I've always had a history of borderline/high cholesterol. In July, my gynecologist did a non-fasting cholesterol test, and the level was 231 mg/dl. He sent me a list of low-cholesterol foods, and told me to check it in a year. In September, my cholesterol was also checked because I went on Accutane-- it was 234. Accutane can cause triglycerides and cholesterol levels to spike-- mine did, staying at 272. After Accutane, the levels should go back to normal, but my dermatologist and I decided to do a fasting lipid profile to be sure. It came back on Thursday, and was 321. We've always been aware of the family history of high cholesterol (my paternal grandma has it), and Dr. D told me to go see an internist and "get some Lipitor".
I was really freaked by this. I've been strictly following my Slim Fast diet for a month, and my family does not eat high cholesterol foods constantly. We use margarine, drink skim milk, eat red meat once a week at most, use only boneless pork loin when cooking pork, and used reduced fat dairy products. Dr. D told me that this is obviously heredity, and to stop beating myself up. He also said that my levels are not at a place yet where they would be a short-term concern, only a long-term concern.
My first question is: how important is it for me to see the doctor ASAP? Dr. D is sending me to his internist; "the doctor the doctors see". They both work in the same building, and he can check up on my case. He's also sending this doctor a letter and my chart... but the earliest appointment is in 5 weeks. I called Dr. D to ask him if it's okay to wait 5 weeks, or should I see someone else, but I called late today and expect a call on Monday. What would you all do?
Also, does anyone know a good website with some good information about high cholesterol? I can't seem to find much.
Is anyone here relatively young and have this problem? It just seems so foreign to people my age.
Finally, are there bad side effects to mixing Lipitor and birth control? The prescribing information says to "let your doctor know about birth control pills", but nothing more. I don't really want to stop taking my birth control if I get put on Liptor.
Thanks so much for your help...
I'm glad I found this board!
--Karyn
P.S. Dr. D recommended that I start aspirin therapy. Is that usually one baby aspirin a day? I was going to wait for that until I saw the internist, but it looks as though it will be a long wait.
I cannot answer all your questions. Now, you've said that high cholesterol is in your family, and that your grandmother has it. Do you have a family history of heart disease?
Your cholesterol has risen considerably, possibly due to the Accutane. How long have you been off it? It's possible that your numbers may still come down. You are obviously very young, so you are most likely not in any immediate danger. If I were you, I would wait a couple of more months, then visit the Gynecologist and ask him to draw blood for a cholesterol screening. That way, you would be able to verify the results from both sources, and maybe allow a little more time for your blood lipids to stabilize before you make any hasty decisions.
I am working somewhat in the dark here since I do not know what your other numbers are, such as HDL, LDL, and triglycerides. Naturally, nobody wants to take drugs if they don't have to. But, in any case, I think that a person like yourself may in fact do well by following the Atkins diet, or some diet which closely resembles it. It has been very successful for many people. Cholesterol levels have actually dropped on this low-carb diet, and people's blood-lipid profiles have improved considerably. Yes, you would probably be consuming more fats and less carbohydrates, but quite often blood-lipids still improve. Don't ask me why, because no one has yet been able to explain it. But, for many people, it seems to have worked wonders. So, it may certainly be worth a try.
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"Men and nations will act rationally when all other possibilities have been exhausted."
Thanks so much for your response. It put me at ease. No, my family does not have a strong history of heart disease, but it may be a factor, and my grandma does take a statin drug, and is constantly watching her cholesterol. My dad avoids doctors, so I don't know what his levels are-- but I'm sure they could be high.
I agree with you about the Accutane. I am curious as to why and how my cholesterol rose to 321 after it was 272 for most of my Accutane therapy. This test was 2 months after I ended the drug, and I did not eat/drink anything for at *least* 12 hours before the test. Part of me just wants my derm to run another test, but I understand his position in sending me to his internist--1) I've had truly high cholesterol for awhile 2) this is not his area of expertise and 3) obviously for malpractice reasons.
