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Old 08-03-2005, 12:17 AM   #1
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Do I need medication if my risk ratio is in range?

Hello All,
Sneaking over here from the thyroid board - where many of us have high cholesterol -

my readings are:
Cholesterol 260 MG/DL (<200) maxed out at 292 two months ago
Triglycerides 240 MG/DL (<150) maxed out over 300 several months ago
HDL 52 MG/DL (>39)
LDL 160 MG/DL (<100)
Risk Ratio 3.08 (<3.22)

So because my HDL is high too - my risk ratio comes in normal - so do I need meds? (I'm 40 years old - but the first time I had my cholesterol checked I was about 32 and it was 241 already) My doc first prescribed Zetia in April 2005- but then changed it to tricor today (is that a statin??) - I've taken neither yet.....

Thank you for any help and feedback you can give me on this!
Best wishes,
Kathy

 
Old 08-05-2005, 11:38 PM   #2
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Re: Do I need medication if my risk ratio is in range?

I found this "desired ratio" listed on the web, but it appeared that it went with the older guidelines where desired level of LDL was under 130, instead of the newer "under 100." They seem to have dropped the ratios on most of the medical sites under the newest guidelines. If anyone else can find it, please correct me with the current ratios.

Desired ratio:
TC/HDL ratio: under 4.0 in males, 3.8 in females.

Your TC/HDL ratio is 5.0.

 
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Old 08-06-2005, 12:18 AM   #3
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Re: Do I need medication if my risk ratio is in range?

Hi Uff-Da,
Thank you - we have the same problem in the thyroid tests - the latest approved ranges are not being used at most labs....so many who need treatment aren't getting it....

so looks like I need medical treatment with these readings then - so far my endo has only given me medicine for triglycerides I think, Zetia and Tricor - I haven't taken either one yet - because I wanted to make sure I needed them - I have a huge medicine chest full of pills already! Thanks for your feedback! I really appreciate it!
Best wishes,
Kathy

 
Old 08-06-2005, 05:31 AM   #4
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ARIZONA73 HB UserARIZONA73 HB UserARIZONA73 HB UserARIZONA73 HB User
Re: Do I need medication if my risk ratio is in range?

Kathy, I think that if you are able to bring your triglycerides down closer to 100, you will be in much better shape overall.
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Old 08-06-2005, 09:37 AM   #5
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Re: Do I need medication if my risk ratio is in range?

Hi Arizona,
Does that help bring the others down too? Are tris my biggest problem here? It's sugars right - so reducing them in my diet might help too?? I take meds for thyroid, reflux, I've lost 40 lbs of a 60 lbs weight gain I had with my thyroid, my BP 130/90, I take BCP and I'm 40 yrs old - do you think it's important to add one of these meds now? Thanks guys - I take so many meds already - I worry about them interacting etc....and the side effects - if given a choice, would you take zetia or tricor?? Thank you so much for your help with this....I really do appreciate it....
Best wishes,
Kathy
Cholesterol Newbie....

 
Old 08-07-2005, 05:52 AM   #6
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Re: Do I need medication if my risk ratio is in range?

Kathy,

Triglycerides sure do contribute towards your cholesterol levels, because approximately one-fifth of triglycerides is made up of VLDL. As you can see by the way total cholesterol is calculated, triglycerides can skew your lipid profile and worsen your ratios:

TC = LDL + HDL + (trigs/5)

Since you said that you are already taking a number of different medications, I can understand why you are hesitant to throw Zetia and Tricor into the mix. You also said you are taking BCP (birth control pills?). That can also worsen your cholesterol numbers. And so can hypothyroidism, if that's what your problem is. Usually, triglycerides can be lowered by reducing your carbohydrate and sugar intake. Of particular importance are the high glycemic carbs, such as starches like breads, pasta, potatoes, corn, etc, and many of the snack foods out there. Also try to avoid or limit those foods that contain trans-fats (partially hydrogenated fats and oils).

Have you tried to lower your triglycerides through dietary changes? If not, you may want to try this first. Try not to worry about ALL of your numbers all at once. You'll make yourself crazy. Focus on one thing first, like getting your triglycerides down. The type of diet that is most successful at accomplishing this is a low-carb diet. As triglycerides come down, HDL levels generally rise. This combined effect can favorably impact your numbers all around, and improve your ratios. A low-fat diet, on the other hand, will likely make things worse in your case, because it includes a lot of carbohydrates. So I would try this first, and see how things work out.

