Cholesterol levels and new numbers.

[ACinKC]

Ok so I went in for my bloodwork last week.  Here are the damn results!

VL-Undetectable
CD4's- 776 (up from 729)
%-35

YAAAAAAAAAAAY!  Those are good.  Now the shitty part...

Cholesterol - 200
LDL-148
HDL-27
Risk factor (1.4-3.3 is considered a good range) 7.4!!!
TriGlycerides- 123 (down from 290 in October of 2005)

Dr. is suggesting Lipitor/Crestor/Pravachol to reduce the number.

This is a gift from my MOTHER's side of the family.  My questions are....

1.  Should I start on the new Statin based meds and burden the ol' liver even FURTHER and continue to eat and not excercise much?
2.  Should I start watching my diet more closely (i dont eat BAD now but i dont eat good either?
3.  Should I start excercising and how much will this help (knowing that i have ADD and cant stick to a plan to save my life)?
4.  Advice on the drugs?  (mom says lipitor is bad in our family, causes major leg cramping and stuff)

Stray?  Aztec?  I know you are brothers in arms with this..... pony up SUCKAS!

[jack]

I have been doing lipitor for at least 10 years. I have not experienced any sides. Prior to HIV drugs my cholesterol was always 220 no matter what I ate or how much I exercised. HIV drugs sent my cholesterol and trys sky high. My cholesterol has been 180 since i started lipitor.

[sweetasmeli]

Fab cd4/vl numbers AC!

As for your cholesterol results, I can't advise on meds - I'm all for natural approches - but I can advise you to have a good crack at 2) and 3) on your list. Healthy diet and exercise wont do you any harm!

At the risk of getting a cyber smack in the gob I will venture to add that ADD or no ADD you can still choose how you approach your health, hon...you just have to work a bit harder than others at sticking to it!

--Melia tentatively clicks on 'post'--

Hugs
 

[BooBoo]

I really don't think that your cholesterol is all THAT bad......it's a little high but very controllable with diet and exercise.  Personally, I wouldn't start taking statins for cholesterol of 200.

If you want to lower your LDL and raise your HDL diet and exercise (especially cardio) are the key.  I would hold off on the meds if I were you.

Jim

[ChaplinGuy]

AC, let me just add to sweets' comment and agree that what food you consume and how you burn it are crucial points here. I, too, have genetically high levels (as well as high BP), but am not yet on HIV (or other) meds. And I am involved in several virgorous sports, including marathon running, cycling and recently added hardcore lifting to bulk up following my diagnosis.

Even with diet and exercise, it can be hard to get your levels down to where your doctor will want them. Studies have shown that people with naturally high CL, BP, TGs can intially drop their levels through diet and exercise, but will gradually go back to a set level because of genetic predisposition. But it adds to your overall health and keeps everything else functioning well. At the risk of sound like one of those "well, duh" espidoes on Discovery Health, I'd recommend plugging in the iPod and running/walking with your wife or a friend - which will hopefully keep your ADD in check. And mix it up - run, walk, bike, climb, lift, swim, row, soccer ... don't let it get boring.

You also may find that once you're into something like running, your body begins to crave it and doesn't feel bored but instead challenged to push yourself further and further. (And you'll sleep better, which is good for your immune system.)

Enough of my Oprahfying on this. I'll get off my soapbox. Good luck, buddy!

[aztecan]

Hey AC,
As you know, I am right there with you. Actually, we have the same HDL, which sucks.  and my LDL is worse at 157.

As you probably already know, the cholesterol is a combination of two things: What you eat and your genes.

So, as to your first questions, have you tried anything else yet? I put off starting statins until I had no other choices. Fish oil (not cod liver oil) may help. I take 4,000 mgs of that a day. While I have never taken Lipitor, my mom has and it did a number on her.
I took Vytorin - bad move. It is a combination of Zetia and Zocor. The statin, Zocor, interacts badly with some of the HIV meds, especially the PIs.
I am now taking Pravachol (Pravastatin). So far, no side effects and its been a few weeks. So, I have my fingers crossed.
Since your mom has said Lipitor is bad news for your family, I think I would opt for Pravachol or Crestor, although I know nothing about Crestor.

