Avoid meds if other options work

Dear Dr. Gott: I am an avid reader of your column, which appears in my local newspaper.

Recently, I had gone to my doctor for my annual checkup. (I am 41.) My reports indicated that I have high cholesterol (204, HDL at 38). My fasting blood sugar read 116, and I have borderline high blood pressure (135/82). My doctor indicated that, because of the above factors, he needs to prescribe Zocor, which he did.

My question is, do I need to take Zocor my whole life? Can I stop taking it if exercise and weight loss bring down my sugar, cholesterol and pressure?

Dear Reader: Yes, you can.

Ordinarily, I prescribe exercise and a low-cholesterol diet before prescribing medication for patients, such as you, because the risks of drug therapy (muscle damage and liver inflammation) seem to exceed the potential benefits. In my view, it is far safer to try other options before relying on medication.

In your case, your cholesterol count is only 204, close to the level that most experts believe is the goal of cholesterol-lowering treatment. True, your HDL (the “good” cholesterol) is low at 38, but I’d be willing to bet that diet and exercise might well raise it.

Here’s my suggestion. Continue the Zocor for now. At the same time, pay attention to (and limit your consumption of) sources of high dietary cholesterol: animal fat, milk, cheese and egg yolks. Exercise (walk, swim, bicycle and so forth) regularly for at least 30 minutes a day, at least five days a week.

At the end of a two-month trial period, get retested for your cholesterol. If the level is high normal (190 to 200), continue the Zocor. If the level is below 150, ask your doctor if you can stop the medicine and continue the exercise/diet program.

To give you related information, I am sending you copies of my Health Reports “Hypertension” and “Understanding Cholesterol.” Other readers who would like copies should send a long, self-addressed, stamped envelope and $2 for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Dear Dr. Gott: I have a friend who has MS. Fatigue and lack of strength are ongoing issues for him. He is depressed and seems to sleep a lot. I’m concerned he may be taking too much medication. In addition to his MS shots, he is taking Wellbutrin, Effexor XR, Xanax and Lamictal. I’ve brought up the matter, but he is not open to discussion.

Dear Reader: As you concluded, one or more of your friend’s drugs may be the cause of his fatigue and weakness. Of course, his symptoms could also be a consequence of his multiple sclerosis, a serious neurological ailment.

If he won’t address these issues with his physician, that is his right. I urge you to back off and not nag him. You have expressed your concern: that’s all well and good. Maintain a supporting and loving attitude without harping.