vera1
03-30-2003, 08:53 PM
Hello Everyone,
I am new to this board and seeking your expert advice. I find all of this information about high cholesterol confusing. I have been on Welchol for several years for genetic predisposition to high cholesterol. I am a 40 something female. My weight is good. My diet is excellent- low fat, high fiber, lots of veggies and fruits. I take several vitamin supplements daily along with Metamucil. I hate to exercise, but I am trying to improve that with pilates and walking. I have had some side effects that I believe may be related to the prescription medication, but I am not sure. I have severe joint pain that started after taking the medication. My doctor diagnosed me with fibromyalgia- a condition that causes pain and stiffness in the connective tissues. I am thinking perhaps that this may be related to the drug. I want to go off the drug and try natural methods, but do not know where to start.
What I need your help with is exactly what I need to take and in what dosages.
Here are my recent numbers while on Welchol:
Total Cholesterol: 240
TRG= 185
HDL= 62
LDL= 141
I'd appreciate any information and guidance. Thanks!
------------------
Vera
I am new to this board and seeking your expert advice. I find all of this information about high cholesterol confusing. I have been on Welchol for several years for genetic predisposition to high cholesterol. I am a 40 something female. My weight is good. My diet is excellent- low fat, high fiber, lots of veggies and fruits. I take several vitamin supplements daily along with Metamucil. I hate to exercise, but I am trying to improve that with pilates and walking. I have had some side effects that I believe may be related to the prescription medication, but I am not sure. I have severe joint pain that started after taking the medication. My doctor diagnosed me with fibromyalgia- a condition that causes pain and stiffness in the connective tissues. I am thinking perhaps that this may be related to the drug. I want to go off the drug and try natural methods, but do not know where to start.
What I need your help with is exactly what I need to take and in what dosages.
Here are my recent numbers while on Welchol:
Total Cholesterol: 240
TRG= 185
HDL= 62
LDL= 141
I'd appreciate any information and guidance. Thanks!
------------------
Vera
Sponsor
midwest1
03-31-2003, 12:26 AM
Nice to meet you, Vera.
While I don't consider myself an "expert" by any means, I'd like to offer my insight.
I took a look at a drug information website I use as a reference, and found that WelChol is said to not be absorbed by the body, but works instead by carrying cholesterol from the body by binding to bile acids. Theoretically, it shouldn't cause muscle or joint pain in and of itself. However, the source also mentions that to lower LDL without drugs, it's sometimes sufficient to simply treat an underlying problem such as diabetes, underactive thyroid, kidney disease, or a liver disorder.
My situation sounds similar to yours. Last summer, I saw a doctor for the first time in years, because of chest pressure that couldn't be ignored. Because the chest pressure accompanied chronic heartburn and a "lump in the throat" sensation, it was diagnosed as gastric in origin.
The lipid panel done at the time showed an LDL level of 147. Because I had no other risk factors for CVD, and because I already ate very well, I opted to try a stricter diet and extra exercise to lower the LDL. After making no headway at all in over 8 months of effort, I realized that my failure to lose even 10 pounds in all that time might indicate a problem with low thyroid function. Upon researching low thyroid, I learned that it is the second most common cause of elevated LDL and triglycerides after poor diet - even more common than genetic causes. (It can also cause arthritis-like pain and muscle spasms, BTW.) As it turns out, all of the symptoms I had (and more) are caused by the hypothyroidism I didn't even know I had.
Because you are in the age bracket where hypothyroidism most commonly begins, I suggest you ask your doctor for a screening test, if he hasn't done it already. But make sure he genuinely knows how to interpret the results, because many internists and general practioners are not knowledgeable about thyroid function or diagnosis of its disorders. They often pronounce the lab numbers "normal", when in fact real people don't fit neatly into the brackets of the reference range.
While I don't consider myself an "expert" by any means, I'd like to offer my insight.
I took a look at a drug information website I use as a reference, and found that WelChol is said to not be absorbed by the body, but works instead by carrying cholesterol from the body by binding to bile acids. Theoretically, it shouldn't cause muscle or joint pain in and of itself. However, the source also mentions that to lower LDL without drugs, it's sometimes sufficient to simply treat an underlying problem such as diabetes, underactive thyroid, kidney disease, or a liver disorder.
