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.

My son is not overweight but many of his uncles and cousins (on his father’s side) had fatal heart attacks early in life. I am concerned that he is not under the care of a physician and, given his family history and his own high triglyceride level, I fear he may end up like many of the men on his father’s side. He doesn’t smoke and drinks socially (three to four beers or cocktails at a time).

Could you please print a reply to my letter so he can see how important it is to lower his triglyceride level and be under the care of a physician?

DEAR READER:
Certainly. A high triglyceride level is often an indicator of coronary artery disease (CAD). This means that the arteries leading to and from the heart have a plaque buildup causing them to become stiff and inefficient. This can be dangerous because blood clots readily form on the plaque and if they break off, can cause heart attack and stroke. Given your son’s paternal family history this is especially worrisome.

The good news in this situation is that with diet, exercise and (possible) medication, your son can likely prevent further damage to his arteries and heart and drastically reduce his risk of serious consequences. He should be on a low fat, low sodium diet and exercise 20-30 minutes at least four or fives time a week. He also needs to be under the care of a cardiologist who can test, diagnose and prescribe any necessary medications and follow up once or twice a year. He also needs a general practitioner who will be able to monitor any drugs your son may need and order appropriate testing between cardiologist visits.

While your son in still in good health, his triglyceride level is about 100 points higher than it should be. Given his family history, a cardiologist would probably want his level as well as his cholesterol level to be lower than normal. (Both should be under 200 in average adults.) Show your son my response and talk to him about your (justified) concerns. He is an adult and entitled to do nothing, but perhaps will make the decision to be proactive in his health if you reiterate your love and concern for him. Good luck.

TO give you related information, I am sending you copies of my Health Reports “Coronary Artery Disease” and “Understanding Cholesterol”. Other readers who would like copies 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(s).

Now to my question. I have type 2 diabetes. A few months ago I read that cinnamon was good for lowering sugar levels. I decided to try it mixed with Splenda on toast several times a day and it seemed to work. I then purchased 500 mg cinnamon capsules and started taking them twice a day, after breakfast and dinner.

Before the cinnamon, I was trying to control my diabetes with diet and exercise but it wasn’t really working. I would often have spikes of 250 or higher (before a meal) for no apparent reason. After the cinnamon, I have not had a reading over 130 before a meal.

Is there anything wrong with this treatment? Are there any side effects? I have also told a friend with severe diabetes about this. It seems to work for him as well.

DEAR READER:
I have received several letters from readers, such as you, who have had a favorable response to cinnamon therapy for diabetes. At the time cinnamon was first mentioned in my column by a reader who was using it for diabetes, he also claimed it lowered his cholesterol levels as well. Cinnamon for cholesterol does not appear to work for the number of readers who wrote to me with their results.

The one side effect I have heard about from my readers is diarrhea. It appears to be dose related. I do not know if this is common in the general public, however. Therefore, I see no reason why you shouldn’t try it (with doctor’s permission, of course).

That being said, there have been a couple of studies on the subject. One of note is found on www.WebMD.com. A researcher with the NWFP Agriculture University in Peshawar, Pakistan says that cinnamon, cloves, bay leaves, and turmeric have shown promise in improving insulin’s action in lab studies. He also says that cinnamon can improve glucose and cholesterol metabolism, improve function of small blood vessels and remove artery-damaging free radicals from the blood. Korean ginseng, flaxseed, garlic, and onions have similar effects.

The best results were achieved in individuals who took three to six grams (6-12-500 mg capsules or 1-1 ¾ teaspoons) each day. This is by no means a small amount and favorable results diminish soon after the cinnamon is stopped. For those people who participated, insulin sensitivity improved, triglyceride and LDL “bad” cholesterol levels were reduced and changes to the HDL “good” cholesterol levels were minor.

If you would like to read the WebMD article it can be found at http://diabetes.webmd.com/news/20031205/cinnamon-helps-type-2-diabetes.

To give you related information, I am sending you copies of my Health Reports “Living with Diabetes Mellitus” and “Understanding Cholesterol”. Other readers who would like copies should send a long, self-addressed, stamped envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
Cinnamon was of no benefit to me. I also received dozens of letters from readers saying it did not work for them. Some readers also experienced severe diarrhea while taking the cinnamon; therefore, I no longer endorse it.

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.