DEAR READER:
Lipitor has been connected with severe leg cramps and pain that can appear anywhere in the body, but most commonly in the calf muscles that are used so often.

Co-Q10 is a naturally occurring enzyme in the body. Reports have revealed a deficiency of more than 50% in less than a month by those patients on Lipitor. The deficiency causes pain. Therefore, I recommend you purchase Co-Q10 over-the-counter and continue the reduced dose of Lipitor. Bring my recommendation to your physician’s attention for an opinion.

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.

In 2002 my doctor put me on Lipitor. At the time my cholesterol readings were: total 143, HDL 43, LDL, 87, triglycerides 63 and ratio 3.3. Now my readings are: total 93, HDL 45, LDL 39, triglycerides 45 and ratio 2.1.

I have done a lot of research and feel I should not have been put on Lipitor. I am now concerned that my very low cholesterol levels may be dangerous. Can the Lipitor and low cholesterol have caused damage to my body?

DEAR READER:
I do not know why your doctor would have put you on a cholesterol lowering medication with your 2002 numbers. Your numbers were even below levels recommended by cardiologists for patients with a history of stroke and heart attack. They were way below recommended levels for average people.

Lipitor is a powerful medication and should only be used to lower cholesterol in people who do not respond well to dietary modifications and exercise or have had a heart attack or stroke. It should not be used to prevent these conditions.

Low cholesterol can also cause problems. Some studies done in Europe have shown that men are at increased risk of depression and suicide from cholesterol levels that are too low.

Return to your doctor and demand an explanation about why he put you on the Lipitor. In all likelihood you can safely stop the medication. Thanks for writing and let me know what happens.

After doing another internet search, this time on TGA episodes, he found that some people (including a retired NASA physician) think that there may be a connection between these episodes and statins. (He also discovered that red yeast rice is a statin.) He also found, after talking to one of his sisters who takes statins, that she has had as many eight TGA episodes. On several occasions she had to be taken to the ER but the connection with the statins was never brought up and she was never told to stop them.

My husband has since decided it best to avoid all statins, despite a family history of cholesterol problems. Given his past experience and that of his sister I cannot blame him so we are working together to modify his diet. We have read your cholesterol newsletter and while he isn’t totally inline with it, he is close and eats oatmeal, grapefruit and bananas on a daily basis. He will have his cholesterol tested in a few weeks to see if it is working. Oh, and he is lactose intolerant so high fat diary products are very easily avoided.

DEAR READER:
Transient Global Amnesia is a sudden and temporary episode of memory loss. It is not associated with any neurological condition. During an “attack”, the sufferer’s ability to recall recent events disappears. They do not know where they are or how they got there and in some cases the individual cannot recall events from a day, month or even a year ago, yet they remember who they are and recognize family and long-time friends.

During an episode it is important to get the individual to the hospital to rule out other causes of amnesia, such as epilepsy, stroke, or transient ischemic attack (TIA or mini-stroke). Transient Global Amnesia doesn’t appear to have any lasting complications but can cause plenty of emotional distress so after an episode it is important to relax.

Nearly half of all TGA episodes occur immediately after physical or emotional stress such as sudden immersion in hot or cold water, medical procedures (such as angiography), strenuous physical activity and more. Individuals who suffer chronic migraines and are between the ages of 56 and 75 appear to be at a higher risk.

That being said, both you and your sister appear to have had similar effects of TGA episodes after taking statin drugs. While medical science may have no answer for this, it is likely that there simply are not have enough reports from consumers to warrant further testing. The medical community can only know as much as drug manufacturers and scientists tell us and if they have failed to research properly these complaints or have simply not informed consumers of this possible side effect, then shame on them.

In my opinion your husband is taking appropriate steps. If diet alone does not work (which is likely because there seems to be a genetic predisposition) I recommend he try omega 3 oil, flax seed oil, or niacin. He still needs to have his cholesterol tested regularly to determine if his modifications are working. Niacin can have the uncomfortable side effect of flushing and can raise liver enzymes (rarely) but can be used in lower quantities (to reduce side effects) in conjunction with either or both of the oils. Be sure to inform your husband’s doctors of any and all changes and medication (even over-the-counters) he is taking to ensure he has proper testing and follow-up.

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:
Niacin is an excellent alternative choice for lowering cholesterol levels. I often recommend patients to start with a relatively low-dose of 250-500 mg daily and then slowly work up to 1000-1500 mg daily, usually in increments of 250 mg. This is primarily to allow the body to become accustomed to the vitamin and reduce the chance of side effects, namely, flushing.

It is important also to have your cholesterol level checked every few months, as well as liver function, to ensure that the medication is working and not causing any damage.

Some individuals are very sensitive to the medication and cannot tolerate it well. For these individuals, I recommend omega-3 oils or flaxseed oil. These do not, to my knowledge, have any side effects but cholesterol testing is still important to determine if the medication is working. If that fails, try combining therapy such as niacin and flaxseed oil daily. This can also reduce the dosage of the niacin leading to a smaller incidence of side effects.

As for red yeast rice, I do not recommend it because it is basically a natural form of the drug Mevacor which is a statin. It is more likely to cause side effects similar to those of other statins, such as muscle/joint pain and liver damage.

To give you related information, I am sending you copies of my Health Reports “Understanding Cholesterol” and “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure mention the title.

DEAR READER:
Lipitor will work the same regardless of what time of day it is taken or even if it is taken with or without food. In my experience most physicians recommend some medications be taken in the morning and others at night simply to reduce the number of pills taken simultaneously and to reduce the chance of drug interactions. If your physician has said you can safely take the Lipitor in the morning, I recommend you take his advice. If that fails to stop the sleeplessness, perhaps you could successfully be switched to another cholesterol lowering medication. You may also choose to try other treatments such as omega 3’s, niacin or flaxseed oil. Ask your doctor about this.

