Daily Column

July 30, 2008 By

DEAR DR. GOTT:
I am a 62-year-old male, weigh 225 pounds and my cholesterol is about 180. I lead a semi-active lifestyle, exercising 30 minutes daily, five times a week.

I was on Zocor for high cholesterol and constantly complained to my doctor of sore muscles. He switched me from Zocor to Crestor a year and a half ago. After a year on Crestor I was really miserable with sore muscles and fatigue. For the prior six months, I had not been able to raise my right arm due to a sore shoulder that still keeps me awake at night. I stopped taking the Crestor for 30 days at the end of 2007 and felt much better, except for my sore shoulder. When I notified my doctor, he then put me back on the Zocor.

From what I have read previously in your column that if a person is over 60 and has a cholesterol level under 200, he or she shouldn’t need drugs. Do I have to take medication that makes me miserable? [Read more...]

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Daily Column

June 17, 2008 By

DEAR DR. GOTT:
What can you tell me about aortic aneurysms? Can they be visually detected? I am worried about my male partner. He is 71 and keeps physically fit by walking, biking and swimming everyday. He takes Zocor because of a cholesterol level of 225.

His stomach protrudes slightly but also has a smaller “bump” beyond that. It’s noticeable through t-shirts or when he lies flat and is located exactly where the internet information says an aortic aneurysm would be. I cannot find anything that says if one can be visually detected, though. This spot looks like a grapefruit is hidden in his stomach.

He is “medically dense” and doesn’t even know that it’s there. Looking straight at it in a mirror, it can’t be seen. I don’t want to raise a red flag if there is nothing to worry about.

DEAR READER:
To the best of my knowledge, an abdominal aortic aneurysm (AAA) is not visible [Read more...]

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Daily Column

May 10, 2008 By

DEAR DR. GOTT:
I recently had my cholesterol checked. My total was 212, LDL (bad) 111, HDL (good) 84, and triglycerides were 86. My family physician suggested I start taking 20 mg Zocor. I am a 69-year-old, fairly healthy female. I am not overweight and don’t smoke. I exercise and do not have a family history of heart problems, but am concerned about the side effects of this medication should I start it.

I have a friend who is a medical doctor who says not to start the medication. She claims that my high good cholesterol offsets the bad because a normal HDL is only around 40. She also says that if my HDL were 40 with the other numbers I have, my total cholesterol would only be 168.

I know that 200 is the magic number, under is best, and over is bad. But my HDL is twice the normal level and everyone says that the higher the good cholesterol the better. Should I take the medication?

DEAR READER:
Your friend the doctor is, in my opinion, brilliant; we agree completely!

In my practice, anyone over 60 years of age was permitted to avoid drug therapy for mildly or moderately elevated cholesterol levels. A total cholesterol of 212 certainly does not warrant medication, especially with an HDL level of 84. Statin drugs are recommended for those who have preexisting heart problems, are at high risk or have a strong family history of heart attack or stroke, or have high cholesterol that does not respond to diet and exercise. You have none of these.

Respectfully decline your physician’s suggestion to take the medication and continue your healthful lifestyle. Remember to have your cholesterol checked each year to ensure it remains as low as it currently is.

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.

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Daily Column

March 22, 2008 By

DEAR DR. GOTT:
Like most of your fans, I would like to start with a compliment. You always seem to have the answer to the questions that many of us have but believe are too insignificant or unimportant to ask our doctor. They are questions to which we really to want to have answers. You never respond in a manner that will belittle the person asking and for that I say thanks.

Now my question. It is a bit complex but I will try to be concise. In 2005 I started developing symptoms of peripheral neuropathy. After a consult with my family practitioner and a few preliminary tests that were negative, I was referred to a neurologist. While waiting for the appointment, I discontinued my Zocor and a mild antidepressant to see if symptoms declined. (One of Zocor’s side effects is neuropathy.) Within a few weeks to a month the symptoms declined somewhat. The neurologist continued with more tests. Most of them were normal. The milder neuropathy symptoms were and still are present but intermittent.

When the results of my protein studies came back, including the paraneoplastic panel, my striated muscle levels were elevated. Because of this, my neurologist ordered a lung scan which was negative. At that point I was told to just wait and see if I had any symptoms that might suggest lung cancer.

Since I am proactive in my health care, I did my own research online and found that small cell lung cancer can be preceded by peripheral neuropathy before the onset of disease. Several existing studies suggested that regular follow up testing was advised because waiting for symptoms can result in poor prognosis if covert cancer is present. I reviewed this information with my family physician who agreed with the wait and see approach of the neurologist.

I had a repeat paraneoplastic panel one year later (2006) and the striated muscle portion was still elevated but lower than the first test.

Is there anything you would recommend? Should I ask for a referral to a different specialty? I am not looking for trouble but on the other hand, I do not want to ignore a problem if there is something I should or could be doing.

DEAR READER:
Your physicians have addressed your problem using excellent medical care. If agree with the wait and see approach, especially given the fact that your blood test improved during 2006. I do not know the cause of your neuropathy (nerve malfunction). If your symptoms are stable or improving, I would not worry too much. If you truly feel uncomfortable, speak with your neurologist or ask for a referral to another doctor for a second opinion. If your symptoms start to worsen, see your neurologist who should order more tests and address possible issues, including treatment options.

Continue with your yearly monitoring and follow your physician’s advice. Good luck and let me know how this turns out.

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