I formerly was walking two miles a day; now I can barely walk a half-mile, and that is with stops. I have tried niacin and red yeast rice. I am currently taking omega-3 and flaxseed-oil capsules.

I am 5 feet, 2 inches and weigh 168 pounds. I am careful about my diet. I feel good and energetic when not taking a statin; however, I’m lethargic when taking the drug. I’m afraid to quit but am truly miserable, so which is the lesser evil? I truly do not know what to do.

DEAR READER: Statin drugs work well, but for some people, the price is high. This poses the question of whether the benefits outweigh the risks. No one wants to suffer a heart attack or stroke, nor do they want unpleasant side effects such as those you have experienced. The answer should be a decision between a patient and his or her physician. That said, there might be alternatives. First, however, let’s hit some possibilities.

You can lower the dose of your medication. This may reduce or eliminate the leg cramps and fatigue but may also reduce the effectiveness of the statin. You can change to another label; however, this might not be successful. You have already cut back on your exercise routine, so I can’t endorse a further reduction. While some researchers question its effectiveness, you might consider ezetimibe, a prescription cholesterol-absorption inhibitor, or you might try an over-the-counter with natural plant stanols and sterols. You don’t indicate if the niacin was at all effective. Did you give it a try for a satisfactory length of time?

If you smoke, discontinue the habit. Eliminate fried foods, the skin on chicken and the fat on steak. Broil meats, and be sure to cut off any excess fat prior to cooking. Continue to exercise and modify your diet. Eat more fruits, vegetables, whole grains, fish and chicken. Limit the amount of cheese and eggs you consume, and switch to fat-free milk.

Ask your physician if he or she would consider an appropriate length of time so you can initiate a new diet and exercise plan. Perhaps a referral to a nutritionist and the physical-therapy department of your local hospital will be appropriate. Consider an OTC that doesn’t contain a statin component.

Ask your physician or specialist for advice on treating your leg cramps. If an underlying cause, such as iron deficiency or peripheral neuropathy, enters the equation, obtain appropriate treatment. Then consider ibuprofen, meditation, yoga and warm or cold packs. Avoid caffeine and alcohol. Place a bar of soap under your bed sheet to alleviate cramping. Exercise, but don’t overdo it, because fatigue will make your symptoms worse.

To provide 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 No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

He is 41, in great physical shape, has high triglycerides and takes several medications (Niaspan, half an 81 mg aspirin, and Pravachol). He also has borderline hypertension that he is trying to control with diet.

The sweats happen whether he takes his medication or not. They seem to appear more on days when he has exercised very hard. Is this a sign of some type of health problem? What can he do about it?

DEAR READER: I’m not certain that your husband’s medications are to blame as a cause for his night sweats. Niaspan (prescription niacin) is known to cause flushing, sweating, chills and more. Side effects generally decrease after three to four weeks of therapy, however. Sweats can also, rarely, be a symptom of hidden infection.

I recommend that your husband be examined and tested by his primary care physician. While awaiting his appointment, he may wish to discontinue the Niaspan temporarily . He should continue the Pravachol, however. If this simple remedy stops the night sweats, his physician can forego the testing and take him off the Niaspan. Your husband may wish to try some other alternative therapy such as Omega 3 or Flaxseed oil in conjunction with the Pravachol. If the night sweats continue, your husband should then follow through with an exam and testing by his primary care physician.

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.

DEAR READER: There are several issues here.

First, Fosamax is a drug used to treat osteoporosis, an age-related bone softening condition, NOT high cholesterol.

Second, if your triglycerides have been high, the nurse’s diet is not an appropriate choice; rather you should avoid dietary fats.

Third, you need to speak to your doctor about a low-fat diet for your cholesterol problem and why you are taking Fosamax. Perhaps there was a misunderstanding about the Fosamax. If you do not have osteoporosis or osteopenia (pre-osteoporosis) you do not need Fosamax and could simply do with calcium and vitamin D supplements. You may also need a cholesterol lowering medication if diet does not lower your numbers.