Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Are There Alternatives To Statins?

Wednesday, 21 Jul 2010 10:22 AM

Question: I backpack four miles in one hour each day over moderately hilly terrain. My diet is limited to chicken, some beef, and low-fat foods. I have been using a popular omega-3 supplement for 10 months (one gram in the a.m. and one gram in the p.m.). I also take 100mg Co-Q10, 400mcg folic acid, and 200mg B12. Recently, my total cholesterol was 257, HDL 39, LDL 199 and triglycerides 94.

I was on Lipitor for several years and have no desire to use statins. I am now adding Smart Balance and oats to my diet, eliminating sugar additives, and am continuing to drink a quart of water each day with one cut-up lemon. Do you have any other advice?


Dr. Hibberd's Answer:

Your exercise, diet management, and supplements seem right in line with current recommendations. I agree your cholesterol readings are mildly disappointing, and do not meet the recommended standards for lipid management. A preferred LDL is under 100 and, indeed, under 80 if you have additional risks such as diabetes mellitus.

You must remember that only 20% of your LDL cholesterol readings are going to be affected by diet, diet supplementation, and exercise. The other 80% is genetically determined, and involves your body’s synthesis of cholesterol within the liver. The most popular and effective way to manipulate this LDL figure is by the use of statin medication. Since you wish to avoid them, you leave yourself little choice but to live with the risk of maintaining high LDL levels, which are associated with early onset of vascular disease with its increased risk of heart attack and stroke. Though there are other medications that can lower LDL, they are not superior, and tend to have more side effects.

Management of HDL is essential to clear up LDL fragments from our circulation. Increasing the amount of HDL may increase your body’s protection from vascular disease.

Niacin, in high prescription doses, will elevate HDL and lower LDL, and may be worth exploring under your physician's supervision. Some newer medications are available, but the current data does not support a decrease in cardiovascular risk in general despite lower LDL and higher HDL. This suggests other risk factors are involved. Despite this recent information, the newer medications are widely used, especially by those with increased risk and known vascular disease.

Discuss these options with your doctor, and be sure other factors such as hypothyroidism are not adversely affecting your lipid values.


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