I have elevated lipoprotein a [lp(a)] and elevated cholesterol levels, am 70 years old and have a coronary artery calcium [CAC] score of 0 (or did before I started statins a short while ago). I just learned about the lp(a) level around 18 months ago. I started a 5 mg dose of simvastatin 15 months ago and it increased my modestly elevated lp( a) score significantly.
About one month before this year's blood draw, I stopped the simvastatin as an experiment. My lp(a) dropped from 43 mg/dl to 26 (this particular lab reports anything less than 30 to be normal). Of course my LDL climbed back into the 130s. HDL is 59. Triglycerides less than 100. I'm athletic, eat plant-based, and fast periodically (but still need to drop some weight).
Here's the thing, I lived for 30 years or more with my elevated total and LDL cholesterol levels and yet my CAC score remained zero. So, I feel like taking a statin that messes quite a bit with the lp(a) level may actually be more risky for me than living with an LDL in the 130s.
I've tried reading a few research articles, but my impression is that there is not real clarity around the lipoprotein a issue at the moment. I would sure love to hear other viewpoints, thoughts and insights.
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Desertflowerchild
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Hello! I find your post very interesting. Over a decade ago I went to my GP as I was concerned that I was approaching the age where my father, his brother and their father (I never met him as he scarcely got past 50) had all passed prematurely because of heart attacks. I was told not to worry as my BP and cholesterol (total 4.2 UK/162 US). Around the same time I was started on 10mg Atorvastain and a mini-Aspirin for PAD (peripheral arterial disease). I then read about Lp(a) and went and asked my GP for a blood test and was refused poinmt blank. To cut a long story short and to simplify things I had a quadruple bypass in 2018 and had my left leg amputated below the knee during the lockdowns after no one would see me despite a worsening ulcer. I am now with a different surgery and now you have reminded me I will ask again but a recent request for an HbAA1c was refused as I had one in November!
Thanks for your reply. I wrote a long reply to you yesterday and thought I had posted it, but don't see it here. First, it is quite awful what happened to you and I am so sorry you went through all this.
My doctor was trying to convince me to go on statins and so ordered one test after another to make his case. That is the only reason I ever heard of lp(a). Your comment made me realize my doctor did not order an HbA1C test this year and it should IMO be a basic annual screening test for anyone on statins.
I'm remembering more what I wrote yesterday that somehow disappeared. A recent study I read reported that those individuals whose Lp(a) increased the most in response to statin therapy tended to have bad outcomes. "Subgroup analyses revealed that a mild-to-moderate increase in Lp(a) was not associated with MACE, whereas there was a strong correlation between the highest quartile increase in Lp(a) (≥ 10.1 mg/dL) and MACE (HR = 2.29, 95%CI = 1.36–3.84, p = 0.002). This correlation was independent of baseline Lp(a) levels but not independent of on-statin Lp(a) levels."
I found out that simvastatin raised my blood sugar levels until I was prediabetec, my cardiologist offered me pravastatin , much lower risk, now on pravastatin and ezetimibe
Based on research, I'm the one that chose simvastatin and I was always on just 5mg whereas the normal dose is 20-40mg. The 5mg reduced the LDL to 90 and with my zero calcium score, doctors were fine with that.
How long did it take for your blood sugar levels to come back down? I have heard the increased risk of T2D remains after stopping statins . As I recall, that study I read had a 3 year follow-up.
What I noticed was, once I started simvastatin, I was hungry ALL THE TIME. My successful weight loss came to a grinding halt, and I began fighting, unsuccessfully, not to gain weight. My doctors (general and cardiologist) both looked at me like I was crazy, saying that was not a side effect of statin therapy. Ha! "The study shows that two statin drugs — atorvastatin and simvastatin — decreased leptin secretion, which may account for increased feelings of hunger. In turn, this could lead to weight gain when using statins long term."
But hopefully pravastatin increases your blood sugar less than simvastatin, at least? I found this reported in a 2018 research paper: "Considering individual types of statins, use of atorvastatin, rosuvastatin, pitavastatin, and simvastatin were significantly associated with increase of Δglu. Pravastatin, lovastatin, and fluvastatin were also positively associated with Δglu, but were not statistically significant."
And it does seem grapefruit is allowed with pravastatin, which, for me, would be a big plus.
Pravastatin does increase your blood sugar levels less, but no evidence that it will drop if you stop statins, in Britain they ask you to go on a diabetes prevention course
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