I am not so concerned about waiting the 5 weeks for my appointment, but I do want to nip this problem in the bud NOW. For 8 years, pediatricians and gynecologists have been telling me to check back in a year, try and eat low cholesterol, etc. I try, and it doesn't work. They say wait another year. I really am glad Dr. D said, "Enough is enough. We aren't messing around with this anymore; I want you to get this checked specifically." I don't want to get heart disease; I don't want to have a heart attack or blocked arteries. If the internist thinks that a drug would be best, I will do that. He may very well say it's not necessary at this point, but I want to be sure. I am extremely concerned that my cholesterol is 121 points above what is considered healthy.
My HDL is 69, and my LDL is 203. My triglycerides are borderline high at 243 as well. I am really surprised that Atkins' lowers cholesterol in some! I have wanted to try that, but carbs are soooo hard for me to give up, and it is also higher in fat/cholesterol, which is not what I would think is good for me. I will get the book and read it, and ask the internist what he thinks. I do like Slim Fast a lot. It's easy to follow, and as a college student who commutes for an hour in traffic with 9 AM classes, it's so easy to throw a bar in my backpack for lunch.
If a drug is recommended, is that a lifelong deal? Have you tried going off the statin with success of still lowered cholesterol? I know that drug commericals are misleading, but all of the Lipitor commercials show people who have a cholesterol level of 256 needing the drug! Mine is 321!
I am so glad I found this board-- there is so much good info to be found.
Take care,
Karyn
[This message has been edited by KarynLR (edited 04-27-2003).]
Karyn, if you do decide to take a statin drug, chances are that your doctor will most likely keep you on it indefinitely, provided you do not develop any complications or serious side-effects. It's a lot like blood pressure medications. Once you are on them, it's generally for the long haul, or for life. You will also have to have blood tests taken every 3 months or so, just to make sure there is no muscle or liver damage taking place. Of course, if you do decide to stop taking the drug, your cholesterol will most likely go up again. If you need to take something, but would rather not take a statin, you can always ask your doctor about trying niacin instead.
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"Men and nations will act rationally when all other possibilities have been exhausted."
Hi everyone; this is an update to my previous post. A letter from my dermatologist referring me to the internist yielded a much quicker appointment-- I saw him last Wednesday. He did a full exam, and told me that I'd probably be on a statin for the rest of my life. Lately, I've been thinking that it isn't the way to go, but he said we can adjust the dose as necessary. I'm continuing on my Slim Fast regimine. Although the doc wants me to do it for him, I'm still doing it for me. I want to lose 3 clothing sizes, so we'll see where that takes me.
My EKG was "slightly abnormal", but I still swear it was due to nerves. The doctor assured me he wasn't sending me out "dignosed with heart disease", but wanted a Cardiolite Stress Test ASAP. I am a worrier, and that freaked me out a ton. He also had me do a new panel of bloodwork.
I got a call from the office on Friday. My total fasting cholesterol was 259-- a far cry from 321. Nobody knows what caused the 321-- I was 8 weeks off Accutane, and fasted. He prescribed 10 mg of Lipitor once daily, which I started yesterday. It seems like a small enough dose, so that's good.
I had the stress test this morning. I was so freaked out about this-- there was me and about 6 men over the age of 70 getting stress tests. The 4 people I encountered at the clinic all looked at my chart, then me, then my chart again and said, "Why are you here? You're 20!" They were incredibly nice and told me not to worry; it was more than likely nothing. My resting heart rate was 111 before the test due to nerves! The cardiologist monitoring the excercise portion of the test told me that everything looked normal, and to not stop worry. The nuclear images should be with my doc in the next few days, and I have another appointment with him in 3 weeks.
The nuclear tech told me to take milk thistle to help my liver. Are any of you doing that? She thought it would be good for my liver while all of this cholesterol stuff is going on.
Thanks so much for all of your help. I am a terrible worrier, even when I shouldn't be. My derm kept telling me that it would be normal to run an EKG and stress test on me, and to not freak... but I did anyway. I don't like that I have to deal with this forever, but I am really glad that I'm dealing with it now before significant damage has occured.
Questions to those of you who know... 
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