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I've got shitty heart genetics so Lipitor here for 2.5 years.  No issues so far.  But "cholesterol" doesn't really tell you anything as far as whether you need it.  LDL gives more insight but you should really look at LDL Particle Count (LDL-P) or ApoB to more accurately assess risk.   A preventative cardiologist that is also a lipidologist is your best bet.  I wouldn't make a decision based on a GP's advice (particularly if they are basing it off "cholesterol") as some people do have side effects so no need to take if you don't need it.  But luckily I have not.  If you really want to educate yourself on this stuff, Peter Attia (has podcast and blog on various health topics but tons dealing with lipids and heart disease) is the best resource I found.   

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The myopathy reaction with statins is pretty rare. Your total cholesterol is 291 so I'd be more worried about having a heart attack then whether or not you'll fall into the 1% of folks who cannot tolerate statins. If you start taking it and get unexplained muscle pain plus dark urine then stop taking it immediately.

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2 hours ago, Skipper said:

  No issues so far.  But "cholesterol" doesn't really tell you anything as far as whether you need it.  LDL gives more insight but you should really look at LDL Particle Count (LDL-P) or ApoB to more accurately assess risk.   A preventative cardiologist that is also a lipidologist is your best bet.  I wouldn't make a decision based on a GP's advice (particularly if they are basing it off "cholesterol") as some people do have side effects so no need to take if you don't need it.  But luckily I have not.  If you really want to educate yourself on this stuff, Peter Attia (has podcast and blog on various health topics but tons dealing with lipids and heart disease) is the best resource I found.   

Solid advice from the Skipper.

My overall cholesterol was under 200 but prescribed lipitor due to LDL being 110 (goal is to be -100).     No issues with Lipitor.   

With a reading of 291 would be best to see a cardiologist for an evaluation.    I am sure you have been told,  let diet and exercise become friends. 

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3 hours ago, Skipper said:

I've got shitty heart genetics so Lipitor here for 2.5 years.  No issues so far.  But "cholesterol" doesn't really tell you anything as far as whether you need it.  LDL gives more insight but you should really look at LDL Particle Count (LDL-P) or ApoB to more accurately assess risk.   A preventative cardiologist that is also a lipidologist is your best bet.  I wouldn't make a decision based on a GP's advice (particularly if they are basing it off "cholesterol") as some people do have side effects so no need to take if you don't need it.  But luckily I have not.  If you really want to educate yourself on this stuff, Peter Attia (has podcast and blog on various health topics but tons dealing with lipids and heart disease) is the best resource I found.   

My LDL is 178

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1 hour ago, Pokoloco said:

My LDL is 178

I think still best to get full set of lipids (LipoProfile Test) and to see a preventative cardiologist, but almost certain they will recommend you get on a statin as well.  That's where mine was but I also learned i have high LP(a) which is genetic and can't be reduced by drugs yet (one is in trials) but for me that increased the need to focus on lifestyle (diet/exercise) in addition to a statin.

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I suffered from myopathy and cognitive side effects when I was on simvastatin in my late 20s/early 30s. I never had overly dark urine, but my muscle mass went to zero and I had severe problems with weakness. The myopathy was livable. The cognitive side effects? Fuck it, I'll take a heart attack and death. It took three years after discontinuing statins for my mind to return to a semblance of normal functioning. Even now, nine years later, my mental functions are sometimes severely degraded compared to what they were. Of course, that might not have been the statins. They mistook my constant fatigue and mental issues for a variety of things, primarily ADHD and depression, so I went through a lot of different drugs until I told the psychiatrist to fuck off and I'll fix the physiological and social problems in my life first and then see if things improve. Unsurprisingly, they did.

 

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I was on crestor for about 10 years.  Before getting on the crestor my good and bad cholesterol was borderline and my overall cholesterol was around 200.  My TriGs usually hovered around the acceptable level.  I have always exercised regularly, I'm not overweight and my diet is fine so my doctor, who is extremely conservative, suggested I take 10 mg. of crestor once a day. Even though my numbers were borderline his view is that the potential downside to taking the crestor was well worth the risk.  It brought all my lipid levels and my TC well within the recommended levels.  The only side effect I notice over time (several years after getting on crestor) was some relatively minor and occasional muscle aches in my thighs, but that honestly could have been from my workouts.  About 9 months ago I quit the crestor--I just wanted a break from popping a pill every day, and I've been monitoring my TC, LDL, HDL and TriGs every 6 weeks or so.  My numbers have stayed within the recommended levels and (I think) I don't notice the muscle aches as much.  But otherwise, I never noticed any other side effects from the crestor.  If my numbers get out of wack I would resume the crestor without hesitation.  While I was on the crestor my doctor would make me come in every six months for a comprehensive blood and urine analysis to make sure all my organs were functioning properly, and I would get a very thorough physical (like Labowski got) every year.  Any myopathy would have been caught early.  At your levels I would make sure you see a good doctor and follow his/her advice.

