A recent carotid artery ultrasound (doppler) showed my left carotid artery to have "40% - 60% artery stenosis". I have this test done annually, and this test is the first in years that shows an increase -- they have always been "0%-40% artery stenosis" in the past.

I realize this indicates an increased stenosis in my left carotid artery, but is it alarming at this point? I manage my cholesterol nicely with 10 mgs. of lipitor and gym exercises. My cholesterol is 172 - Trig.-105, HDL-66, LDL-85 with the Lipitor. I am a 63 year old female and I am not overweight.

Does this mean that an endartectomy is definitely in my future? At what point of stenosis do they usually consider surgery. Also, I note for the first time the composition of the plaque has changed from Homogeneous to Heterogeneous...the later being more dangerous.

Thanks for any input. Brenda

Brenda, I am sorry that this has become a worry for you, I am somewhat confused because you say you have been on Lipitor and it has become worse. Everything we are suppose to believe is that Lipitor will help stop that and even say it will reverse it. I must tell you I am very skeptical. I took Lipitor and Lovastatin (not at the same time) but ended up with too many problems so stopped. I also am a women in her late 60's and I am reading too many reports that question whether an older women should even take statins. It seems when checking nursing homes they found that the women who lived to old ages were the ones that had higher cholesterol not lower. Perhaps you may look to your diet, is it high in saturated fats, keeping in mind that fat is not the evil that we all have been taught in the past, but rather the right fats have an important place in our diet, but really saturated fats are not good and will block arteries. I have a book by Dr. Johanna Budwig who is considered in Europe to be the authority on fats and she talks about the good fats and bad, bad being the ones that lack the electrons that have the spark of life in them. These are hydrogenated fats or fats that are now dead and these the body's puts in the arteries in an effort to get rid of them. We find them in packaged foods (cake mixes etc.) and fast food restaurants, the fat is killed in order to have shelf life. Your heart need fats, these fats go into the lymphatic system and when the used blood is injected into the right-hand ventricle of the heart each heart beat deposits lymphatic fluid into the blood this is the spark that the heart needs, but if no spark is there because of dead fats then it is rejected and end up in the arteries. Simplified version. :wave:

Brenda,

With the degree of stenosis that you currently have, you are not a candidate for surgery, and may never be. Unless I am mistaken, doctors will not even consider surgery unless the stenosis progresses to at least 80-90%. Why? Because the surgery is risky, and so there would really be no point in subjecting a person to this until it reaches a point where it presents a substantial risk. As I said, you may never even have to undergo this surgery. You can go for many years without seeing any further progression. For example, my father had surgery on his right carotid artery 11 years ago, when he was 65. Of course, he had over 90% blockage. I believe his left carotid artery had about 70% stenosis. Over the last 11 years he has had it checked annually. So far, the 70% stenosis has not gotten any worse. So I would advise you to try not to worry too much about it. Just continue to keep a check on it.

Brenda, I am sorry that this has become a worry for you, I am somewhat confused because you say you have been on Lipitor and it has become worse. Everything we are suppose to believe is that Lipitor will help stop that and even say it will reverse it. I must tell you I am very skeptical. I took Lipitor and Lovastatin (not at the same time) but ended up with too many problems so stopped. I also am a women in her late 60's and I am reading too many reports that question whether an older women should even take statins. It seems when checking nursing homes they found that the women who lived to old ages were the ones that had higher cholesterol not lower. Perhaps you may look to your diet, is it high in saturated fats, keeping in mind that fat is not the evil that we all have been taught in the past, but rather the right fats have an important place in our diet, but really saturated fats are not good and will block arteries. I have a book by Dr. Johanna Budwig who is considered in Europe to be the authority on fats and she talks about the good fats and bad, bad being the ones that lack the electrons that have the spark of life in them. These are hydrogenated fats or fats that are now dead and these the body's puts in the arteries in an effort to get rid of them. We find them in packaged foods (cake mixes etc.) and fast food restaurants, the fat is killed in order to have shelf life. Your heart need fats, these fats go into the lymphatic system and when the used blood is injected into the right-hand ventricle of the heart each heart beat deposits lymphatic fluid into the blood this is the spark that the heart needs, but if no spark is there because of dead fats then it is rejected and end up in the arteries. Simplified version. :wave:

I'm also a bit confused now too, as U said, we were told statins decrease this problem, or even reverse it. Of course I have always said, if my husband took Lipitor for 7 years after his artery cleaning, how come the little they left isn't gone? It is the exact amount and in the same place as it was in 94 when he had the surgery. Brenda's problem seems to contradict what we have been led to believe.....Hmmmmmmm.

