Thursday, March 27, 2008

Saying 'No, thank you' to Lipitor

Yesterday I posted about my lab results, which I had just received from my doctor's office. Today I want to explain why I've decided not to go back on Lipitor unless my LDL goes over 120.

Here are the numbers again:

Triglycerides: 128 (should be below 150)
LDL: 112 ("should" be under 100 for a diabetic, though is more like under 130 for a non-diabetic)
HDL: 77 (should be above 40 — the higher the better)
Total: 215 (should be below 200, though this does not take into account high HDL)
Ratio: 2.8 (should be below 4.5)
CHD risk: less than 0.5 (should be 1 or less)

Compare this to the last time I tried getting off the Lipitor, more than two years ago:

Triglycerides: 95
LDL: 138
HDL: 79
Total: 237
Ratio: 3.0

And although I can't find the records to prove this, I'm pretty sure my LDL was around 150 — and my HDL just barely above 40 — when my first endocrinologist put me on Lipitor, back in 2002.

Do you see what I'm getting at? My LDL has gone down and my HDL has gone up, meaning that I'm healthier than I was before. Is an LDL that is only 12 mg/dL too high worth taking Lipitor — and assuming the risk of liver damage that comes with it?

Personally, I don't think so.

Furthermore, I can't help but wonder about the study (or studies) that decided that all diabetics are automatically at a high risk for heart disease. One of the first things I ever learned upon becoming diabetic is that 80 percent of diabetics die of heart attack.

Yet compare that to some other statistics: Ninety percent of all diabetics are type 2, a form of the disease that is usually (though not always) associated with obesity, poor diet, and lack of exercise.

So when they tell me that I'm at a higher risk for a heart attack simply because I'm diabetic, are they talking about normal-weight, type 1 diabetics — or all diabetics in general? And when the researchers analyzed the data regarding diabetics and heart attack in order to make that generalization, did they control for type of diabetes, weight, diet, and lifestyle?

I'm 5'4" and weigh 123 pounds. I eat an organic, low fat, primarily vegetarian diet. I'm reasonably active. My blood sugar is under good control (my A1c hasn't risen above 7.5 in more than three years, and has lately averaged in the high 6s).

I just don't think I'm in that great danger of heart disease at this point in my life, which is why I've decided to stay off Lipitor as long as my cholesterol stays under 120.

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