As far as Zetia and Tricor are concerned, I would wait until I've seen what kind of an impact the dietary changes made first. I think Zetia is probably far safer than Tricor, and is unlikely to cause serious side effects. I would consider Tricor only IF I was unable to lower my triglycerides by more natural means. But I think if you made such dietary changes by taking a disciplined approach to decreasing carbohydrate intake, you should be able to significantly reduce your triglycerides and improve things all around.

I wouldn't skimp on supplements either. Make sure that you take a good multi-vitamin supplement, and take additional antioxidants, such as vitamins C and E. Chromium picolinate may also be of help. And I would certainly supplement with fish oil as well. Fish oil can reduce your risk of developing heart disease even better than statins, and it can also lower triglycerides. I wish you much luck and success. Keep us posted on how things turn out.
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Old 08-07-2005, 07:07 AM   #7
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Re: Do I need medication if my risk ratio is in range?

Hi Arizona,
Thank you so much for that information and taking the time to reply with such a helpful message! Very kind of you - my endo put me on a low-fat diet! But with my thyroid trouble I really can't eat more than 800-1000 calories a day without gaining weight - I'm mostly hypo - have thyroid nodules - but don't know if it's autoimmune (where you swing between hypo and hyper).....I will work at low carb - I don't eat much rice, pasta or bread - but will watch for those now....I have one "bad" meal a day - then I have a thing of yoplait for lunch, then a can of veggies for dinner....or sometimes I splurge with popcorn and a soda. I've cut way back on the soda...so I hope that helps - seems the triglycerides tend to vary quite a bit - probably more sensitive to what I have recently eaten....(I have blood tests every 6 weeks -2 months with my endo). I REALLY appreciate you having taken the time to write this message - This was really helpful to me. Thank you so much!
Best wishes to you as well!
Kathy

 
Old 08-07-2005, 07:43 AM   #8
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Re: Do I need medication if my risk ratio is in range?

I agree with Arizona's recommendations, especially about skipping the high glycemic carbs. If you are trying to keep your calorie count way down to avoid weight gain, it would be best to restrict your diet to nutrient dense foods. If they are going to give you any calories, they ought to be packed with nutrients, too. So skip the soda entirely, if you can. Replace it with skim milk, water, tea or herb tea. Fresh veggies are great if you make them the low calorie ones like broccoli, cauliflower, green pepper, carrot sticks, celery and the like. Include a little bit of fat in the meal, like a low-fat, not a fat-free, salad dressing. That helps the body absorb the nutrients in the veggies.

You didn't say what you include in your "bad" meal of the day, but make sure your large meal includes plenty of protein, and avoids the "bad" carbs and trans fats.

 
Old 08-07-2005, 09:36 AM   #9
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Re: Do I need medication if my risk ratio is in range?

Hi Uff-Da,
Thanks very much - I also have IBS so have a very difficult time with "healthy" foods - raw veggies, salad, even some cooked veggies, anything with high fiber is really not worth the terrible abdominal pain it causes for me (also have adhesions from abd sugery) so sometimes I feel caught in a catch -22.....

Ok - fessing up the bad meal is breakfast - I have 11 grams of fat in my breakfast, 235mg of cholesterol (yes I have an egg) 30 g of carbs (prob the english muffin), 290 calories (100 calories from fat) and 17g of protein, 0 transfats!.....But this way - if I give myself one bad meal - I feel less like binging the rest of the day...it's so hard with hypothyroid....for 37 years I was lucky and could eat anything and everything (probably why my chol is high) and never gained any weight - weighed 117 all my life and then - wham - thyroid disease!

I'm working on the soda - I'm down to 8-12 ozs a day from having four or five a day (and never drank diet - aspartame gives me headaches) so am doing better there...but will try harder - don't drink coffee either so need a little caffeine somehow...maybe - or maybe I don't....

That's an excellent suggestion about the nutrients - I hadn't thought of that and with all the pills I take I'm not too good at getting the vitamins in there too - although I'm starting to get better....

I really appreciate your suggestions - you'd think knowing I had high tris and chol all these years I'd know something about it - but I haven't educated myself and actually my docs haven't said much until in March 2005, I asked, "are you worried about those numbers?" That's when he prescribed the zetia - I'll try diet first - then maybe the zetia....

Thanks again - I am very grateful for your help!
Kathy

 
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