My situation sounds similar to yours. Last summer, I saw a doctor for the first time in years, because of chest pressure that couldn't be ignored. Because the chest pressure accompanied chronic heartburn and a "lump in the throat" sensation, it was diagnosed as gastric in origin.
The lipid panel done at the time showed an LDL level of 147. Because I had no other risk factors for CVD, and because I already ate very well, I opted to try a stricter diet and extra exercise to lower the LDL. After making no headway at all in over 8 months of effort, I realized that my failure to lose even 10 pounds in all that time might indicate a problem with low thyroid function. Upon researching low thyroid, I learned that it is the second most common cause of elevated LDL and triglycerides after poor diet - even more common than genetic causes. (It can also cause arthritis-like pain and muscle spasms, BTW.) As it turns out, all of the symptoms I had (and more) are caused by the hypothyroidism I didn't even know I had.
Because you are in the age bracket where hypothyroidism most commonly begins, I suggest you ask your doctor for a screening test, if he hasn't done it already. But make sure he genuinely knows how to interpret the results, because many internists and general practioners are not knowledgeable about thyroid function or diagnosis of its disorders. They often pronounce the lab numbers "normal", when in fact real people don't fit neatly into the brackets of the reference range.
vera1
03-31-2003, 10:39 AM
Hello Midwest1,
Thanks for the reply. My doctor did do a thyroid test and pronounced that all was well. I do not know if he himself read the results, or had them sent out to a lab. He is a GP. How do I determine that he is knowledgeable on the subject? Do I take the results to a specialist that can interpret them properly? Who would be the proper physician to interpret those results? I appreciate your input.
Vera
Thanks for the reply. My doctor did do a thyroid test and pronounced that all was well. I do not know if he himself read the results, or had them sent out to a lab. He is a GP. How do I determine that he is knowledgeable on the subject? Do I take the results to a specialist that can interpret them properly? Who would be the proper physician to interpret those results? I appreciate your input.
Vera
midwest1
03-31-2003, 12:06 PM
One other thing I forgot to mention in my first post is that the autoimmune form of hypothyroidism (which is the commonest kind) often goes hand-in-hand with other autoimmune disorders, such as fibromyalgia.
Do you by chance know what your lab number for TSH was, Vera? And were any other tests done, such at T4 or thyroid antibodies?
The test used to screen for thyroid disorders is called TSH. A high reading indicates low thyroid function. The American Assn of Clinical Endocrinologists announced in January '03 that the lab reference range norm should be lowered.
Previously, normal was between 0.5 and 5.0 micro units per milliliter of blood. The new guidelines, however, stipulate normal to be within a much narrower range, between 0.3 and 3.0. Far too many docs think in terms of lab values only, and are not educated enough in thyroid issues to know that most people feel best when their TSH value is between 1-2. Another complicating factor in taking TSH at face value is that it can appear "normal", indicating that thyroid hormone is being produced by the gland, when in fact the body cells may not be absorbing the hormone in a usable way. TSH alone is almost never the only guideline that should be considered in diagnosis.
My own soon-to-be-former PCP thinks that treatment isn't even warranted till the value reaches a whopping 6, which would just about put me in a coma! (No exaggeration; it can really happen!)
If you want to investigate further whether this could be your problem, visit the Thyroid Disorders board here at Healthboards, and do a search to find the thread titled "Information Archive". There's much info there regarding testing, symptoms, and problems with getting a proper diagnosis.
If you're like most women (and myself), you may have symptoms that you've ignored, thinking they weren't bad enough to seek medical help for, or that you thought are primarily cosmetic and related to other things such as aging. The thyroid regulates activity in every cell of the body, and can cause many diverse kinds of symptoms. Some seem minor - like dry, coarse skin; but some - like high cholesterol - can have dire consequences if ignored. It's worth checking out, because if you need treatment, it will reverse the high cholesterol. It could even help tremendously with the fibromyalgia.