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.

DEAR READER:
Statin drugs are effective in lowering cholesterol levels and reducing the risk of heart attack and death in patients with known coronary artery disease. Lipitor (atorvastatin), Lescol (fluvastatin), Mevacor (lovastatin), Pravachol (pravastatin), Zocor (simvastatin), and Crestor (rosuvastatin) fall into the statin category. If you are on any of these medications, you are taking a statin.

The most common side effects are elevated liver enzymes and leg cramping. If you are on a statin, your doctor should schedule periodic laboratory testing to determine if your levels are within normal limits. If the cholesterol level remains high despite the medication or the liver enzymes start to rise to dangerous levels, he or she will likely make a determination to change to another drug that will be more effective.

I don’t wish to be offensive but it is just plain foolish to be taking any drug without knowing what it is, why you’re taking it and how long. It is also important to know if it should be taken with food or on an empty stomach, if there is an equally effective yet cheaper generic brand and what the consequences might be if you miss a dose. Because statin drugs can have serious side effects, it is often necessary to undergo a trial period of two or three weeks to determine if you can tolerate it. Diet modifications must be made before any cholesterol-lowering medication is prescribed. A low fat, low salt diet may even eliminate the need for statins and should be continued once you have been diagnosed with elevated cholesterol levels.

I urge you return to your primary care physician with a list of questions. Take a spouse, relative or friend with you if you wish. Two heads are often better than one when it comes to remembering important information. You owe it to yourself to be an informed consumer and your doctor owes it to you to explain why he or she is recommending you subject your body to medication.

To give you related information, I am sending you a copy of my Health Report “Consumer Tips on Medicines”. 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.

He is 57, has had two heart attacks but is now healthy and has a low blood pressure. He is on Zetia, Benecar, Lipitor, aspirin and Effexor.

His problem is that when he lies on his left side, he hears a pulsating blood flow noise in his right ear. It has the same timing as his heart beat. If he turns his head to the right or lies on his right side the noise stops. Occasionally it happens while he is standing or sitting upright. It is not debilitating but is very irritating to him. If he presses on the carotid artery, the sound stops but resumes once he releases the pressure. He cannot remember if this started before or after his heart attacks.

His hearing has been checked and is normal.

We would both appreciate any suggestions you may have. He claims he will even sleep with a bar of soap under his neck if it will help.

DEAR READER:
A noise in the neck that stops when pressure is applied to the carotid artery suggests that there may be blockage in that artery.

This possibility can be very dangerous. If left untreated, the blockage will get larger and may severely reduce or stop blood flow through the artery. A piece may also break off and be carried to the brain where it could lead to stroke.

Therefore, I recommend that your husband ask his physician to order a carotid ultrasound. It is safe and easy. This will diagnose a blockage if one is present.

If, as I suspect, your husband has a blockage, treatment will depend on the severity. He will most likely need to start anticoagulant therapy such as warfarin (Coumadin). He may also benefit from a procedure called angioplasty that uses a balloon-like device to break up the blockage and restore blood flow.

Your husband’s cardiologist is the best source for more information about causes and possible treatment options. I suggest you start with him or her and bring along a copy of my response to your letter. Let me know how this turns out.

To give you related information, I am sending you copies of my Health Reports “Coronary Artery Disease” and “Stroke”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 FOR EACH report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

I take Lipitor for high cholesterol and high triglyceride levels and would like to try this approach. However, since niacin can cause side effects, I don’t want to try it until I know it will not adversely interact with the Lipitor. Any thoughts on this?

DEAR READER: Don’t make any changes in your medication unless your doctor has approved of them. Niacin doesn’t work for every body and it has the unpleasant side effect of flushing. Non-flushing niacin does not produce the flushing but may not have the outstanding results of standard niacin.

There are no harmful drug interactions between Lipitor and niacin (a vitamin) to my knowledge. You could certainly try the combination, but — once again — run this by your primary care physician. He or she may prefer you stop the Lipitor while trying the niacin. This will better gauge whether your cholesterol and triglyceride levels will decrease with niacin. If it does not work for you, continue with the Lipitor. If it has minimal effects, it may be best paired with the Lipitor or perhaps you could try flaxseed oil or omega-3 fish oil. You may even be lucky enough to have dramatic results and not need to go back on the Lipitor.

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: Unfortunately, yes. However, your husband appears to be willing to make some modifications. He has taken a step in the right direction by using niacin. For appropriate benefits from this vitamin, he should be taking 1000-1500 mg every day (500-750 mg twice daily works best).

An important step he has yet to take is to modify his diet. A low fat, low cholesterol diet may, by itself, reduce his cholesterol level dramatically. From your brief note, it appears his cholesterol is high due to dietary and lifestyle choices, rather than genetic factors. If diet does not significantly lower his numbers he may have a genetic predisposition to elevated cholesterol and will need medication. If he chooses to start with alternative therapies, I recommend niacin, flaxseed oil and omega-3 fish oil. These can be taken individually but may have a bigger impact if taken together. If these fail, he may then need to consider prescription medications, such as Vytorin or Lipitor.

Your husband needs to make changes. He is at risk for coronary disease, heart attack and more. However, he will not change until he is ready. Unfortunately for many people, it takes having a heart attack or other serious health disorder, before they become serious about making changes and understand that it could have been prevented if they had just made a few early changes. I hope your husband is not one of these people and that he takes his health seriously.

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, number 10 stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.