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    Old 12-21-2006, 06:53 AM   #1
    smithnj
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    Question Help!! Need Second Opinion!

    Last night my doctor told me that I need to go on statin drugs. I'm thinking about seeing another doctor. Let me explain some background ....

    I had a physical back in April 2006, and had some bloodwork done. I was in basically decent shape - 33 yrs old, 185 lbs (at 5'9 I was technically 25 lbs overweight), nonsmoker, my cholesterol was 207, HDL was 36, LDL was 99, trigs were 364, fasting glucose was 106. I worked out semi-intensely a few times a week alternating between cardio and weight training. During that time I was also going out a lot, doing lots of social drinking, and not eating right. In fact, I had probably been out socially a few days before my physical, and probably did not fast the full 12 hrs before my blood test. For several years I have been checking my blood pressuse, and it averaged 130/80 when I checked it at the drug store/supermarket, and it was 122/80 at my physical. I did not speak to a doctor about my blood results at the time, I got them in the mail after I passed my physical.

    From May thru August I was on a work assignment away from home, doing lots more social drinking and not eating right. I did exercise while away, in fact I passed an equivalent of the military fitness test, but the exercise was cancelled out by the constant eating out and alcohol, so my weight remained the same while I was away.

    I had a routine appointment with my primary doctor at the end of October, and I showed him my blood results. I also had my blood pressure taken by the nurse when I first showed up with a reading of 126/82, and twice by the doctor at 135/95 and 130/90. He told me that I had metabolic syndrome that needed to be treated aggressively right away with statins, daily aspirin, and a low-dose diuretic to reduce blood pressure. He basically told me that I was obese, would soon have diabetes, and also heart disease. I was very shocked at hearing this. I told him that I wanted to try some lifestyle changes before going on drugs for the rest of my life, but I did agree to go on the low-dose diuretic to reduce BP.

    After the appointment I realized that my diet tended to be poor, and that it really needed to be fixed. My wife is pregnant since September, so we have stopped going out so much. I started eating right and exercising more in the beginning of November, and I have only had alcohol a handful of times. I had another blood analysis on Tuesday. THe doctor called me last night and told me that my cholesterol had dropped from 207 to 172, but my HDL went from 36 to 35. My trigs went from 364 to 194, and my glucose went from 106 to 95. I have also lost about 6 pounds. To my shock and dismay he still said I need to go on statin drugs. I told him I want a second opinion, which I will seek out. I told him that I am confused as to why he does not seem to think lifestyle changes can fix my blood levels over the long term - it has only been 7 weeks! I also bought fish oil supplements but have only been taking about one tablet a day for about 3 weeks. He said that I still had metabolic syndrome because of the low HDL, high trigs, and high BP. But, my feeling is that for all 3 it is borderline, so I should continue with lifestyle changes instead of immediately going on drugs.

    What do you think??? Thanks for reading.

     
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    Old 12-21-2006, 07:57 AM   #2
    HubbleRules
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    Re: Help!! Need Second Opinion!

    smithnj,

    I think you should give the lifestyle changes at least 3 months before deciding on any medication.

    Coincidentally, your height-weight, cholesterol and glucose numbers are almost identical to mine when I was your age. I never had a blood pressure problem though. I also traveled extensively for work - and social eating and drinking was always an issue. I was able to overcome it thru my 40s via jogging - but now that I'm 52, I find that I have to watch what I eat/drink when I go out.

    I'd ask your doctor why he thinks a statin will help you. They are good at dropping LDL, but not at raising HDL or lowering Triglycerides, and they do nothing for blood pressure. Whey wouldn't he be considering instead a fibrate, like Tricor or Lopid, which is much better for high triglycerides.

    Continue to exercise, and cut back on carbs and saturated fat. Eliminate sugar and trans-fats (anything with the word 'hydrogenated' anywhere in the ingredient list). Continue to drink moderately. Dropping the extra weight will help triglycerides significantly. Try to eat more foods with a low glycemic index. Avoid 'white' carbs (sugar, white potatoes, bread, rice...). Consider a 'mediteranean' diet (more veggies, less meat, more mono-saturated fats like olive oil, less saturated fats).

    Also try one-half teaspoon of cinnamon per day - it helps lower your blood glucose level.

    The fish-oil won't help at the dose you're taking. For it to have any effect on cholesterol, you need to be taking at least 3 grams per day of EPA + DHA combined... That's probably 6 or more tablets daily - and even that may not be enough. However, taking just one a day is still good for you - since the American diet tends to give us too much omega-6 and 9 and not enough omega-3...

