Nexium, Advair and Lovaza.
The reason I’m writing is that I have also suffered with high cholesterol and triglyceride levels. I started taking Lipitor about four years ago and didn’t notice any effects until the end of my second year. I developed very achy muscles, tingling in my fingers and feet, pain in my neck, hips and back, and my legs became very weak with cramps. My doctor believed it was the Lipitor. I went off it for about two months and felt better with no symptoms. I waited another two months, and he started me on Crestor. I took it for about two months and began to have the achy muscles and weakness again. I felt as though I had the flu. My doctor told me it was the Crestor. We tried several statins, but the symptoms always came back. I even tried niacin, which made me very flushed. He told me to stop that, too. I tried Zetia, which did nothing to lower my numbers. He told me that it was not good for my heart, so I stopped that. I tried Welchol, but the constipation, gas and heartburn were horrible, and the muscle aches returned.
This is a long way to get to my question. What can I do to lower my cholesterol and triglyceride levels? My doctor just shakes his head, so I only return to his office two or three times a year for blood work. Is there anything without niacin I can take? I’m aspirin-sensitive, so Tylenol is all the pain medication I can take.
I take a daily vitamin, flaxseed, vegetable laxatives and Tylenol on occasion. I don’t know whether I should worry about this or just let the good Lord take me when my time is up. I have a good outlook on life and am a very happy person. Is there any hope?
DEAR READER: I hope so, but you aren’t leaving me many options from which to choose. And I can sympathize with your physician, who has tried every conventional treatment he can think of. Other than the statins, Zetia and niacin, there are bile acid sequestrants (colesevelam) or fibrates (genfibrozil or fenofibrate). Obviously, you should stay away from all statin drugs, which cause you so many problems.
Some people have had success with over-the-counter plant sterols and stanols. There are several from which to choose. Then there’s cinnamon, which has helped some people lower cholesterol levels. Sprinkle it on your toast, add it to products you bake, sprinkle it over cereal, or get creative with other dishes in the kitchen. You may also wish to buy cinnamon capsules. The product has been known to cause diarrhea, so begin slowly until you see how you will react. Add omega-3 oils and discontinue any smoking habits.
Then comes your diet. Substitute nonfat frozen yogurt or sorbet for ice cream. Pass up luncheon meats, pastrami, sausage, hot dogs, pork and bacon. Decrease your consumption of high-fat cheese to no more than one portion each day, switch from whole milk to 1 percent or nonfat, eliminate fried foods, broil your meats, substitute tub margarine for butter, and take extra caution when eating out. Those wonderful gravies, sauces, oils used to prepare fried food and rich, mayonnaise- containing products can shoot your levels sky-high.
Continue to exercise. This will help keep your weight down and may reduce those frustrating cholesterol levels.
Continue your periodic lab testing to be sure that you are on the right track.