Monday, March 22, 2010

Close Encounters of the Statin Kind


Mono Lake from Mount Dana 13,200ft - September, '08
Earlier this year I attended a two hour session at Kaiser on prevention of strokes and heart attacks. The doctor delivering the information was quite passionate about the subject and he delivered good information to the 20 or so attendees, none of whom had had an attack but had lipid levels in the high risk bracket.

The presentation was followed by a one on one session with a team of residents. With printouts of my blog and the statistics that you have all seen in hand, I spoke with a resident. He quite appreciated that I had titrated niacin and EFA dosage to achieve the necessary results and encouraged me to stay the course. Before I left he suggested we both have the doctor review the recommendation.

In less than a minute, the presenting doctor dismissed the resident, glanced at my chart and pointed out my peak HbA1C at 6.4 (from Feb, 08) and LDL 159 (from Nov, 07) - and proceeded to prescribe 40mg/day of Lipitor suggesting that I achieve an LDL level below 100. I offered to try to achieve that level using niacin, to which he said, "You'll have to take 7 gms/day to get to those levels."

"Great, I'm happy to do that!" I said, causing him discernible aggravation. 

"No, you should treat yourself as a diabetic and aggressively take Lipitor to bring your LDL down below 100. If you want, you can start with 20mg/day." he said. 

"What's the smallest Lipitor tablet?" I asked and with a little more discussion and I negotiated him down to 10mg/day. With prescription entered on the system, I left.

I emailed my primary care physician, reviewed the interaction and right away he had the Lipitor prescription canceled and encouraged me to continue with my regimen.

Statin mongers are everywhere - if you've experienced an episode, statin is a blessing so that lipids can be quickly controlled. You must follow your doctor's recommendation. If however, you've caught the symptoms early, get on the diet + exercise + EFA + niacin regimen in consultation with your physician to avoid having an episode before you start on a statin regimen - give yourself a chance. You can always fall back on statins.

As corroboration that this statin-free regimen works, look at a good friend's lipid chart below. His numbers are heading the right way after only 4 months on the diet-exercise-EFA-niacin regimen! It works!!
Final word: get a handle on your lipid statistics - get tested every six months, more frequently (every 3 months) if your plan will allow it, especially when getting started. Getting blind-sided thinking all is well when it really isn't would not be a good outcome.

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