LDL Colesterol 4.56, Statins or Lifestyle?
LDL Colesterol 4.56, Statins or Lifestyle?
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Discussion

BikeBikeBIke

Original Poster:

14,631 posts

145 months

Wednesday 9th September
quotequote all
My LDL is 4.56, target is 2.5.

Nurse said I can try lifestyle changes for 2 months and then start on statins if that doesn't work. (I've made some useful, sustainable, changes in reponse to the test, but I've been living like a monk since 2018 so there are limits to what I can do in terms of lifestyle. I'm active in general and run 5k a couple of times a week.)

Google says there is 0% chance of my getting down to 2.5 with lifestyle changes alone. 15% is the top end.

Given I'll be on statins anyway, should I call the doc and ask them to put me on statins now? Or wait the 2 months.

Any risks or downsides to statins?

(Yes, I've asked AI, but I suspect PH will know better.)

grumbledoak

32,571 posts

263 months

Wednesday 9th September
quotequote all
I would certainly try the lifestyle changes first.

Statins have been among the most profitable drug classes in pharmaceutical history. Although generics now, lowering the guidelines and prescribing them to ever more people keeps profits high.

They can and do have nasty side effects. Those get minimized by the doctors and blamed on anything else. You will have to see for yourself.

There are specific benefitting groups, e.g. secondary prevention - men who have had a previous heart attack.

Outside those groups the absolute risk reduction is way less than you would guess. It is possible to have nasty side effects for years and live only a couple of days longer.

Number needed to treat / NNT is over 100. They are playing the odds by medicating everyone. That makes someone a lot of money, of course.

Go read more. And try lifestyle changes

cliffords

4,493 posts

53 months

Wednesday 9th September
quotequote all
I would really take specific medical advice and whatever you do ignore anything written on here in terms of medical advice or other people's experience of using the drug .
It's a balance of all factors for you personally. This includes your own health and family history.

No-one writing on her knows your medical history nor has examined you and spoken to you in detail.

Derry Rhumba

354 posts

21 months

Wednesday 9th September
quotequote all
grumbledoak said:
I would certainly try the lifestyle changes first.

Statins have been among the most profitable drug classes in pharmaceutical history. Although generics now, lowering the guidelines and prescribing them to ever more people keeps profits high.

They can and do have nasty side effects. Those get minimized by the doctors and blamed on anything else. You will have to see for yourself.

There are specific benefitting groups, e.g. secondary prevention - men who have had a previous heart attack.

Outside those groups the absolute risk reduction is way less than you would guess. It is possible to have nasty side effects for years and live only a couple of days longer.

Number needed to treat / NNT is over 100. They are playing the odds by medicating everyone. That makes someone a lot of money, of course.

Go read more. And try lifestyle changes
Great advice.

OP, you need to fully research statins and I just don't mean what the MSM peddle, try and dg a bit below the surface.

I am on medication for HBP, have borderline cholesterol issues and yet I wouldn't touch statins with a bargepole.

Good luck. smile

BikeBikeBIke

Original Poster:

14,631 posts

145 months

Wednesday 9th September
quotequote all
cliffords said:
I would really take specific medical advice and whatever you do ignore anything written on here in terms of medical advice or other people's experience of using the drug .
It's a balance of all factors for you personally. This includes your own health and family history.

No-one writing on her knows your medical history nor has examined you and spoken to you in detail.
I take your point but the nurse prescribing these things is putting near 0 thought into it. As all things health related in this country you really have to work this stuff out for yourself.

Another issue is WTF is medical advice? I can think of 5 medical issues I've had first hand involvement with where the doctor wouldn't give any advice. Ive pleaded with them to give me a clue what's best. I had (on the spot) to make a decision between options I had no knowledge of. - This latest encounter is a classic example. I had to choose on tbe spot between statins and lifestyle with no clue about the pros and cons. My bias is against meds so I chose lifestyle, then I came home to google and it turns out lifestyle is going to achieve nothing.

Anyway, thanks all. Sounds like waiting 2 months and seeing what giving up the last remaining of life's pleasures will achieve is the way ahead. Meanwhile I'll try to read up.

bigpriest

2,543 posts

160 months

Wednesday 9th September
quotequote all
Medical advice is based on the guidelines and payments that GP practices are contracted to provide. Cholesterol control and statin prescribing is linked to patients with CHD, PAD, Stroke/TIA or CKD.

See page 14 onwards for the disease registers and requirements. Points equal prizes.

QOF

Derry Rhumba

354 posts

21 months

Wednesday 9th September
quotequote all
@BikeBikeBike......you are spot on the money bud, "medical advice" is a redundant term in he west now, it is basically the vested interest of Big Pharma masquerading as independent advice.

