Friday, January 7, 2011

December Test Results In...

And better than I had hoped. Overall cholesterol: 165. This is better than the 180 I predicted. I was on 4 g of Omega-3 (Lovaza) , Trilipix, Zetia, and 500mg Niaspan just before the test. No statins.

LDL was 103; I predicted 100. Right on the money, not bad but up from my low of 77 and my goal of 75.

HDL was 39; down from my high of 47 (and from my prediction of 43). Nisaspan is most important here and I was taking only 1/3 of the recommended dose. So there's hope. I've restarted Niaspan and plan to build up to 3/day (1,500 mg). I was able to tolerate 2/day at one point with not too much flushing or stomach upset. I'll go to 2/day in about two weeks (with the aspirin). That's by the last week in January.

Triglycerides: 115 - Normal; predicted Normal. This is due to Trilipix, I think. Very powerful. Possibly also partly due to the 14 pound weight loss at the time the test. I will be continuing the 1/day Trillipix.

Had a good conversation with my GP. Highest priority is getting my HDL above 45. This is quite realistic using Niaspan.

Next priority is getting my LDL down in the 70's again. This is also quite realistic using Crestor and not much of it: 2.5mg/day. (I'll need to get that pill cutter.) This is a bit of a balancing act because Crestor, as a statin, can lower all lipids, including the good HDL. So this is a reasonable, incremental approach. 5mg did produce the LDL 77 before. 2.5 should get me close without affecting my liver enzymes. If it is worth it, I can restore the full 5mg/day.

I am happy to report that my liver enzymes, AST and ALT, are well within normal this time, so neither Crestor nor Niaspan is pushing these tolerances. This gives me confidence that if I hold the Crestor at 2.5/day and build up the Niaspan first, I won't drive up the liver enzymes too much. If all is good at my April test (with Niaspan at 2 or 3/day), and I want to push further, then I can consider 5mg/day Crestor, but I don't think this will be necessary. The upshot is that I will not be using any more medication than necessary to get the desired effect.

I'll try to keep from regaining the weight that I lost in China. I've regained about 4 of the 14 pounds that I lost. More vegetables and exercise. Maybe less dairy and cheese. I've cut down on diet drinks about 90% since the sweeteners my have some contra-weight loss triggering effect.

My GP reminded me that I have a follow-up appointment with my cardiologist. The thalium stress test showed some occlusion, as did the heart scan. He says that things could change in a year that might show up in the thalium stress test. He discouraged me from doing another heart scan to see whether I had arrested the progression of plaque buildup or even reversed it. Too much radiation, not enough time for the program to work (18-36 months the 1st time we discussed it last year). Also, the medication/program would be unaffacted. Still, it would be interesting to see the results of a program revealed in physical terms. I have a cardiologist appointment for early February.

Although not specifically lipid-related, it's been 5 years since my last colonoscopy, so I have that to be scheduled early in the new year.

So the next main post will be in April when those test results are in.