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Cholesterol Support
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80 mg Atorvastatin and Anxiety

I'm brand new and looking for answers. I never smoked, I worked out, and kept my weight down. My cholesterol numbers were pretty normal. Even so, 15 years ago I developed full body RA and had a heart attack at 46 (on my daughter's 2nd birthday). My doc put me on Plavix, Metropralol, Ramipril, and 20 mg Lipitor/atorvastatin. The heart attack was a shock and I had some initial anxiety/PTSD over it, but with some counseling my life resolved. For 15 years I have been as active as my RA will let me with no cardiac symptoms or anxiety to speak of. Also no muscle pain. I exercise and walk 5-10 miles a day. In December a stress echo revealed another blockage and I had another stent placement. My doctor upped my Atorvastatin to 80mg and also prescribed Brilinta. About a month out from my procedure I started feeling very anxious off and on throughout the day seemingly out of the blue and have had trouble sleeping, which I've never had a problem with. I'm trying to determine if going from 20mg to 80mg Atorvastatin is contributing to my anxiety. It makes it very difficult to stay focused, especially at work. And I have no appetite. I also wonder about the Brilinta. Anyway, I'm grasping at straws. I want my old life back. Has anyone experienced anxiety and insomnia on high dose Atorvastatin? I'm considering dropping back to 20 mg Atorvastatin just to see if it makes a difference. Thanks.

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I can’t comment on your meds etc but magnesium supplements are good for anxiety and helping with sleep.

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Speak with your doctor. You’re at high risk for repeat cardiac events. You don’t want to rock that boat. Have you considered you might be entering menopause? That interferes with sleep. There are blood tests to determine where you are with that. Good luck. I hope you find relief.

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I’d share your views but it doesn’t find much support from clinicians, one of those who do you believe ‘the maker or the taker’ - I think my symptoms settled with time but this might prove helpful:

healthunlocked.com/choleste...

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Welcome to the cholesterol community Igor, and thank you for your question. Statin dosage does indeed play a role in anxiety - at least it did in my case.

Before I relay the story please first read this:

To help in answering your question, please provide some vitals:

height, weight, waist size;

What is the nature of your diet? Do you consume:

- soft drinks, alcohol or fruit juices? If so, how often?

- pasta, rice, bread, pizza, potatoes?

- potato chips (crisps), pretzels, crackers?

- fried foods (including fried eggs)? French fries?

- cookies, cakes and other desserts?

- dairy?

- red meat, processed meats like cold cuts, bacon or sausages?

- packaged food from the grocery store?

- sugar, honey, agave, maple syrup, or other sweeteners?

All of the above are 'inflammatory foods' for the body and trigger the body's immune system including, among others, LDL cholesterol production.

Do you consume, daily, any of these ANTI-Inflammatory foods?:

An anti-inflammatory diet should include these foods:

- tomatoes.

- olive oil.

- green leafy vegetables, such as spinach, kale, and collards.

- nuts like almonds and walnuts.

- fatty fish like salmon, mackerel, tuna, and sardines.

- fruits such as strawberries, blueberries, cherries, and oranges.

Source: health.harvard.edu/staying-...

Heart disease, diabetes and RA are all related in that they can result, in most cases, from an inflammatory diet and lifestyle.

Brilinta has 'anxiety' listed as a side-effect.

It is an anti-coagulant, anti-platelet medicine to avoid blood clots.

You can accomplish this instead, with supplements by taking Folic acid (vitamin B9) along with Omega 3 fish oil pills, B6 and B12.

Or you can eat wild-caught salmon or trout, or arctic char, 2-3 times per week, use extra virgin olive oil instead of butter, and eat one of these 3 greens DAILY:

- arugula, kale, or broccoli.

Get yourself a good Mediterranean Diet cookbook, but focus on low-carb meals. You can have healthy fats such as olive oil, avocado, nuts and nut butters (organic, unsweetened, unsalted), MCT (medium chain triglycerides) foods such as goat and sheep dairy products, and MCT oil, among others.

Monitor your fibrinogen and homocysteine values in your blood tests regularly which measure blood platelet aggregation. Read this:

lifeextension.com/Protocols...

A couple of good sources for recipe ideas are:

- pritikin.com/pritikin-at-ho...

- ricardocuisine.com/en/recip...

Legumes should become a staple of your diet going forward.

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I had a triple bypass 4 years ago (March 2015) and subsequently required 4 additional stents.

My medication regimen was metoprolol, ramapril, clopidogrel (plavix), and 5 mg of the statin, Crestor, plus a daily baby aspirin of 80 mg.

I am a male, at that time 53 years of age, 5' 10" (178 cm), and was at that time 195 lbs (88.5 kg);

The surgery itself resulted in sleepless nights due to anxiety, but in time (a long time) that subsided.

In follow up visits with my cardiologist he adjusted my statin (Crestor) and increased it initially to 10 mg, then 20 and finally 30 mg. He said I had FH (familial hypercholesterolemia).

I was compliant but noticed an elevated level of anxiety throughout the day for months. I became very pessimistic and saw the world through dark clouds. I had this impending feeling of imminent doom. Nights were awful and I dreaded going to sleep.

I was always an upbeat, optimistic person and recognized that this was out of nature for me. I kept using 'self-talk' as a technique to counter these negative feelings.

By November 2015, my left shoulder began to hurt and stiffen up. By late December, my left shoulder was immobile and was throbbing with pain to the point that I couldn't sleep.

I initially thought it was a rotator cuff injury from summer golfing.

