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Old 12-29-2006, 08:11 PM   #1
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jkhh HB User
Vytorin 10/20 WOW!

Just received my labs from this morning and they are impressive with one exception ;

Total= 155
LDL= 81
HDL= 42
Trig= 158

These numbers were after a 6 week trial on Vytorin 10/20. It works well! My numbers from 11/06

Total= 242
LDL= 167
HDL= 37
Trig = 190

My best numbers before (on Crestor 5 mg) were from 11/05

Total =155
LDL= 87
HDL= 36
Trig= 162

Now, I have a tough decision to make. Do I keep taking Vytorin weighting these results vs. the risks of side-effects especially from long term use (I'm age 39). Second, are the rewards that great anyway? The way I calculate it, I go from a 3% chance of a CHD in the next 10 years (Framingham Risk Assesment) to a <1% chance.

BIGGER PROBLEM: My ALT (liver enzyme) went up to 81 (36 is high range at my lab). I have been taking 500 mg Niaspan in the morning and the Vytorin in the evening. Also, I had taken Tylenol PM (2) for the past several nights due to tooth pain. Any ideas on why my ALT would again increase? When my numbers were so good in 11/05 (Crestor 5 mg) my ALT was 85.

I would appreciate any input. I will make an appt. to see my Internist early next week to chart my future treatment.

Happy New Year Everyone !

 
Old 12-29-2006, 09:45 PM   #2
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Re: Vytorin 10/20 WOW!

I will answer your question with another question : are you sure your body doesn't need the cholesterol your liver used to produce before you used drugs to interfere with this process? Your cholesterol is too low anyway. And it sounds like your liver is unhappy about it too.

Mark
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Old 12-30-2006, 04:16 AM   #3
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Re: Vytorin 10/20 WOW!

Mark1e,

Thanks for the reply. Can you (or anyone else) give me an idea on what woud be a safer cholesterol range? Would you consider my 11/06 that I've listed (no statin or Zetia) a safe range? Actually, I think more along the lines of how you've questioned me, however, the risk of a CHD is pretty influential .

 
Old 12-30-2006, 05:12 AM   #4
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Lenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB User
Re: Vytorin 10/20 WOW!

judge,
Tylenol is among the most difficult drugs for the liver to manage. I think it's the first suspect.

What kinds of ALT's did you get while on Crestor in 2005? If they were normal, then the simvastatin in the Vytorin is not likely to be the culprit.
That then leaves the ezetimibe to consider.

Order of business: get a retest of liver functions AFTER discontinuing the acetamenophen for a week. If still high, do a month's trial with just simvastatin (Zocor) and test again.

And then work in a trial of Vitorin without NIACIN, another potent liver insult!

You've got a puzzle with 4 possible answers some of which might be synergistic.

It's tough to pin down the murderer when 4 suspects are holding smoking guns.
But I think "the acetamenophen, not the butler, 'what done the old dame in!'"

A 3% risk of diagnosed CHD by age 49 is ghastly, indeed.
Put it in this context: lifetime chance of dying of CHD is nearly 50%... tripling that risk doesn't give one much wiggle room, does it?

Your numbers are great on the Vytorin/Niacin. Triglycerides might indicate you have a sweet tooth, a well-bent elbow, or are overweight. I guess there's ALWAYS something to work on!

Last edited by Lenin; 12-30-2006 at 05:21 AM.

 
Old 12-30-2006, 09:59 AM   #5
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Re: Vytorin 10/20 WOW!

Lenin (and everyone else),

From 9/04 to 11/05, my ALT fluctuated from 55 to 85 (while on Crestor 5 mg). My last good ALT was 32 in June, 2004 (cholesterol untreated but total=271 . My ALT is my big concern (as always) about my cholesterol treatment. Still, Vytorin 10/20 would be considered a low dose, right???

Also, my Testosterone got really low on Crestor 5 mg and is really why I ultimately quit this past summer. That's why I pay attention when Hubble others are promoting COQ10. After quitting Crestor and rechecking my testosterone it gained about 300 points back in about 2 months (and I supplemented with COQ10 and Vitamin B-12 during that time). I'll be watching the Vytorin closely to see if the low T symptoms return yawn: .

Do you think that ibuprofin pm has the same liver concerns as Tylenol???

I guess the tri's were the result of having my labs taken right after xmas . I'm betting I'll be a good 50 to 100 points lower in the spring/summer. Plus, I've not been following my red wine regimen much lately either. My HDL is the best since June 2004 . So, I think the Niacin and Vytorin combo is responsible for that result.

 
Old 12-31-2006, 05:57 AM   #6
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Lenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB User
Re: Vytorin 10/20 WOW!

Judge,

If you like the PM part of the analgesic why not just go buy some generic diphenhydramine and take 50 mg. at bedtime (the more expensive brand name is Benadryl.)
Ibuprofen won't hurt your liver like acetaminophen but it can wreak havoc on the stomach. Worth the risk if treating pain but not worth it just as a carrier for the sleepy-making component.

Hmmm, Crestor knocked your testosterone eh? I never heard that. I've taken Lipitor for 9 years and regularly run testosterone levels over 600.

 
Old 12-31-2006, 06:57 AM   #7
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Re: Vytorin 10/20 WOW!

Lenin,

Crestor definitely wiped me out. I had the symptoms of low T and my doctor ordered the test (total was 125 ). My thighs ached and were sore but not like some have complained of here. I try to exercise 3x per week so I feel like that was part of it. As to the low T, I stopped the Crestor and supplemented as previously stated and brought it back up to the 500 range. As I've stated before, Crestor is wicked and my real concern with Vytorin is it will do the same. My new internist feels like it's a milder statin (Zocor) than Crestor but we'll see.

I'm convinced that you have helped me discover the source of my ALT elevation. I've been a regular on the PM and even the regular Tylenol for some time, but I definitely know one of my new year's resolutions now . Also, I've been on Amoxicillin 500 mg for a few weeks due to my tooth problem and I discovered it is a main culprit in elevated Liver panels. I'll discuss both with my internist this week.

Now, can you (or anyone/everyone else) help me make a new years resolution. You've already called me out on my sweet tooth with regards to my tri's , but I'd like input on how else to modify my diet in the new year so that I can eat better for not only my heart health but general health as well. ANY IDEAS WOULD BE GREATLY APPRECIATED.

Lenin, I wish you a happy new year. You're a great help to me. Same to everyone else who puts their thoughts and experiences on this forum.

 
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