As far as the good fats, are U saying the hydrogenated fats are suppose to be the good one? I always thought if something said partially hydrogenated it was no good. Seems the more I read, the more confused I get, but hey, at 64 maybe my mind is going....... :D
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Brenda, I don't know how long they let it go before they do surgery, but in 94 they found my husbands right side 90-95 % blocked, even though he had perfect cholesterol and was never on a statin until after the cleaning. I forget the name of the surgery, but we call it a Roto Rooter job, which I know is becoming more and more popular instead of the anigoplasty. All I remember is the dr. inserted something that took out the plaque, he then inserted the balloon to make sure everything was totally clean. There was a lil blockage on the left side, but they didn't bother with it, as it was small and they were more concerned about the right side. So far, so good, as he has an image exam at least once every 2 years, and his last one was in Jan. 05, and things looked fine, but that lil bit on the left is still there. It hasn't gotten bigger and he has no discomfort, so they are just keeping an eye on it. No, he doesn't take statins any longer, as they caused him alot of problems, but he did take them for 7 years, and obviously it didn't clean what lil plaque was left, so that therory of statins cleaning arteries doesn't fly with me!

I certainly hope all goes well and U get more info. from your drs. as to just what is going on. Take care, and keep us posted...... :wave:

Sorry, I couldn't edit my post for some reason, but my husband had the surgery on his left side, not the right, and the lil plaque that is left is on the right side. His last image test was a Mibi image test, think it is one of the newer machines out now.

As Arizona said, I believe, unless U are having problems, they don't do the procedure unless it is at least 75 % blocked, but each dr. is different, so U might want to ask your dr. Hubby was having a little shortness of breath and alot of coughing, but kept saying it was his sinuses. This went on for about 8 months, so I went with him to his next drs. appt. as I knew he wouldn't mention it to the dr., so I did. After a week they did the catherization which showed the blockage, so a week later he went in and had the procedure. Like I said, it has been 11 yrs. now, and he seems to be doing just fine. I believe the lil plaque he still has on the right side is about 25%, so they just keep an eye on it, as it has been the same for 11 years now. Just try to relax, as I am sure if it was serious your dr. would say something.

BTW, this is what I found about when they feel it is necessary:
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The surgery has been found highly beneficial for persons who have already had a stroke or experienced the warning signs of a stroke and have a severe stenosis of 75 percent to 99 percent.
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Best wishes..... :wave:

I'm also a bit confused now too, as U said, we were told statins decrease this problem, or even reverse it. Of course I have always said, if my husband took Lipitor for 7 years after his artery cleaning, how come the little they left isn't gone? It is the exact amount and in the same place as it was in 94 when he had the surgery. Brenda's problem seems to contradict what we have been led to believe.....Hmmmmmmm.


A lot of people believe that just because statins dramatically lower LDL, that plaque buildup can be halted, or even reversed. But I don't quite buy it. I think those claims are wildly exaggerated in order to promote these drugs. People need to understand that LDL is not really the villain that it's portrayed to be. LDL only becomes dangerous once it becomes oxidized. Vitamin E easily penetrates the LDL molecule and prevents or minimizes the oxidation of LDL. Although statins lower LDL, they also cause vitamin E levels in LDL to drop and LDL, in turn, oxidizes more quickly than normal. Thus, although such drugs do lower cholesterol levels, they may actually increase the damage to blood vessel walls. Interesting, isn't it?

Thanks for the responses. As I understand it, Lipitor will help control your lipid levels, but it doesn't necessarily mean that you are out of the woods. Diet, exercise, etc. are important parts of the overall picture, as we all know. I have been fighting high cholesterol (Cholesterol was 300+ and Triglyceries were over 1,000) since diagnosed with it in 1988. I was on Lopid for years and also Questran. They discontinued that and I went to Lipitor 20 mgs. in 1999.

I am a fanatic about reading labels and know the rules about transfats, good fats vs. bad, etc. I lost 30 lbs. and kept it off, walk 3 miles a day, and am in the gym for 2 hours every other day. I was able to get my cholesterol and all my lipid numbers well under control (as noted in my original post) with diet and exercise. They dropped my dosage down to 10 mgs. in 2002 (which may be the problem here). I might have gotten a little too confident. I also take lots of vitamins (including E and CoQ10, etc.). I agree with Arizona - statins alone don't do it - but I tried diet alone and that didn't come close to cutting it.

