People’s Pharmacy: Does everyone with high LDL cholesterol need a statin?
Q. I am an 81-year-old woman in excellent health. The only thing that might be worrisome is my LDL cholesterol of 181. I understand that is way over the acceptable level. I have no other risk factors for heart disease.
I work out on a spin cycle four times a week and walk 3 or 4 miles a day. In addition, I lift weights and do yoga. People say that I look to be about 60. No one can believe my actual age.
When a calcium scan was done, my score was 0. I know the new guidelines for LDL cholesterol would call for a statin, but my doctor says there is nothing to treat. Is that a reasonable assessment?
A. Trust your doctor! With your physical fitness, you should be the envy of people half your age. If your parents and other close relatives did not die of cardiovascular disease at an early age, you are in good shape.
The new guidelines recommend that adults get their low-density lipoprotein cholesterol (LDL-C) under 100 if their calcium score is between 1 and 99 and they do not have atherosclerosis. For people over age 75, cholesterol-lowering therapy is left to the doctor’s discretion.
To learn more about many other risk factors for heart disease and non-drug approaches, you may wish to read our “eGuide to Cholesterol Control and Heart Health.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. I use NasalCrom (cromolyn sodium nasal spray) several times a day. It helps a lot at night when I would otherwise be congested.
I can’t use corticosteroid sprays, and antihistamine nasal sprays cause dry eye problems. I also use nasal strips at night. The combination of NasalCrom and nasal strips help keep my nasal passages open better than anything I’ve ever tried.
A. Your combination strategy is one of the safest approaches for nighttime congestion. This time of year, spring pollen can lead to allergy symptoms, stuffy nose and trouble sleeping.
Cromolyn sodium (NasalCrom) is frequently overlooked as an allergy treatment. It is neither an antihistamine nor a corticosteroid. Instead, this very old medication is a mast cell stabilizer. Mast cells release histamine and other inflammatory compounds. Preventing this can remove the source of congestion.
Q. I have been plagued most of my life with jock itch. I live in central Florida and spend a lot of time working outside and sweating to pay the bills.
After finding that Vicks VapoRub worked to give me relief from my hemorrhoids, I decided to try it for treating my jock itch as well. To my surprise, it was the solution that I had been looking for.
A. Thank you for sharing your experiences. We have been severely spanked for sharing someone else’s use of Vicks VapoRub on hemorrhoids.
First, we must point out that the Food and Drug Administration has not approved this chest rub for anything other than topical treatment of coughs or minor aches and pains. The warning on the label is clear: “Do not use on wounds or damaged skin.” That includes hemorrhoids.
The ingredients in Vicks include camphor, eucalyptus oil and menthol. They all have antifungal activity. Since jock itch is usually caused by fungal overgrowth in warm, damp skin folds, we are not surprised that you found this familiar product helpful.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”