Do you by chance know what your lab number for TSH was, Vera? And were any other tests done, such at T4 or thyroid antibodies?
The test used to screen for thyroid disorders is called TSH. A high reading indicates low thyroid function. The American Assn of Clinical Endocrinologists announced in January '03 that the lab reference range norm should be lowered.
Previously, normal was between 0.5 and 5.0 micro units per milliliter of blood. The new guidelines, however, stipulate normal to be within a much narrower range, between 0.3 and 3.0. Far too many docs think in terms of lab values only, and are not educated enough in thyroid issues to know that most people feel best when their TSH value is between 1-2. Another complicating factor in taking TSH at face value is that it can appear "normal", indicating that thyroid hormone is being produced by the gland, when in fact the body cells may not be absorbing the hormone in a usable way. TSH alone is almost never the only guideline that should be considered in diagnosis.
My own soon-to-be-former PCP thinks that treatment isn't even warranted till the value reaches a whopping 6, which would just about put me in a coma! (No exaggeration; it can really happen!)
If you want to investigate further whether this could be your problem, visit the Thyroid Disorders board here at Healthboards, and do a search to find the thread titled "Information Archive". There's much info there regarding testing, symptoms, and problems with getting a proper diagnosis.
If you're like most women (and myself), you may have symptoms that you've ignored, thinking they weren't bad enough to seek medical help for, or that you thought are primarily cosmetic and related to other things such as aging. The thyroid regulates activity in every cell of the body, and can cause many diverse kinds of symptoms. Some seem minor - like dry, coarse skin; but some - like high cholesterol - can have dire consequences if ignored. It's worth checking out, because if you need treatment, it will reverse the high cholesterol. It could even help tremendously with the fibromyalgia.
vera1
03-31-2003, 02:34 PM
Hi Midwest1,
Wow! You are a life saver. I will ask my doctor to go over the results of the tests I had, and tell me exactly which tests he took. I think I will have him retest me again, since these tests were taken about 5 years ago. Since my fibromyalgia diagnosis occured around the same time as my high cholesterol, I seem to think there is a connection. Fortunately, my doctor is very good about listening to what I feel is good for my body. He knows that I don't like taking drugs for treatment,unless absolutely necessary. I am lucky to have a health care professional that I feel I can talk to openly, who listens to me and understands my feelings and concerns. I will talk to him about the hypothyroidism. What are some of the symptoms? Were you diagnosed with this? Thanks so much for your input!
Vera
Wow! You are a life saver. I will ask my doctor to go over the results of the tests I had, and tell me exactly which tests he took. I think I will have him retest me again, since these tests were taken about 5 years ago. Since my fibromyalgia diagnosis occured around the same time as my high cholesterol, I seem to think there is a connection. Fortunately, my doctor is very good about listening to what I feel is good for my body. He knows that I don't like taking drugs for treatment,unless absolutely necessary. I am lucky to have a health care professional that I feel I can talk to openly, who listens to me and understands my feelings and concerns. I will talk to him about the hypothyroidism. What are some of the symptoms? Were you diagnosed with this? Thanks so much for your input!
Vera
midwest1
04-01-2003, 01:13 AM
Hello again.
You are so lucky to have a great doctor. I too detest unnecessary meds. When my doc first saw my high LDL measurement, he immediately wanted to prescribe Lipitor. I insisted I be allowed to try natural remedies first, after calculating my very low risk factors with the help of the good folks here on this board; but with each repeat test, he still pushed that statin. I'm so glad I resisted, since I have learned more about the various causes of high cholesterol.
In the course of all my reading about thyroid disorders, I became irate to learn that the statin manufacturers themselves state in their prescribing information for physicians that thyroid function should be tested before prescribing statin drugs. I had to beg this guy for a TSH test, even after informing him my mother has the condition, which is strongly familial.
So, to answer your question, I have not yet been formally diagnosed; but my TSH on that test was nearly 5.0, and I have an appointment in two weeks with an AACE member endocrinologist. She only schedules appointments for new patients whose test results indicate there may be a genuine problem, so I'm hopeful of beginning treatment soon.