What really sucks is your ratio, not necessarily your cholesterol, even though it is a bit high. I have the same problem. The only way I know to increase your HDL is through exercise and diet. The exercise brings up the HDL and the diet lowers the LDL.
My problem was that, even though I did a pretty good workout three times a week, my HDL didn't respond. I can lower my LDL through diet, and have in the past. But it was such an austere diet I finally gave in to temptation.

Also, when my LDL dropped (like a stone, may I add), my HDL did too. My ratio was not improved. In fact, my HDL dropped to 17. 

For me, it was all of the above. I try to get regular exercise, I watch my diet, but don't go to extremes, and now I am taking Pravachol and Zetia.

By the way, there was a Spanish study, pointed out to me by our Stephen from Down Under, that shows very beneficial results for Hi-fivers on meds using this combo. I will see if I can find it and post it for you.

I wish you the best with this. It is an ongoing source of frustration for me.

HUGS,

Mark

[Lwood]

by odd coincidence I just got back from my latest Dr. visit and Lab results, the main focus of which was my cholesterol levels, after being on lipitor for about  6 months, Im now in the ' optimal ' range for both HDL and LDL  and I haven't had any significant side effects from the Lipitor. however as they say,
" Individual results may vary"  
I was a bit freaked about the possible interaction with my meds, but those scary warnings arent unique to Lipitor.You may want to consider a supliment to boost your HDL, but thats a whole different topic.

[Strayboy74]

Dr. is suggesting Lipitor/Crestor/Pravachol to reduce the number.

This is a gift from my MOTHER's side of the family.  My questions are....

1.  Should I start on the new Statin based meds and burden the ol' liver even FURTHER and continue to eat and not excercise much?
2.  Should I start watching my diet more closely (i dont eat BAD now but i dont eat good either?
3.  Should I start excercising and how much will this help (knowing that i have ADD and cant stick to a plan to save my life)?
4.  Advice on the drugs?  (mom says lipitor is bad in our family, causes major leg cramping and stuff)

Stray?  Aztec?  I know you are brothers in arms with this..... pony up SUCKAS!

My Dear ACinKC... 

Your numbers aren't that bad, except for your HDL (High Density Lipoprotein) - 27?  that really sucks! Especially since 45 is generally considered the low end of good.  I would do more to increase it with exercise.  Cutting fats in your diet would help the most with the LDLs, but read on... Lipids are fats... don't get confused by labels that read "cholesterol free" because they can have trans-fatties and other fats up the wazoo (LIPID=FAT).  And, anyway, for most people, consumed cholesterol isn't as big a deal as consumed fats - which the body PROCESSES into cholesterol and then can't get rid of fast enough.

Your LDL (Low Density Lipoproteins) are on the cusp of bad.  These are the ones that will be effected greatest by diet.  These are also the ones that oxidize with free-radicals and bond to your arterial wall causing arteriosclerosis (sp?)...  leading to heart attacks or strokes. 

I would be happy to have your numbers (except the HDL ).

If you choose to go the medication route, you should talk with your doctor about the following options:

1.  Niacin.  (Flush free is bad because it makes a longer lasting impact on your liver.)
2.  Vytorin or Simvastatin (zocor).  Vytorin is composed of a statin (simvastatin) and also contains a fat absobtion inhibitor (ezetimibe) which keeps your intestines from absorbing as much fat from your diet.  Though it can cause some people to have loose stools.
3.  Ezetimibe.  It, alone can impact your cholesterol, if your diet doesn't change.
4.  Statins. You may not deal with them well based on what you've said.  However, it's possible you may have a different outcome with their use than your family - just watch for the side effects.

The only way you'll be able to get significant increase in your HDL (btw, your HDL numbers really suck! did I tell you that already???) is to increase exercise.  Your other numbers are really at the cusp of being bad, so whatever you HAVE been doing, to positively effect your numbers - keep it up.  And take a children's asprin daily (if not just because they're yummy!).

I also take Milk Thistle as a vitamin supplement - it helps your liver to repair itself.

Oh, quitting smoking would help -- but I know I'm just pissing against the wind here. So... get your ass to the gym!

-joseph

[Strayboy74]

And btw, I'm take 80 mg of Simvastatin, 400mg of Niacin (I itch and turn red like a motherfucker), 2 glasses of red wine, 2 asprin (taken shortly before the Niacin to decrease the flushing effects), and a really fucked-up, fat-selective diet.