Also in 1996 I was diagnosed with Subclavian Steal Syndrome. That is a blockage in my right subclavian artery going down my right arm...this is why I have the annual doppler tests - to monitor this. The Steal blockage has not progressed I don't think. They told me I had a small amount of blockage in my left carotid artery at that time, but I just assumed it wasn't getting any worse. They report blockages in generalized percentages - which is the best they can do with a doppler. As I pointed out, up until this test I had remained in the 0% - 40% range. I might well have been on the high end of that all this time and only recently tripped over that 40% line - so this increase may not be as dramatic as it appears. But nevertheless, I am now in the 40% - 60% blockage category. I am also alarmed to note that the composition of the plaque now is categorized as heterogeneous -- which is more prone to break off and cause a stroke. This type of plaque in itself is an elevated stroke risk factor. Up until this past test, the composition has been homogeneous.

I will see my PCP in two weeks and hopefully he can answer some of my questions. Hopefully Arizona is right and I may not have to face surgery for years. I am betting he puts me back on Lipitor 20 mgs. at the least though -- other than that I haven't a clue what I can possible do.

It is frustrating when I have good lipid readings for several years now and feel confident that I finally have it figured out, only to find that I haven't.

Good to hear surgery success stories about Arozona's father, and JJ's husband. It is not surgery to be taken lightly.

Thanks. Brenda

A lot of people believe that just because statins dramatically lower LDL, that plaque buildup can be halted, or even reversed. But I don't quite buy it. I think those claims are wildly exaggerated in order to promote these drugs. People need to understand that LDL is not really the villain that it's portrayed to be. LDL only becomes dangerous once it becomes oxidized. Vitamin E easily penetrates the LDL molecule and prevents or minimizes the oxidation of LDL. Although statins lower LDL, they also cause vitamin E levels in LDL to drop and LDL, in turn, oxidizes more quickly than normal. Thus, although such drugs do lower cholesterol levels, they may actually increase the damage to blood vessel walls. Interesting, isn't it?

Well if U remember correctly, we had this discussion a few months ago, and that is just about when hubby has his Mibi tests, still showing the slight blockage. After hearing that, I was convinced statins DO NOT clear blocked arteries. As I have said over and over, if someone can take those drugs with no problems, fine, just don't expect me to take them, or hubby, we had our share of problems and don't wish to repeat them.

We use to take the vitamin E, but his cardio. man said it wasn't all it was cracked up to be, so except for what we get in our multi we eliminated the extra 400 IU's. Hubby tried the Folic Acid, but broke out in hives from that. He is on so darn many meds. now, maybe it was interacting, but he had to stop. At present, we both take the multi, the cinnamon, and I take vitamin C, 500 mgs. twice daily, hubby takes 500 with the multi after supper. Of course I also take calcium and garlic and drink tons of the green tea, but who knows if that is what really took my numbers down last time or not? Doesn't really matter, as I love the tea anyway. I'm just going to keep on doing as I have been for the last 6 months and see what happens, as there really isn't much more I can do. I'll chance it, as I am not going to knock myself out trying to have low numbers, life is short enough to be stressed over numbers, and as far as statins, our QUALITY of life is much more important then living longer with no quality. JMHO

Have a good one, and BTW, it went down to the 40's here last nite, some higher elevations went to the high 30's. WOW, talk about a wacky turn around huh? CYL......... :wave:

JJ, I'm sorry I must not have made myself very clear......Hydrogenated fats partially or any other way are BAD. This was the point that I wanted to make, hydrogenated fats are dead fats, they no longer have the electrons that have a life spark in them, as a result the body realizes this and can't use it and so deposits the unused fat in the arteries just to get rid of it. That is why our ancestors could eat butter and lard and not have the heart disease that we are seeing now, not until things like Crisco, a major dead fat, have we seen so much heart disease. I have to say I used Crisco for years, made the best pie crust and cookies etc. I'm sure I will pay for that now. I try to read the labels carefully so that I don't get it now, but it is hard because it is in so many packaged foods and worse yet in all the bakery goodies. I use olive oil , butter and I have bought Smart Balance Margarine because it does lower Cholesterol and does not have any hydrogenated oils in it. :wave:

JJ, I'm sorry I must not have made myself very clear......Hydrogenated fats partially or any other way are BAD. This was the point that I wanted to make, hydrogenated fats are dead fats, they no longer have the electrons that have a life spark in them, as a result the body realizes this and can't use it and so deposits the unused fat in the arteries just to get rid of it. That is why our ancestors could eat butter and lard and not have the heart disease that we are seeing now, not until things like Crisco, a major dead fat, have we seen so much heart disease. I have to say I used Crisco for years, made the best pie crust and cookies etc. I'm sure I will pay for that now. I try to read the labels carefully so that I don't get it now, but it is hard because it is in so many packaged foods and worse yet in all the bakery goodies. I use olive oil , butter and I have bought Smart Balance Margarine because it does lower Cholesterol and does not have any hydrogenated oils in it. :wave:

Ok, I gotcha now!!! See, that is what happens when U have a birthday and get another year older, ya can't read right..... :D Yup, the stuff we get these days is nothing like they had many years ago, even before my time!