Here is a list of the classic symptoms. I have all but a few. Some I've had for at least twenty years, and never had a clue what they might indicate. The old symptoms are getting worse, and new ones continue to appear. A person needn't have every symptom on the list to have thyroid disease, and the presence of only a few may not be a concern. But most people with thy probs typically have at least a dozen or many more. (It makes it easy to see why a unsympathetic or uninformed doc might think the patient is a hypochondriac when he hears the litany of complaints, doesn't it?)
SIGNS OF LOW THYROID FUNCTION
fatigue
weight gain, inability to lose with diet and exercise
decreased heart rate
low body temperature
hypersensitivity to cold
high LDL cholesterol and/or triglycerides
constipation
indigestion
slow healing, frequent infections
problems with memory and concentration
depression
apathy
goiter (enlarged thyroid gland)
shortness of breath, tightness in chest
muscle pain or weakness
joint pain
loss of interest in sex
numb, tingling hands, often carpal tunnel syndrome
dry skin
yellow skin, particularly palms and soles
brittle, ridged nails
dry, gritty eyes, blurred vision
dry mouth
eyes hypersensitive to daylight
progressive hearing loss
chronic sinusitis
swollen eyelids
swollen hands, legs, torso
light headedness or vertigo
dryness, loss, or premature graying of hair
loss of outer third of eyebrows
adult acne
snoring or sleep apnea
irregular menstrual periods - more frequent or heavier
infertility
hoarse, gravelly voice
feeling of a lump in the throat
I hope I haven't told you more than you wanted to know. Sorry to blah-blah on and on. It's just that the cholesterol/thyroid connection was completely unknown to me less than a year ago, and I do a lot of reading about health and wellness. Seems the med community isn't too interested in getting the word out. There's a ton of cash to be made in the statin market...so what's the incentive to find other ways to treat cholesterol problems? I know that may sound cynical, but that's another symptom...LOL.
You are so lucky to have a great doctor. I too detest unnecessary meds. When my doc first saw my high LDL measurement, he immediately wanted to prescribe Lipitor. I insisted I be allowed to try natural remedies first, after calculating my very low risk factors with the help of the good folks here on this board; but with each repeat test, he still pushed that statin. I'm so glad I resisted, since I have learned more about the various causes of high cholesterol.
In the course of all my reading about thyroid disorders, I became irate to learn that the statin manufacturers themselves state in their prescribing information for physicians that thyroid function should be tested before prescribing statin drugs. I had to beg this guy for a TSH test, even after informing him my mother has the condition, which is strongly familial.
So, to answer your question, I have not yet been formally diagnosed; but my TSH on that test was nearly 5.0, and I have an appointment in two weeks with an AACE member endocrinologist. She only schedules appointments for new patients whose test results indicate there may be a genuine problem, so I'm hopeful of beginning treatment soon.
Here is a list of the classic symptoms. I have all but a few. Some I've had for at least twenty years, and never had a clue what they might indicate. The old symptoms are getting worse, and new ones continue to appear. A person needn't have every symptom on the list to have thyroid disease, and the presence of only a few may not be a concern. But most people with thy probs typically have at least a dozen or many more. (It makes it easy to see why a unsympathetic or uninformed doc might think the patient is a hypochondriac when he hears the litany of complaints, doesn't it?)
SIGNS OF LOW THYROID FUNCTION
fatigue
weight gain, inability to lose with diet and exercise
decreased heart rate
low body temperature
hypersensitivity to cold
high LDL cholesterol and/or triglycerides
constipation
indigestion
slow healing, frequent infections
problems with memory and concentration
depression
apathy
goiter (enlarged thyroid gland)
shortness of breath, tightness in chest
muscle pain or weakness
joint pain
loss of interest in sex
numb, tingling hands, often carpal tunnel syndrome
dry skin
yellow skin, particularly palms and soles
brittle, ridged nails
dry, gritty eyes, blurred vision
dry mouth
eyes hypersensitive to daylight
progressive hearing loss
chronic sinusitis
swollen eyelids
swollen hands, legs, torso
light headedness or vertigo
dryness, loss, or premature graying of hair
loss of outer third of eyebrows
adult acne
snoring or sleep apnea
irregular menstrual periods - more frequent or heavier
infertility
hoarse, gravelly voice
feeling of a lump in the throat
I hope I haven't told you more than you wanted to know. Sorry to blah-blah on and on. It's just that the cholesterol/thyroid connection was completely unknown to me less than a year ago, and I do a lot of reading about health and wellness. Seems the med community isn't too interested in getting the word out. There's a ton of cash to be made in the statin market...so what's the incentive to find other ways to treat cholesterol problems? I know that may sound cynical, but that's another symptom...LOL.