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  • 1 year later...

Took my first 20 mg of Atorvastatin this morning.  I have been borderline high for years, but have resisted taking a statin due to potential side effects.  My new doctor recommended a CT calcium scan.  My zero score on that indicates no issues in blood flow to the heart resulting from my high (146 LDL) cholesterol.  He told me I could continue to ride it out, but a scan of the carotid artery would be a good idea as well as periodic heart scans.  After some more thought, I opted for 20 mg of Atorvastatin 3x per week.  If I have problems, I can switch or we can work something else out.  But I figured trying it won't kill me in the short term.

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30 minutes ago, dcbc said:

Took my first 20 mg of Atorvastatin this morning.  I have been borderline high for years, but have resisted taking a statin due to potential side effects.  My new doctor recommended a CT calcium scan.  My zero score on that indicates no issues in blood flow to the heart resulting from my high (247) total cholesterol.  He told me I could continue to ride it out, but a scan of the carotid artery would be a good idea as well as periodic heart scans.  After some more thought, I opted for 20 mg of Atorvastatin 3x per week.  If I have problems, I can switch or we can work something else out.  But I figured trying it won't kill me in the short term.

Welcome to the club !    You should be fine and hopefully will be impressed by the results.

Diet and exercise still very important.   And an annual blood test (CMP) to insure no adverse effects.   Most have none.

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3 minutes ago, torre said:

Welcome to the club !    You should be fine and hopefully will be impressed by the results.

Diet and exercise still very important.   And an annual blood test (CMP) to insure no adverse effects.   Most have none.

I'm a runner and work out several times per week.  I'm overweight, which doesn't help obviously.  But I'm active.  I've got an older sister (no pics) who is in great shape, eats very healthfully, and has shit cholesterol numbers, too.  I mentioned this to the doc, and he said that 80% plus of people with bad cholesterol are that way due to genetics.  I'm going back every six months for now.  But I'm sure it will be fine.

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  • 2 weeks later...

How are you a runner who works out several times a week and still overweight?  You could accomplish that on my plan of eating poorly and rarely exercising to be overweight rather than put forth all of that effort. 

I had the calcium test you mentioned but I also paid for the extra ultrasound on my arteries.  They found a little build up in my carotid artery.  My doctor said the statin would slowly dissolve the buildup over the years.  I will go back and have another scan next year as it's been 4 years since my last scan.  I'm curious to see if it is working or not.

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On 8/22/2019 at 10:59 AM, Skipper said:

look at LDL Particle Count (LDL-P) or ApoB to more accurately assess risk.

This. Also ask your cardiologist to include inflammation markers in your blood test. Cholesterol is only one part of the equation. Another is inflammation. The are some foods that increase systemic inflammation and are to be avoided. PUFAs, for example. Carbohydrates also.

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On 9/22/2020 at 6:18 PM, Hate said:

How are you a runner who works out several times a week and still overweight?  You could accomplish that on my plan of eating poorly and rarely exercising to be overweight rather than put forth all of that effort. 

I had the calcium test you mentioned but I also paid for the extra ultrasound on my arteries.  They found a little build up in my carotid artery.  My doctor said the statin would slowly dissolve the buildup over the years.  I will go back and have another scan next year as it's been 4 years since my last scan.  I'm curious to see if it is working or not.

You can't outrun a bad diet, I guess.  Oh, and I drink a lot of beer a few days a week, too.  As far as why I'm still a runner.  Answer:  Because I've always been a runner.  It's a sickness.

Doc mentioned that if I stayed off of the statin, he recommended the ultrasound on the carotid, etc.

So I had a pretty good amount of muscle pain for the first week, but that's subsided.  So we'll see how this does for the next 6 months until my next round of blood work.

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