-joseph

[bocker3]

Hey AC,

First off -- if you DO smoke, that is probably dragging down your HDL, and like a number of folks have pointed out, that is where you problem really lies.  Your LDL and Total Chol are borderline.  So, stopping smoking would definitely be a BIG positive factor (I could look up in the Smokers thread to see if you've mentioned this, but I have ADD too and.................  well, you know    )  Exercise is also another great way to positively impact your HDL.

I've been on statins for close to 12 years now -- most of that on Zocor, but had to switch to Lipitor when I started the Sustiva/Truvada.  Ironically, I have read that Sustiva can raise HDL and amazingly, mine has gone up from the 40's to the 60's!!!!  I've not had any of the muscle issues and, except for an episode of Hep A, my liver enzymes have always been quite good.

IF you are going to go the statin route, you can always start at a low dosage.  I've seen some posts in this thread with a 80 mg dose -- I would hope your doctor would start you much lower.  I have always taken 20 mg (there may even be a 10 mg dose??).  I also take Omega-3 capsules (get the burp-free type -- for the sake of your lovely wife, who probably doesn't want her man to have "fish breathe").

You have to decide what might work -- if you don't think "behavioral changes" will take, then a medicine is probably the best way to go -- just start low and see how it affects you.

Mike

[Strayboy74]

Oh yeah, and there's a new test called the CRP test that measures your arteries for likelihood of heart attacks or strokes... it's a new test, and many doctors aren't totally aware of it (I insisted that my doctor learn about it).

-joseph

[Strayboy74]

IF you are going to go the statin route, you can always start at a low dosage.  I've seen some posts in this thread with a 80 mg dose -- I would hope your doctor would start you much lower. 

Mike-

I'm an extreme case.   Believe me, I started at the lower doses myself.

-joseph

[ACinKC]

All good advice so far.  I do not REALLY smoke.  Just when I drink which is maybe once a month.

[Queen Tokelove]

My dearest AC,

I'm glad you didn't call my name out for advice on this one cause I really have none to give...   I can only say that I am somewhat in your boat, so I'm definitely feeling you. My problem is my good cholesterol is too low but my bad ones are low too, ain't that a kick in the head! My doc put me on Tricor last week, I don't know much about it but will have to do some research. All I can offer is my best wishes, I hope that is enough.


(who is bummed about now)

[bocker3]

Hey Joseph --

You mustn't be that extreme of a case or they wouldn't be making 80 mg pills!!!! 
I've tested blood samples with total cholesterol results of over 1,000 -- now I have no idea if they were really fasting or not, but even when not fasting that is just way to high!

Oh yeah -- the CRP (C-Reactive Protein) has gotten some "bad press" lately -- i.e. some studies saying that it is not meaningful, but it certainly doesn't hurt to get it done - because the early studies may be right. 

Mike

[Strayboy74]

Thank you for taking my inventory.

-joseph

Dear Mike-

My comment (above) sounded kind of bitchy.

Let me own the fact that I read your response to me in such a way as to make me feel threatened.

Please forgive me.  I'm sorry.

-joseph

OOOPS!  I modified, instead of quoted.     I'm SORRY!   I'm an ASSHOLE.

[whizzer]

The latest and greatest study of C-Reactive Protein (CRP) did NOT show the correlation between elevated CRP and coronary artery disease that they were expecting to see.  So the jury is still out on the significance of CRP.

I would not opt for meds for cholesterol at this point if I were you  (and, apparently, I AM you, or at least close.....my last cholesterol test was 199, but my HDL was 55).  Before starting ARVs my cholesterol was usually around 135, no matter what I ate.  Mine is related to the SQV that I take, I guess I'm one of the 9% that get lipid effects from it.

I have been eating whole grains and fish like crazy since those last results, and doing an hour of cardio every night, in an effort to reduce it.  Oh, and taking fish oil.  And eating a VERY low fat diet.  Hopefully this will work.  I really don't want to take any more pills, dammit.

[Ihavehope]

I was under the impression that Diet and exercise was important when on meds but it sounds like it goes hand in hand for most drugs. I LOVE to eat, as a matter of fact I am a comfort eater, love my Mexican and Italian foods and to let go of most of them will not make me happy. 

If i were to be sensitive to all drugs which ones are less likely to cause problems with cholesterol?

