To statin or not to statin?

[TheWolvesAreRunning]

My age 50 health check has revealed high cholesterol. I really don’t want to start on medication this young so would be grateful to hear thoughts/experiences…

total cholesterol 6.9
ldl 4.2
hdl 2.4
triglycerides 0.64
hdl/ldl ratio 2.9

i am otherwise fit and healthy… bmi 20.5, good bp, non smoker, largely Mediterranean diet, walk lots & do yoga. Q risk was 1.7. In peri menopause, 6 mths since last period.

there is some family history but only heart attacks have been aunt/gp, both heavy smokers and poor lifestyles.

i would like to try lifestyle approach - oats, plant sterols, increased cardio - for 3 months and retest. Does this seem reasonable?

My DH is on statins. His cholesterol was the same as yours. Lifestyle approaches and supplement recommended by the doctor didn't help. His cholesterol has come way down with the medication.

I am 62 been on statins for over 10 years, I tried dieting, cutting out bad food etc., but levels didn’t really budge. Both my parents had heart issues, so it seems sensible to take them for me, DH levels were 5.1 one month before he had a heart attack and he’s on a high dose statin for life.

Interesting background info on the role/risks of cholesterol, if you have the time.

I wouldn't take a statin with a QRISK3 of 1.7 unless I had a really compelling family history of heart attacks and strokes at an early age.

Wasn't there a big Scandanavian study that showed for women there wasn't any benefit (in terms of risk of heart attack) to taking statins? Different for men though. I may not be remembering this completely accurately, but worth looking out the study.

Also, how was your thyroid function looking? As thyroid dysfunction has an effect on cholesterol levels (some GPs know this, and some don't).

I’m a fair bit older than you, my cholesterol is marginally higher and less well balanced, my qrisk is higher. But my gp doesn’t offer statins until qrisk is 10% - has yours suggested statins?

Didn't have time to find the study, but a very cursory Google found this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1867901/#:~:text=A%20meta%2Danalysis%20published%20in,heart%20disease%20events%20in%20women.&text=Of%20greater%20concern%20is%20that,in%20both%20men%20and%20women).

In my 60s My cholesterol hasn't shifted from around 6.7 for the past 5 years - No family history BMI, BP fine - non smoker, don't drink. Good diet. My Qrisk is 7.5% but my GP said statins advantages outweigh any disadvantages. I've started them this week and have a 6 month review for blood tests etc.

DP stopped taking statins due to the joint side effects he was experiencing- his body his choice. DM takes hers but has constant sore legs.

My mum (late 80s now) developed liver issues and diabetes after being on statins for 30 years. The liver issues sorted out shortly after she stopped them - after a bit of a row with her GP. He did some research and discovered that yes, they can cause both.
Unfortunately her diabetes is bedded in now, so she’s on meds for that after managing by diet for many years.

Dad went on them too. He changed a lot right after - seemed more lethargic, depressed. But he died a couple of years later from a stroke. I don’t think there was a connection because he had something else going on that may have contributed to his early demise.

I’d not take them, regardless.

When he was in his early 50s my DH had a similar result to yours and statins were recommended. He told the GP he'd like to do what you suggest (3 months of very healthy living, (oats, plant sterols, increased cardio etc) for 3 months and retest.

She was insistent that it would make no difference, but he persevered. Upped his exercise, concentrated really hard on reducing stress, benecol stuff, gave up alcohol and caffiene, lost weight - the whole nine yards.

Three months later he was retested and his cholesterol levels were absolutely normal. The GP was astonished and said it was something she never saw happen. I wonder if lot of people don't completely throw themselves at the changes they need to make and that it is possible to change your cholesterol levels (in some cases) if you really try.

Some medications mess with your cholesterol levels e.g. Citalopram. If you're taking other medication might be worth looking into that.

My cholesterol was high sorry can't remember the number but the doctor took a family history from me . My dad was super fit, playing football several times a week but he had a heart attack at 42. He survived but did have problems with heart failure later on in life and died youngish. The doctor felt my cholesterol was genetically high so diet etc would only make a marginal difference so recommended statins.
I was worried about taking statins as I have osteoarthritis and read that statins can cause joint pain, something that I wasn't short of already. But I took the doctors advice and I did have additional pain somewhere new ( my arm's bizarrely) but my system quickly got used to it and now my cholesterol it's under control .

