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High Cholesterol Message Board

High Cholesterol Board Index

I had a cardio-cath in June 05; 40% blockage in Left Coronary Artery - 30% blockage in right coronary artery. Since that scary experience, I've been on a jihad to keep my heart healthy and, if possible, reverse the coronary artery disease.

Was on a program of lipitor (20 mg) and Zetia (10 mg) along with a ton of supplements, vitamins, and anything that even remotely promised to lower LDL. My numbers were pretty good by Oct 06: HDL - 49; LDL - 33; Trig - 33. BUT, my liver numbers weren't good - my October numbers for ALT/AST were 90/88, so my doctor took me off Zetia and told me to get the beer drinking down (I went from 3 six packs to 1 six pack per week). Liver panel in early Dec showed ALT/AST at 39/33, but my LDL jumped to 63 - a 30point increase. I told him I wanted back on Zetia to get the low LDL level back, and I would limit the beer drinking.

Anyway, I'm beginning to think the negative liver result is just not from drinking beer; after all I've been doing that for over 40 years and my routine blood work never showed any liver issues. I suggested to my doctor how about cutting the lipitor to 10 mg and adding Niacin sustained release; he pooh-poohed the idea, saying that won't help things, especially the liver, and the Niacin "flush" will drive me crazy. I'm not sure he's right on this based on what I've read.

Any opinons out there or experience using a mixture of lipitor, Zetia, and Niacin to drop LDL down to low levels? (I would like to keep my LDL at between 45-50 since that is the Cleveland Clinic results in March 06 showed a small regression in heart disease (about 7%/year) for a majority of folks who kept their LDL at very low levels.)


Your blockages aren't all that bad; probably most Americans have blockages at that level especially if they are 40, 50 or older.

Your doctor is're asking for liver damage if you take all 3 meds. Niacin works better for HDL and triglycerides than it does LDL in my experience. I had no problems with my liver function tests on a high dose of Lipitor, but when Niacin was added, they went up...I am continuing to take Niacin only because I have severe heart disease (had a 99% blockage in my LAD that required a stent) and absolutely nothing else will keep my HDL in a normal range.

Zetia works primarily on cholesterol that you eat, so why take a med if you can decrease your cholesterol (i.e. animal based) intake? Have you checked into eating plans like McDougall or Ornish? I could never stick with them 100% but the closer anyone can get to eating as close to them as often as possible, the less you will need any med, especially those like Zetia.

There is absolutely nothing wrong with an LDL of 63...most heart disease patients would kill to reach that level even with a lot of medication. I can't speak specifically about the study you are referring to, but as far as I know the recommendation for people with confirmed heart disease is still LDL below 70 IF they can achieve it, and most can't.

I'm sure there are folks who will come along soon warning of the dangers of extremely low LDL. While I don't necessarily agree with them, keep in mind that our bodies (especially our brains) need some cholesterol. My opinion is you should stick with no more than 1 or 2 meds at most and concentrate on your eating habits and other natural ways of keeping your cholesterol low.
I wonder why they did surgery on you when your blockages were so low???? You might want to read the info on cath surgery (recent). It is titled "New Data will make doctors less likely to perform angioplasty" Most people have no problem with blockages up into the 70's...there is tremendous capacity in the arteries. Looks like some doctor needed some cash. That cleveland clinic study had major flaws in their trials. You ldl was getting way to low. You need to understand that LDL transports cholesterol to the cells in your body. I would research the importance of cholesterol in the body. You liver was suffering, as well as the other cells in your body. If you wern't taking Coq10 you doctor should be fired. But then Zetia stops the absorption of Coq10 as well as other vital number. You might have had low numbers....but your body was suffering. It still puzzles me about your supposed coronary artery disease.... those blockages are just plain normal! By the way, if you have liver problems,, niacin and lipitor don't mix well together.

I would consider staying off the Zetia.

Like Connie said, the primary benefit of niacin is an increase in HDL so with any liver issues, it might not be wise to add to Lipitor. I do both but I badly need the HDL boost; you don't.

I'm surprised that removing the Zetia DOUBLED your LDL. I didn;t realize it was quite so good. Perhaps some of that was coincidence.

All things considered, your 63 LDL is superb and will also slowly reduce the plaque load in your arteries. I'd think it would be IMPOSSIBLE to increase plaque with your current blood lipids.

Eighteen (18) cans of beer per week should be perfectly fine, beneficial even, with just the one drug...Lipitor.
Give up the beer and you're apt to see a significant drop in your HDL.:dizzy:
[QUOTE=eagleheart;2720475]I'd like to thank everyone for commenting on my question. I think the advice is good. I'll try lowering my saturated fat intake for 2 months and review the bidding re: Zetia then. I was under the impression that you needed an LDL of 50 or so to get CAD regression based on the reports I saw in the Washington Post in March last year. It's comforting to know I still have a "good" number for LDL, even at 63. Also, thanks NHone for the tip on angioplasty, and I didn't know Zetia stopped Co-Q10. Yes, I've been taking 2-150 mg tabs per day of Co-Q-10 on my own - doctor never mentioned it.

BTW: To complete the story. I had a Calcium test in 2001; scored a 101. Doctor said no biggie, but eat right, exercise, etc., and we'll check you in 4 years. In 2005, I scored a 336 - he (and I) didn't like the trend. He sent me for a "nuclear" thorium stress test. The films showed my heart was dilating under stress instead of pumping harder. I never felt any pain and had no other symptoms like shortness of breath. Next step two days later: on the table for a cardio-cath for a definitive diagnosis at Walter Reed Medical Center (I'm retired Army). Looking up at the monitor, I asked the doctor what all those lines were - he said plaque, as in 40% blockage on the left and 30% blockage on the right side of my heart. Oh yes, I had a small artery already 90% blocked, but they couldn't do anything with it because they thought the stent would explode it. They said don't worry about it - probably would feel it if it closed completely, since it was "minor." (Military medicine is always logical.)

So ... after that significant emotional event, I lost 35 pounds in one and a half years, take all the meds they prescribe, do a lot of research (and participate in forums with other folks afflicted like I am), spend 5-6 days a week on a stationary bike or treadmill, and ... evidently still eat too much saturated fat and drink too much beer. I'm 60 right now and trying to make it to a second retirement at 67, so I can at least drink the beer!!

Thanks again all!![/QUOTE]

I too was a heavy drinker, until I had a ultra sound done which showed a "mass" on my liver which propmted a CAT SCAN and that showed no cancer of the liver but turned up some ALCOHOL DAMAGE of my liver and was told to stop the booz -- all. Was off the stuff for over nine years and feel great.

Botom line -- I drank ALCOHOL FREE beer and never wished it was the genuine stuff. Try that for a awaile and see how you react I'll bet you will like it as well --- unless you want to get TANKED UP. Try it, you'll like it !!!!!!

I'm now 81 and doing well having a beer or two once a month.

Good health to you.

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