I try like crazy to read as many labels as I can, but also go by alot of what other's use, both on this board and friends who are trying to watch their numbers too. We are all in this thing together, so sharing is very much appreciated by myself and I'm sure MANY others. We very seldom use butter, so I usually still buy the Land O' Lakes, but like many others, have used margarine for years, so I'm sure we did some damage. Oh well, all we can do is try to correct our mistakes and move forward. Thanx a bunch for clearing it up, as I must have brain fog tonight.

Take care, and TTYL....... :wave:

Brenda, don't feel bad, we all feel the same way, just when we think we have it right, we are wrong. Just relax and wait until U see your dr. to get more info. Do keep us posted, and hopefully U will not get any lousy news. I know how much of a shock it was for us to find out about hubby, as even the dr. was surprised, as like I said, his cholesterol numbers were always fine. We are just happy it was caught in time, and he has a fantastic dr., who is not only a great cardio surgeon, but has a marvelous personality, and will explain anything to U if you ask. Ain't many like him around.


Sorry U couldn't control your numbers with all the diet and exercise, as it sure sounds like U do try very, very hard and also do your homework, but like alot of us, we still fight the battle.

Take good care, and will chat with ya later... :wave:

I'm still waiting for some sort of a follow-up on that small UK study which was completed a couple of years ago. It was based on the Pauling Therapy, and involved 200+ males. As far as I know, it still hasn't been published. But it was a 3-year clinical trial, utilizing 6000mg vitamin C, 6000mg lysine, and 800 IU vitamin E. The result of this trial was that plaque growth was virtually halted to about 2-3% per year in comparison with natural progression of 15-30%. Brenda, maybe you ought to give this a try. The supplements are all very safe and inexpensive. What would you have to lose? There may actually be something to this.

JJ,

I think your cardiologist is basing his opinion on those studies which have used synthetic vitamin E, not natural vitamin E. Also,there are plenty of other studies which have shown a clear benefit. I don't see how those studies can be discounted. Anyway, it's ALWAYS best to use natural vitamin E, preferably a full spectrum vitamin E which contains all 4 of the tocopherols and all 4 of the tocotrienols. That's the complete vitamin E family.

I'm still waiting for some sort of a follow-up on that small UK study which was completed a couple of years ago. It was based on the Pauling Therapy, and involved 200+ males. As far as I know, it still hasn't been published. But it was a 3-year clinical trial, utilizing 6000mg vitamin C, 6000mg lysine, and 800 IU vitamin E. The result of this trial was that plaque growth was virtually halted to about 2-3% per year in comparison with natural progression of 15-30%. Brenda, maybe you ought to give this a try. The supplements are all very safe and inexpensive. What would you have to lose? There may actually be something to this.

JJ,

I think your cardiologist is basing his opinion on those studies which have used synthetic vitamin E, not natural vitamin E. Also,there are plenty of other studies which have shown a clear benefit. I don't see how those studies can be discounted. Anyway, it's ALWAYS best to use natural vitamin E, preferably a full spectrum vitamin E which contains all 4 of the tocopherols and all 4 of the tocotrienols. That's the complete vitamin E family.

When I have time, I have been looking up more and more of that Pauling thing, and it makes alot of sense to me. Of course with C, U also have to go by your own system, as it can cause intestinal problems, especially when first starting. I had to send hubby an article before he would even start more C, he is rather set in his ways, but getting to listen to me a lil more.

U just might be correct on the E, as that is what we were using. I also think the dr. tries to spare us a lil expense, as he knows we are on a fixed income, so I don't fault him there. Next time I see him I have a few questions for him, so will add that to the list. Wish this guy was our PCP, he really is soooo easy to talk to, and will give U a direct answer. I still have to ask him what cholesterol thing he tried at the convention he attended, as he said he wouldn't give it to an animal, let alone a human. Whatever it was, wasn't in pill form, cause he said it tasted horrible and he got very constipated from it, plus he said these conventions sucked. LOL This guy is a total trip.

Almost time for some of my premier shows tonight, so I had best sweep the kitchen floor so I can sit and watch. Thanx as always for the info. and have yourself a great nite...... :wave:

JJ,

I realize the dosages recommended by Pauling are high, especially with vitamin C, so it would be best to start at a lower dose, and gradually increase the dosage.

