DEAR DR. GOTT:
I have had a high cholesterol level for several years. As a 67- year-old female I try to eat responsibly and really feel my condition is hereditary since my two sisters have the same problem. Whatever the cause, my doctor put me on Vytorin to help lower my levels. Is he on the right track and should I go along with his recommendation or is there something better out there to get my levels under control?
DEAR READER:
Vytorin contains ezetimibe and simvastatin, two compounds designed to lower cholesterol levels. Its purpose is to lower total cholesterol and low density lipoprotein (LDL) levels while raising high density lipoprotein (HDL) levels.
The manufacturer warns that all individuals who are prescribed Vytorin and experience muscle pain, tenderness and weakness should report that information to their primary care physicians.
Now comes the questionable news release on this product. The FDA has announced it will begin an investigation of the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) trial because of the possibility of users experiencing an increase in the occurrence of cancer. The trial was designed to determine if a combination of the two ingredients could reduce cardiovascular events in patients with a diagnosis of aortic stenosis. Preliminary data showed the trial did not exhibit any benefits but it also revealed a larger percentage of those treated with Vytorin were diagnosed with and died from various forms of cancer. The trial was done over a five year period and showed a greater incidence in the Vytorin group as opposed to the placebo group. Despite the preliminary report, it is anticipated to take another six months for completion of the investigation. I am sure full disclosure will follow.
The FDA is also investigating two other ongoing trials of Vytorin, specifically the Study of Heart and Renal Protection (SHARP) and the Improved Reduction in High-Risk Subjects (IMPROVE-IT). To date there are no reported cancer risks associated through these studies. Keep in mind, however, that the SHARP trials will be completed in 2010, and the IMPROVE-IT in 2012.
You did not advise me what your levels are and I am therefore reluctant to recommend something different. It would depend on whether you have any cardiac abnormalities or other diseases, if your levels are minimally or overwhelmingly high, if you have modified your dietary intake and increased your level of exercise, and more. Perhaps an over-the-counter medication such as Cholest Off taken in combination with 1000 mg Flax Seed capsules would be a possibility. Statins always have the risk of affecting the liver. Red Rice Yeast, an over-the-counter supplement used by some individuals to lower cholesterol levels, is a naturally occurring statin drug similar to Mevacor.
Armed with my response, you should return to your primary care physician for his or her input.
To give you related information, I am sending you a copy of my Health Report “Understanding Cholesterol”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
About Dr. Gott