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    Old 12-21-2006, 09:11 AM   #3
    Lenin
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    Re: Help!! Need Second Opinion!

    When I started reading your post, my first thought was Metabolic Syndrome: High triglycerides, overweight, low HDL .
    Check for obesity...nope, only overweight according to BMI of 27.3.
    I was then going to ask about your bellyfat...normal would be a 32 or 34 inch waist.
    Reading further, your doctor's estimate of Metabolic Syndrome implied a 36 or 38 inch waist???? Right?
    Then I was going to ask about sugar issues...yep, you called it.

    You re going in the right direction Mr. Smith and thus I would say don't go on statins til you can see how much success you can get without them.

    Buy a glucose tester and check daily fasting glucose...get a month-long average.
    Get your weight to 165...a 20 pound loss.

    What killed your 4 grandparents...if still alive, what are their ailments> How are your parents heartwise?

    Diuretic???
    Buy a BP tester and the mantra: test twice a day, relaxed in a comfy chair with arm cuff at heart level. That will give you 60 readings in 30 days. IF the average is >140/90 then medicate, otherwise just keep on with the weight loss...the greatest immediate benefit of weight loss is lowered BP.

    Remember guy,
    The normal pattern for a 5'9" guy who is 185 at 33 is for him to be 205at 43 and 225 at 53. Don't go that route; start reversing it today!

    Last edited by Lenin; 12-21-2006 at 09:14 AM.

     
    Old 12-21-2006, 01:39 PM   #4
    Connie122516
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    Re: Help!! Need Second Opinion!

    Just want to chime in with what others have said and encourage you to continue with life style changes and more natural means of lowering those triglycerides and getting the HDL up before going on more meds. Exercise, avoiding refined carbs (key word there is refined, i.e. the white stuff like sugar and flour), and losing weight are the primary methods to do that, as others have discussed. Personally, if those don't work to get the HDL up and the triglycerides down (should at least 40 and below 150 respectively), I'd consider trying the B vitamin niacin under a doctor's supervision before I'd go on a prescription drug.

    However, if you are unable to maintain the lifestyle changes over the long haul, then you might at some point want to consider more drugs. A lot depends upon your family history, stress level, and other coronary risk factors. But based upon what you've described, I see similarities to my history at or near your age, and I had to have a stent placed one week after my 54th birthday...all those borderline things do put you at risk (or, at least they put me at risk).

    Last edited by Connie122516; 12-21-2006 at 01:39 PM.

     
    Old 12-22-2006, 10:17 AM   #5
    smithnj
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    Re: Help!! Need Second Opinion!

    All,

    Thank you very much for your input and advice.

    Lenin - you asked about my waist size - a couple days ago it was 37 inches. I took it at the widest point. I wear size 33-34 jeans. Also, regarding my grandparents, both of my grandfathers died around age 70 of heart attack. My one grandmother died at 80 due to heart attack, and my other grandmother died at age 89 of stroke. But, all of them smoked, except for my one grandmother who died at 89. None of them ever exercised from what I have heard. My father is in decent shape at age 67, although he has had blood pressure issues. My mother recently had a stroke at age 70. My father smoked until he was about 40, my mother never smoked but her diet included way too much carbs and white flower, not nearly enough "mediterranean" style foods or exercise. I have lots of older aunts and uncles who are in good shape, in their 70s and 80s, dont smoke, but never exercise. A couple aunts have diabetes, and they seem happy to medicate their condition rather than try to improve their diet. Some of them look at me funny when I mention that I go running a few times a week - they wonder why I waste my time - they just don't understand.

    All of your advice has helped reinforce that continuing these lifestyle changes is really a life and death choice. I weighed myself yesterday after running and I was at 177. So far so good! There is a 5K run I do every July - last year I did it in 28.5 minutes - this year my goal is 25 minutes!

    One other note about the doctor - I think his attitude just pisses me off. After 30 seconds of looking at my bloodwork in Oct he wanted to put me on statins. Did not consider for a single second natural remedies or lifestyle changes. I am the one that has to live with the after-effects of whatever medicine that I put in my body. This has given me the motivation to lose weight and eat right. If you ever stop and read the labels on the things you eat, it is shocking how much trans fat there is out there.

    I have decided that in another 3 months I will see a different doctor in the same office and get his thoughts. Hopefully by that time I have gotten down to close to 170 lbs and be in much better shape - both physical and cardiovascular shape. If I still have high trigs and low HDL, I will certainly ask about fibrates and niacin (thanks for those tips!!)

    Thank you again for your advice. Good luck to you all.

     
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