Discussions that mention pravachol

High Cholesterol board


6 years ago I developd a fatty infused liver. My doctor prescribed a small dose of lipitor and advised a low fat diet. That's all I was told, except that my cholesterol levels were a tad high:

351 total, and 657 triglycerides. I don't have the LDL and HDL record, but LDL must have been at least 175.

I didn't take it very seriously, after the liver issue went away. I stopped taking Lipitor.

In 2002 I had retired early and decided I should address the issue agressively. I did some research and went on an Ornish diet. Very low fat, exercise etc. Result:

216 total 130 LDL 40 HDL 229 triglycerides

Not exactly the numbers I was looking for considering I was living on twigs.

My doctor put me on 20mg of Pravachol. I didn't retest until 2003:

235 total 145 LDL 37 HDL 265 triglycerides

Mind you, the above is after a year of medication, a strict low fat diet, and I lost nearly 50 pounds and was within only a few pounds of my optimal weight.
This result is called "lipid bounce". Doctors don't know why, but in FH you can eat and exercise the same and suddenly get a lipid rise.

This is the point where i realized I had FH and asked for more intensive treatment. I was put on 40mg of Pravachol, and 10mg of zetia. Here is my results at the beginning of this year:

182 total 93 LDL 39 HDL 252 triglycerides

After two solid years under doctor care, and working hard to improve diet and exercise...I was EXACTLY where I started in terms of MI risk given that my total to HDL ratio was only marginally changed.

My doctor then doubled the Pravachol to the max dosage of 80mg along with the zetia. Here are the results from 2 weeks ago:

178 total 113 LDL 34 HDL 157 trigs

Not exactly moving in the right direction, eh? I went to a nurse practitioner (I'm in the stix) and she changed me to 40mg of Lipitor, and maintained the zetia. I suggested that a stronger dose of lipitor is indicated given my resistance to treatment and her response was, "this is what I do".

So, I've dropped her like a bad habit, but I'm staying on the 40mg Lipitor and zetia as a test for 8 weeks, and then I've an appointment with a real doctor who will hopefully address things more aggressively. Meanwhile it seemed that 8 weeks could be a good test of tolerance to the new drug.

My expectation is that 40mg of Lipitor and 10 zetia will perform about the same as or slightly better than 80mg of Pravachol, with a marginal increase in HDL from the drug. Trigs at least are nearly under control, and Lipitor may improve those as well.

I test on November 8, and will post results here.
I'm AMAZED at your stamina, Mark. I wish I had the OOOMPH to try so low-fat a diet as Ornish or even Stillman...but lord, I love meat and cheese.

I am pretty sure that the results of the 40 mg. Lipitor and 10 mg. zetia will blow you away especially combined with your fastidious dieting.

I envy you the drink a day...for me it's either 0 drinks or a pint of Gibsons.

I think I share your Famial hperlipidemia...My poor mother tried so hard just before statins were developed to get her cholesterol to decent results with absolutely no luck...and she died of progressive heart disease in spite of skim milk, egg whites, no cheese, a beer a day, and a life of low body weight. Without statins I'd be facing her fate.

Continued good luck to you...and I'll keep your post for inspiration:D:D.

BTW, depending on how you look at it there's not a lot of difference here [quote]182 total 93 LDL 39 HDL 252 triglycerides

After two solid years under doctor care, and working hard to improve diet and exercise...I was EXACTLY where I started in terms of MI risk given that my total to HDL ratio was only marginally changed.

My doctor then doubled the Pravachol to the max dosage of 80mg along with the zetia. Here are the results from 2 weeks ago:

178 total 113 HDL 34 HDL 157 trigs
(I presume you mean 113 LDL in the second group) You've simply traded VLDL for LDL with similar risk, since that drop in Triglycerides off 95 equals about minus 19 VLDL and compares with the +20 LDL...I hope a bit clearer than mud:D
In my case, I have FCH, Familial Combined Hypercholesterolemia, in that I have more than one lipid disorder. LDL and trigs are out of whack.

One obvious sign is when cholesterol levels don't respond to diet. With roughly half the cholesterol receptors of the average person, cholesterol levels don't drop much on a low fat diet. A 15% drop is typical. I've managed a nearly 30% drop from baseline on a low fat diet because I've followed Ornish's diet which is much lower than even the step II AHA diet. I reduced from 351 to 216.

People with FH also tend to respond to statins less well than the general population. It usually requires maximum medication to begin approaching good levels. That's true for me. I was on zetia and 80mg of Pravachol...the max dose, and still had unsafe levels of LDL.

FH people also have a pre-disposition towards metabolic syndrome and type II diabetes. My mother had the former, and in her 60's developed the latter. I have the former and am pre diabetic.

So there are a number of ways you can be pretty sure whether you have it or not without a genetic test. Most people in this country are hypercholesterolemic, but only 1 in 500 have FH. Nevertheless, that makes it a very common illness affecting more than half a million people here in the US.