Modern medical interventions are driven by algorithms and so called pathways; you are 100% correct....you need to work it out for yourself.

Again, good luck.

JimPD

115 posts

151 months

Wednesday 9th September
quotequote all
Google Dr Malcolm McKendrick, a UK Doctor who has written extensively on the subject despite the 'establishment' view.

e.g.: His book:- The Great Cholesterol Con

He also has a long-running Blog to work through which has a lot of relevant articles.

Then make your mind up.

My experience: moderate cholesterol, prescribed statins (10 years ago), experienced severe pain in lower back & legs, stopped taking statins, pains stopped, still here!



J


DT1975

1,504 posts

58 months

Wednesday 9th September
quotequote all
Last month

Serum cholestoral 6.5
HDL 2.46
LDL 3.7

No statins required after I gave BP results, resting HR (40's) , weight and height plus exercise regime.

In 2024 thise figures were 7.1
2.11
4.4

So back then I asked if i could make lifestyle changes but its wholly come down to diet. I didn't really change anything until 6 months ago when I cut out all processed crap and more importantly addressed my late night sweet tooth choccy / biscuit craving. I'm sure those figures will continue to drop as I've lost 10 pounds in the last 3 to 4 months.

the-photographer

5,179 posts

206 months

Friday 11th September
quotequote all
BikeBikeBIke said:
My LDL is 4.56, target is 2.5.

Nurse said I can try lifestyle changes for 2 months and then start on statins if that doesn't work. (I've made some useful, sustainable, changes in reponse to the test, but I've been living like a monk since 2018 so there are limits to what I can do in terms of lifestyle. I'm active in general and run 5k a couple of times a week.)

Google says there is 0% chance of my getting down to 2.5 with lifestyle changes alone. 15% is the top end.

Given I'll be on statins anyway, should I call the doc and ask them to put me on statins now? Or wait the 2 months.

Any risks or downsides to statins?

(Yes, I've asked AI, but I suspect PH will know better.)
4.5 is a bit high, you might want to ask for a hypercholesterolemia test.

Definitely the diet and exercise for a couple of months and then retest.

Otherwise there are statin alternatives like ezetimibe which use a completely different mechanism, but the stats suggest you won't notice anything on 10mg atorvastatin, and get the benefit of its cardiovascular protection.

alfa aficionado

146 posts

153 months

Friday 11th September
quotequote all
It s not so much what your figures are but what your cardiovascular risk is - this takes into account additional factors such as family history, BP, smoking, weight etc. Main one used in the UK is the Qrisk3 score. It used to be that statins were only recommended if your score was >20% but this was later brought down to offering them to anyone with a score >10%.

The numbers needed to treat depend upon the individual s risk, e.g. the NNT are much lower if you have a higher risk score. The NNT, for primary prevention (ie trying to stop you from having a heart attack or stroke or needing to have a stent) are fairly high if your risk is low, e.g. at 5% the NNT could be >100 but if your risk is 25% then the NNT could be as less than 20.

Edited by alfa aficionado on Friday 11th September 23:14

irc

9,868 posts

166 months

Saturday 12th September
quotequote all
JimPD said:
Google Dr Malcolm McKendrick, a UK Doctor who has written extensively on the subject despite the 'establishment' view.

e.g.: His book:- The Great Cholesterol Con

He also has a long-running Blog to work through which has a lot of relevant articles.
I have read his blog and have the book. His arguments make sense to me though I am not medically qualified. I am 65 and not on any medication. After nagging from my other half I went to my GP for a checkup a year ago as one of my siblings has high cholesterol. As it happens mine was high end of normal as was my BP. My GP did not suggest statins.

My Q risk was 11% so borderline as per guidelines but I would be inclined to avoid statins as people I know have had side effects.

Interestingly, Dr Kendrick successfully sued the Mail on Sunday for libel when they (paraphrasing) called him a quack.

The journalist concerned was being fed information by prominent figures in the statin establishment who also (as proved by emails) checked his article before publication and suggested edits. This does not seem like independent advice to me.

.https://brokenscience.org/kendrick-harcombe-trial-the-conspiracy/

The journalist concerned seems to have gone into it without an open mind. He wrote

" ‘we’re planning a big takedown of statin deniers.’

And at one point in the planning stages wrote

‘I must admit I have not read Malcolm Kendrick’s book."’

In court he also admitted he had not read any book or paper Kendrick had written.

Seems to me if you want to criticise something you might at least read it first.

https://drmalcolmkendrick.org/2024/12/05/finally-t...