vera1
04-01-2003, 11:21 AM
Hello Midwest1,
Thanks for the reply. And, no I don't think that you are rambling on. You have been so very helpful! I checked the links that you suggested on the topics page under 'Thyroid problems' and did a lot of reading. It seems like I have at least 12 of the symptoms that you describe in the list you sent me. I am definitely going to bring this to the attention of my physician. If only for my peace of mind. I will let you know about my results, and please keep me informed about how you are progressing. I found some good leads through the sites I visited for some exceptional endocrinologists at the Cleveland Clinic(not too far from where I live). If I need to see one, I am happy that I found a good source. I also found a list of some naturopaths that are in my vicinity. They are all degreed medical doctors. It might be a good idea to pay them a visit for a general overview and thorough check up. Maybe you should consider that as an option. I still love my physician, but his practice is so large that it is hard to see him. Although,he is always accomodating if I have to get in to see him right away with my chronic UTI problems. It is a shame that we have to fight for good health care. We know our bodies better than any doctor out there does. They need to listen to us more, instead of being so arrogant that they refuse to consider our views and concerns. Find yourself a good, compassionate doctor that is willing to listen and try different means of treatment, other than just loading you up with meds. Good luck. Keep in touch.
Vera
Thanks for the reply. And, no I don't think that you are rambling on. You have been so very helpful! I checked the links that you suggested on the topics page under 'Thyroid problems' and did a lot of reading. It seems like I have at least 12 of the symptoms that you describe in the list you sent me. I am definitely going to bring this to the attention of my physician. If only for my peace of mind. I will let you know about my results, and please keep me informed about how you are progressing. I found some good leads through the sites I visited for some exceptional endocrinologists at the Cleveland Clinic(not too far from where I live). If I need to see one, I am happy that I found a good source. I also found a list of some naturopaths that are in my vicinity. They are all degreed medical doctors. It might be a good idea to pay them a visit for a general overview and thorough check up. Maybe you should consider that as an option. I still love my physician, but his practice is so large that it is hard to see him. Although,he is always accomodating if I have to get in to see him right away with my chronic UTI problems. It is a shame that we have to fight for good health care. We know our bodies better than any doctor out there does. They need to listen to us more, instead of being so arrogant that they refuse to consider our views and concerns. Find yourself a good, compassionate doctor that is willing to listen and try different means of treatment, other than just loading you up with meds. Good luck. Keep in touch.
Vera
midwest1
04-01-2003, 01:01 PM
A good naturopath would fit my health philosophy very well. Unfortunately, there is no licensing board for them in my state, and I don't want to risk finding a loony quack with a 6-week, correspondence-school education.
May I ask how you found your list of medical doctors who practice naturopathically? I'm sure there must be some here, but I haven't a clue how to find a good one.
Also, I've ended up at the Cleveland Clinic website often during my health searches of the Web. It's a great site, chock-full of information. Made me think it would be a good institution for someone who lives in that area.
May I ask how you found your list of medical doctors who practice naturopathically? I'm sure there must be some here, but I haven't a clue how to find a good one.
Also, I've ended up at the Cleveland Clinic website often during my health searches of the Web. It's a great site, chock-full of information. Made me think it would be a good institution for someone who lives in that area.
vera1
04-01-2003, 05:03 PM
Hi Midwest1,
Here is the link for finding a physician in your area. http://thyroid.about.com/library/weekly/bldoc1.htm
I found it on about.com under the heading "Thyroid Top Doctors Directory". (This is a great site)! I searched under my state. There I found both listings for thyroid specialists as well as naturopaths. You can probably find some in your area as well by doing a search on Yahoo or similar search engine under 'naturopathic physicians'. Let me know how you did.