[Queen Tokelove]

"my HDL was 55".... You think that is low, mine is 11...

[aztecan]

Oh Akasha,
I feel your pain, love. I was ecstatic when mine rose to 27!  I thought, "Wow, I must be doing something right."

Of course, the lowest mine got was 17. Your's was 11?

I am learning to close my eyes at the grocery store. Actually, its made shopping easier: I buy eiher fish or boneless, skinless chicken - and of course tofu. The rest of the time is spent deciding on fresh vegetables and fruits (oranges will soon be too expensive, so I'm enjoying them while I can), and whether to buy regular or vanilla soy milk.

I'm upping my trips to the gym to at least four days a week. Maybe that will help. Wanna join me?

HUGS,

Mark

[randym431]

I was on Pravastatin for a month and it just made me feel weird. And I got swollen glands and all kinds of strange things, that my doc said was not, or he never heard of Pravastatin causing that. But I stopped Pravastatin and got back to feeling normal after another month or so. I also have read a few studies that statins can cut the cd4 in half. The doc denies that too, but the studies are out there with those results.

I wonder if high cholesterol is a bad thing for everyone. I actually had that new cat scan test they can do for $200 to detect any buildup of plaque in the veins and my test came back with no plaque detected. Zilch! So I just don’t know what to think or believe.
Its hard to exercise here in the winter (its -2 outside right now). I do lots of biking in the summer, but the winters I just sleep, eat and work.

[Lou-ah-vull]

This has been a recent issue with me too.  Before I started HAART in May 2006, my tri were down to 153 after being on Tricor for a little over a year (they had been in the 400s.)  I have had low HDL ever since testing, never higher than the mid 30s even with regular exercise.  After HAART, I had lipids done in July, 2006 and my trys had jumped up to 480, my total cholesterol up to 224 (it had never been higher than 150), my HDL was 37 and my LDL was 91. Go figure!

I still take Tricor once a day, but did not switch to a statin because of interactions with my PI (Kaletra.)  I am getting ready to do blood work (including lipids) again this month.  I know I am going to have to do something if the lipids keep rising.  My diet could be better, but it is not awful...I am somewhat pessimistic that diet and exercise are going to make that significant of a change for me. 

I guess we will all figure this out together!  I continue to read others' posts on this subject with great interest.

Gary

[ACinKC]

Ok can someone explain the relationship of LIPIDS to this debate?  I am assuming that LIPIDS are cholesterol   ie. the HDL LDL Total # type thing.... is that right?

If so, can the Atripla im on cause a deviation in those numbers?  And should i consider a med switch to help?

[bocker3]

Hi AC,

I was told, when I started with Sustiva/Truvada, that Sustiva can cause a slight raise in Chol, but it can also raise HDL (a good thing).  It seems that Sustiva is less problematic to lipids than most of the PIs (except for Reyataz, but if you boost it, the Norvir can impact chol & triglycerides).  People are using the term "lipids" much more frequently now vs. Cholesterol.  LDL stand for Low-Density Lipoproteins, HDL = High-Density Lipoproteins and VLDL is Very Low-Density Lipoproteins. These all "add up" to your total cholesterol level.

You might want to talk with your doctor about switching, but really, other than your HDL, your results aren't really all that bad (they could be better, but my total chol was closing in on 400 and my LDL was well over 275 when I started on statins -- Long before I had HIV).  If this was the first time that you've had results like this, I would definitely not change anything without a repeat -- make sure that you fast for 12 hrs, nothing but water and/or black coffee.

Hope that helps.

Mike

[ACinKC]

Thanks mike.

[bocker3]

I almost forgot.....   I was also told that Tenofovir might have a positive impact on cholesterol.

Of course, everyone can react differently to these drugs.

And -- you are very welcome AC!!

Mike

[Eldon]

AC,

You are healthy as a thoroughbread horse! Congrats!

[Strayboy74]

http://www.medicinenet.com/script/main/art.asp?articlekey=23820

This is another great link describing the various fats and how they affect cholesterol - The good fats and the bad fats... 

This should really help you out, queen.

-joseph

[bear60]

AC.......My partner Kurt had worse numbers than you.  He has been on a diet and taking Lipitor.  His numbers were good after a year. Diet helps a lot but it seemed to take that extra help from Lipitor.