I have FCH and have been on statins for years with no problems. I am also on two other drugs as my cholesterol level untreated is very high and still high on statins alone. A couple of years ago after a bit of pushing and following my mother's death (cardiovascular) I was genetically tested and I have a faulty gene and unable to breakdown cholesterol. My child was also tested and fortunately I haven't passed this on, had a 50/50 chance. Many other family members have raised cholesterol levels. I do yet the impression the genetic problems are more common than people realise.

Read Dr. Malcolm Kendrick on cholesterol. I wouldn't touch them.

I read this.
I find the whole issue very confusing, as on one hand we’re told (by people like Kendrick and Zoe Harcombe and many others) about the bad science behind cholesterol, but at the same time the NHS is totally wedded to cholesterol = bad even when there’s very contradictory evidence.
Both my parents have recently come off statins to see if it helps with their mobility and confusion issues, which could both be simply down to old age.

Get them to talk to the pharmacist about water based Statins which are more expensive but have fewer side effects like cramps and joint pains. I refused to take the ones the GP first prescribed but the pharmacies happy to swap me over , I take one 3x a week.

I was on statins for years, despite my initial cholesterol reading being 5.2! I came off them last year, as I was suddenly experiencing night cramps to the point of sscreaming.
Cholesterol naturally dips and rises, depending on when the test has been taken.
I'd never take them again.
It's slightly odd that when I went on them, the GP had pens, note block, mouse pad and a mug, all advertising that particular medication, on his desk... 🤔

I'm on a statin now because i have heart disease, but between learning my cholesterol was 7.3 (having jumped to that from 5.5 a year before) i happened to have to undergo a very strict low fat diet because of gallbladder issues. It had lowered to 6 within a couple of months, but then i got the heart diagnosis so started on statins. You could try the very low fat diet. It's all fat below 3% and sat fat below 1.5%. It's hard, and if i didn't have the gallbladder pain to frighten me i would have struggled, but your motivation, a healthy heart, might also be all the inspiration you need.

Thank you for all the feedback, it’s so helpful. Speaking to a doctor later this week but the nurse suggested I’d be offered statins if my levels were higher than 6 so I want to be prepared.

My GP mumbled something about statins a good decade ago. I asked him about evidence and he gave a twisted smile and said there wasn't anything conclusive but some patients just like to have something prescribed.

Goodness.

I’ve been offered them but have refused. There is evidence that statins increased the risk of diabetes - I think especially in non overweight women. I’m far more worried about T2 diabetes which I’m at higher risk of as I have PCOS and had gestational diabetes, than about heart issues/stroke (no family history at all).

I also have hypothyroidism- didn’t realise there was a link with cholesterol. Interesting.

I’ve also lowered my cholesterol naturally - not by a low fat diet (I eat a lot of fat…) but by upping my exercise from zero to quite a lot.

I’ve got high total cholesterol- it went up from 6.5 to 8.1 in 5 months last year, which seems a bit odd

I am not overweight, relatively fit (training for a half marathon, VO2max of 41) have been vegetarian for decades but don’t have much dairy, don’t drink or smoke or have caffeine, don’t have junk food or a lot of sugar, no history of familial heart disease. I am peri/menopausal though which I know makes your cholesterol rise and I’m also going to get my thyroid checked.

I am very hesitant to take statins as I don’t think the evidence is conclusive.

Back in October my results were very similar to yours OP, I'm early 40s, healthy BMI, don't smoke or drink, don't exercise as such but walk everywhere. However I had some bad habits, I eat a lot in general and a big part of that was full fat cheese, full fat yoghurt, mayonnaise, butter... I decided to change my diet and eliminated most of the above, had Benecol every day too. Retested in February and total cholesterol was 4.3 with a big change in LDL. If you can identify bad eating habits like mine then I think it's definitely reasonable to try to change those first and retest in 3-4 months. Good luck!