Vera
Here is the link for finding a physician in your area. http://thyroid.about.com/library/weekly/bldoc1.htm
I found it on about.com under the heading "Thyroid Top Doctors Directory". (This is a great site)! I searched under my state. There I found both listings for thyroid specialists as well as naturopaths. You can probably find some in your area as well by doing a search on Yahoo or similar search engine under 'naturopathic physicians'. Let me know how you did.
Vera
midwest1
04-01-2003, 05:55 PM
It was right under my nose, Vera! Too funny.
The Top Docs list is where I found the name of the specialist I will be seeing on the 16th of this month. Many of the members on the Thyroid board recommended the list to me. I don't know if she's a naturopath, but she is a thyroid specialist. I'll go back to that site to look for a primary care doctor.
Thanks for getting the information to me, and best of luck in finding a reason for that high cholesterol. It sounds as if you already treat yourself well... so I know you'll be fine.
Hope to meet up with you on the boards again to share success stories!
The Top Docs list is where I found the name of the specialist I will be seeing on the 16th of this month. Many of the members on the Thyroid board recommended the list to me. I don't know if she's a naturopath, but she is a thyroid specialist. I'll go back to that site to look for a primary care doctor.
Thanks for getting the information to me, and best of luck in finding a reason for that high cholesterol. It sounds as if you already treat yourself well... so I know you'll be fine.
Hope to meet up with you on the boards again to share success stories!
BethS
04-10-2003, 12:14 PM
Just caught this thread and wanted to give my two cents worth. After a routine blood donation I received a report that my blood was rejected due to a positive results for a virus. I saw an infectious disease specialist who said I did not have a spreadable virus but the test was probably positive due to an autoimmune disease. Two docs (OB/Gyn & GP) tested for lupus, RA and a host of other things including thyroid. However, he only tested the TSH and not T3, T4 or antibodies. Several months later I starting researching after symptoms of hypothyroid arose (choking sensation in front of throat, losing outer third of eyebrows, coarse hair, weight gain of 20 lbs., fatigue, memory loss, etc.) I found a doc listed in the Top Thyroid Docs and he did TSH, free T3, free T4 and reverse T3. The results showed a normal TSH but below normal T3 and T4. He put me on Thyrolar for the T3 and Synthroid for the T4. It has made all the difference in the world. This doc says he only uses test results as a guideline -- he is more interested in how the patient is feeling. What is normal for one person is not normal for another. Find a doc who listens to your symptoms -- not just a TSH result.
vera1
04-10-2003, 01:54 PM
Hi Beth,
Thanks- I do appreciate your two cents. I am going to see another doctor within my insurance network who was referred to me by a friend of mine who is a nurse. She said he is so thorough and unrelenting with his testing, that he found a cancerous cyst in my friend's colon that would have been easily missed and gone undetected. It was at his persistence and listening to her symptoms that saved her life! I still believe my doctor would do a good job. I would have to know what to ask for, but a second opinion and round of tests can't hurt. I don't have the falling out of the hair or soreness in the throat like you do, but I do have so many of the other symptoms that leads me to believe something else is wrong. I will get it checked out soon and let you guys know what my results were. I so appreciate your input.
Take care everyone!
Vera
Thanks- I do appreciate your two cents. I am going to see another doctor within my insurance network who was referred to me by a friend of mine who is a nurse. She said he is so thorough and unrelenting with his testing, that he found a cancerous cyst in my friend's colon that would have been easily missed and gone undetected. It was at his persistence and listening to her symptoms that saved her life! I still believe my doctor would do a good job. I would have to know what to ask for, but a second opinion and round of tests can't hurt. I don't have the falling out of the hair or soreness in the throat like you do, but I do have so many of the other symptoms that leads me to believe something else is wrong. I will get it checked out soon and let you guys know what my results were. I so appreciate your input.
Take care everyone!
Vera