DEAR DR. GOTT: I am a healthy 5-foot-tall, 100-pound, 63-year-old woman. My blood pressure is normal. I eat healthy and generally exercise two to three times per week. My cholesterol is 265, HDL 76, LDL 171 and triglycerides 88. The last time I had it taken was five years ago, and the total was 231 with an LDL of 139. I asked the doctor about taking omega-3 fish oil, and he felt that it only helps the good cholesterol and would not help me. I have been reading about niacin and was going to start taking it, but I am unsure about the dosage and read that you should have regular blood tests when taking it as it can be as harmful as statins. I also tried red yeast rice, but I noticed a few hours after taking it I would get stomach cramps. The doctor also said to watch my diet and eat more fish. I do eat low-fat foods; I am not a fish eater, but I am trying to add more to my diet. My downfall is ice cream once a week. My doctor is giving me six months to try and lower the numbers before starting any treatment.
DEAR READER: I concur with your commitment to appropriate nonprescription methods to lower your cholesterol levels.
Regular blood work (one to two times a year) is recommended for individuals with elevated cholesterol levels, regardless of treatment. This allows the physician and patient to know whether the treatment is working. If the treatment is with statins, the liver must be tested as well to ensure the drugs are not harming it.
As for nonprescription treatments, niacin is an excellent choice. As a start, I recommend 500 milligrams taken twice a day. I recommend blood work four weeks after starting to see whether this level has had any effect. If not, try increasing the dosage to 500 milligrams taken three times a day and then 1,000 milligrams twice a day, having blood work done four weeks after each increase. Be aware that niacin can, in some people cause varying degrees of flushing. Should this occur, stop or reduce your dosage.
If this approach does not work for you, it may be time to consider prescription drugs, such as statins. Recently introduced to the market are drugs such as Vytorin and Zetia, which work in the digestive tract and might be an option for you.
Finally, your consumption of ice cream is acceptable. If you were to have it more than once a week, I would recommend sherbet or sorbet, which contain less fat. In fact, I don't consider your weekly ice cream treat a downfall. Life is no fun if you don't allow yourself some treats — in moderation, of course!
Work closely with your doctor to find a plan that accommodates both his and your requirements. Good luck!
To give you related information, I am sending you a copy of my Health Report "Understanding Cholesterol."
DEAR READER: I concur with your commitment to appropriate nonprescription methods to lower your cholesterol levels.
Regular blood work (one to two times a year) is recommended for individuals with elevated cholesterol levels, regardless of treatment. This allows the physician and patient to know whether the treatment is working. If the treatment is with statins, the liver must be tested as well to ensure the drugs are not harming it.
As for nonprescription treatments, niacin is an excellent choice. As a start, I recommend 500 milligrams taken twice a day. I recommend blood work four weeks after starting to see whether this level has had any effect. If not, try increasing the dosage to 500 milligrams taken three times a day and then 1,000 milligrams twice a day, having blood work done four weeks after each increase. Be aware that niacin can, in some people cause varying degrees of flushing. Should this occur, stop or reduce your dosage.
If this approach does not work for you, it may be time to consider prescription drugs, such as statins. Recently introduced to the market are drugs such as Vytorin and Zetia, which work in the digestive tract and might be an option for you.
Finally, your consumption of ice cream is acceptable. If you were to have it more than once a week, I would recommend sherbet or sorbet, which contain less fat. In fact, I don't consider your weekly ice cream treat a downfall. Life is no fun if you don't allow yourself some treats — in moderation, of course!
Work closely with your doctor to find a plan that accommodates both his and your requirements. Good luck!
To give you related information, I am sending you a copy of my Health Report "Understanding Cholesterol."