As for the vitamin E, I have also suffered somewhat of a setback. I had been buying a good vitamin E supplement from Puritan's Pride, which contained both the tocopherols and tocotrienols. It was introduced only a couple of years ago. Well, just the other day, when I went online to order some more, I found that it had disappeared off the radar screen. In other words, apparently they no longer offer it. So I searched for a replacement, and I think I found an excellent one. It's called Tocospan. It contains all of the tocopherols and tocotrienols in their natural form. It is available in both 200 and 400 IU potencies. In fact, I've even heard a doctor talking about it on the radio, and he highly recommended it. You can do a search on it, and read about it for yourself. The company that makes it also makes the hydrosoluble form of CoQ10 known as Q-Gel.

JJ,

I realize the dosages recommended by Pauling are high, especially with vitamin C, so it would be best to start at a lower dose, and gradually increase the dosage.

As for the vitamin E, I have also suffered somewhat of a setback. I had been buying a good vitamin E supplement from Puritan's Pride, which contained both the tocopherols and tocotrienols. It was introduced only a couple of years ago. Well, just the other day, when I went online to order some more, I found that it had disappeared off the radar screen. In other words, apparently they no longer offer it. So I searched for a replacement, and I think I found an excellent one. It's called Tocospan. It contains all of the tocopherols and tocotrienols in their natural form. It is available in both 200 and 400 IU potencies. In fact, I've even heard a doctor talking about it on the radio, and he highly recommended it. You can do a search on it, and read about it for yourself. The company that makes it also makes the hydrosoluble form of CoQ10 known as Q-Gel.

Well I have always taken an extra 500 C, so adding another 500 wasn't too bad, but I will keep it at that for a lil while. Hubby never took any except for what was in the multi, so I have him just taking the 500 for now. Like anything, go slow and work your way up.

I will have to do a search tomorrow about the E, as I truthfully never knew anything about a natural form, so as usual, I'm learning. I hate that when U get use to ordering something for awhile and then go and find it doesn't exist any longer, bummer!! Hubby likes to listen to some radio station that has a dr. on it, but I forgot which station. Guess he also watches someone on tv too who also has a radio station. Don't ask me the name off hand, my BRAIN FOG is in full swing tonight..... :D

Have a great nite what is left of it, and CYT...... :wave: :yawn:

Sorry U couldn't control your numbers with all the diet and exercise, as it sure sounds like U do try very, very hard and also do your homework, but like alot of us, we still fight the battle.

Take good care, and will chat with ya later... :wave:


JJ: Just wanted to correct something you may have misread. I HAVE CONTROLLED my numbers for several years now with diet, exercise, weight loss, and Lipitor. That is the frustrating part. My numbers are well within a good range.

Oh well, I guess I will just keep on doing what I have been doing. At least I am aware of the blockage, and will keep close tabs on it with the annual doppler.

Good luck to all. I read the posts on this board all the time and have learned so much from you all.

Thanks, Brenda

Brenda,

Just know that the difference between 0-40% and 40-60% CAN be a difference of 0%. Maybe there really has been no change or very little change.

Arizona...it's been 2 1/2 years since that UK study was finished and results would be "published SOON." That timeframe seems outside the expected range of "SOON." What's the scoop?
Dealing with rumour about unpublished studies doesn't seem a wise way to gain information.
After all these decades of claims, can't they get at least ONE RELIABLE STUDY published about the action of megadosing with ascorbic acid? Just ONE?

JJ: Just wanted to correct something you may have misread. I HAVE CONTROLLED my numbers for several years now with diet, exercise, weight loss, and Lipitor. That is the frustrating part. My numbers are well within a good range.

Oh well, I guess I will just keep on doing what I have been doing. At least I am aware of the blockage, and will keep close tabs on it with the annual doppler.

Good luck to all. I read the posts on this board all the time and have learned so much from you all.

Thanks, Brenda

Brenda, I thought U were trying to go without the Lipitor but couldn't control the numbers without it, sorry, I swear my eyes are going too... :D

Like U said, just keep doing what your doing and let the drs. keep tabs on the blockage. Like I said, hubby still has some on his right side, and has since 94, and God only knows how long it was there before they did the surgery, but he is doing fine. His cardio man keeps an eye on it, and tells us if he gets worried about it, he will go in and see what is going on. Trust me, his dr. is a worrywart too, so I feel things are ok when he isn't worried.

Yes, the folks on this board are alot of help and I also have learned plenty. Like they say, U are never too old to learn!!! U take care, keep us posted how things are going, and enjoy your day....... :wave: