Sunday, August 24, 2008 Mike George asks

Q: Total Chol: 164, LDL: 115, HDL: 30, Trig: 97 - statins/niacin to help?

To whom it may concern:

I am a very physically active 42 year old male, 69 inches tall, 185 lbs. Current numbers are:

Total Chol: 164

LDL: 115

HDL: 30

Trig: 97

My total chol has ranged from 120-170 the past 20 years, with HDL hovering between 30 and 35, all of this despite the fact that I eat a very disciplined low-fat/high fiber diet, consume 1000mg of fish oil a day, drink a glass of red wine a day, and engage in 4 aerobic and 4 anaerobic workouts (at least 35 minutes in duration) per week.

My doctor is concerned about the ratio of HDL to LDL/Total Chol and has recommended 20 mg of Zocor and 1000 mg of Niaspan a day. What are your thoughts? Is this the best way to increase HDL and decrease LDL? All the heart doctors seem pretty sure of statins, but I haven't heard much from doctors that specialize in the liver/kidneys...should I be concerned with liver/kidney damage from either drug or the combination of the two?

Thank you for your time.

Sincerely, Mike George

Answers (1)

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Neil MD

8/24/08 3:36pm

Hello Mike George,

For all that you do, your HDL is surprizingly low. I can understand your and your doctor's concern.

If your doctor thinks that treatment with niacin and statins are a good option for your health, I would take them. The concerns about statins hurting the liver are fairly overblown. Yes, you should get liver function tests(LFTs) 2 months after treatment starts, yearly afterwards, and 2 months after any dosage increases, the relatively few people that get increased LFTs return to completely normal after stopping taking the medication. These drugs RARELY ( I mean less than 1/20,000 patients) get a condition called rhabdomyolysis which can hurt your kidneys. Niacin definately raises HDL, but is not terribly well tolerated in patients because of a sensation of flushing (harmless, but irritating) that a lot of people seem to get.

Be sure to discuss with your doctor if your take your medications at your next visit!

To your health,

Neil MD

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Q: Total Chol: 164, LDL: 115, HDL: 30, Trig: 97 - statins/niacin to help?

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