However, one sleepless night around Christmas 2015 I started looking up the side-effects of all the medications I was taking.

Needless to say once you look up the side-effects of statins (atorvastatin, crestor and others) there is an endless volume of information. Those from the medical community believe its the best drug for heart disease, while those who have taken it write about all of their side-effects.

I made the decision that night to slowly wean myself off of the Crestor. I wanted to know how to lower cholesterol naturally.

To make a long story short I radically changed my diet, and became a vegetarian but still ate fish and dairy products (mostly goat and sheep cheese). I completely stopped having sugar, and simple carbohydrates and all of the inflammatory foods I listed above - this resulted in a 3-week period of withdrawal symptoms, as refined carbohydrates and sugar are addictive. I was in a foul mood, short-tempered and full of self-pity throughout the 3 weeks that I could no longer eat such foods. Once I passed this point, my mood improved and I noticed that I had more energy, was more relaxed, tolerant, and was very slow to anger. In short, I my personality improved.

Watch this video:

- TV program 60 Minutes (13 min. episode)

I also cut the Crestor dosage from 30 to 25 mg without permission from my cardiologist to see the impact.

Additionally, I systematically walked daily, progressing gradually to 90 minutes per day, and then supplementing with resistance training at the gym 3 days per week. I also play hockey once per week.

This resulted in weight-loss at a rate of 1-2 lbs per week (early on it was 2 lbs/week). As the weight came off I ran blood tests every 6 weeks to monitor LDL-C and the rest of my blood bio-markers.

My LDL-C continued to decline even though I began to wean off Crestor at a rate of 5 mg every 6 weeks. Concurrently I began getting dizzy spells - my blood pressure was too low. I spoke with my GP and he said to cut the ramipril in half. I did so, but continued to have low blood pressure as my weight continued to come off. By the summer of 2016, I completely stopped the ramapril as my blood pressure, without it, was normal.

The clopidogrel (plavix) therapy along with baby aspirin is a standard,12-month, post-surgical protocol. This ended in May of 2016 for me on the 12-month anniversary of my last angioplasty (stenting). By summer's end of 2016 I was only taking metoprolol and 5 mg of Crestor.

I saw my cardiologist for a routine follow up and he was very pleased with my progress. By this point my weight was down to about 165 lbs. (75 kg). He told me that I wouldn't be able to go below 5 mg of Crestor as my LDL, which had fallen to about 1.7 mmol/l, would likely go back up to levels he said were sub-optimal for my condition.

I also questioned the need for metoprolol as this was a beta-blocker that slowed down my heart rate and lowered blood pressure. I looked up the drug and saw that it was designed for those with a heart attack (I didn't have one), atrial fibrillation and other heart problems, none of which I experienced. Thus I decided I was going to wean off of this drug as well.

I continued to experience anxiety throughout this period as my decision to eliminate all pharmaceuticals was contrary to conventional medical guidance.

By this point my knowledge base on cholesterol and cardiovascular disease had increased significantly as I read 2-3 medical studies every evening and a litany of other medical literature.

When I began weaning off of the metoprolol, my anxiety went through the roof even though the cardiologist said weaning wasn't necessary, I could just stop. By October 2016 I took my last metoprolol and last dosage of Crestor, then ran a blood test.

All blood markers were excellent, EXCEPT the LDL-C, which doubled to over 3 mmol/l.

My GP called immediately and said 'what are you thinking?!'

I told him that it was likely the 'rebound effect' of stopping Crestor. He didn't know about the rebound effect of stopping medications. This was when I realized my knowledge base about cholesterol and cardiovascular disease was beyond the scope of a general family doctor. I also realized the medical system in general was subject to potential conflict of interests due to the influence of the large pharmaceutical firms.

Since my cholesterol ratios were still good even after my LDL-C popped up, my GP agreed to go along with me and wait for the next blood test.

6 weeks later, my next blood test showed my LDL-C began to drop again albeit not to the sub 2.0 mmol/l recommended by my cardiologist.

My anxiety began to slowly dissipate and my left shoulder problems completely resolved and I regained full mobility again and was pain-free. My weight by the end of 2016 had levelled off at 155 lbs (70.3 kg). My waist size went from a high of 42" (106.7 cm) down to 31" (78.7 cm).

I then began to learn about vitamins and supplements and the importance especially of vitamin C.

Humans cannot synthesize collagen which is critical in the repair of human tissues. This is especially important for people who exercise a great deal as exercise, in spite of its significant benefits, still triggers inflammation. In the absence of collagen, the body produces more cholesterol. Furthermore, I learned that when the body has more vitamin C and increases collagen production, cholesterol production drops.

I began to take 2,000 mg per day of vitamin C and noticed a nearly 20% drop in my LDL-C.

I have been tinkering with my diet and supplement routine since then.

This is the Vitamin C I take now: livonlabs.com/

Today, I have small portions of lean grilled chicken breast twice per week. I eat red meat only 4 times per year on special occasions, again in very small quantities (2-3 ounces).

I can tell you that changing medication dosages as well as vitamin and supplement dosages will trigger anxiety (yes even supplements). Therefore always change dosing gradually and recognize that you might get a temporary bout of anxiety.

When my supplement dosing is steady and unchanging, I do not have any anxiety.

I have reduced my baby aspirin to once every other day. I read a study that said the potentially efficacy of baby aspirin is not materially reduced with this schedule.

This week, a new study was released questioning baby aspirin therapy for primary prevention although it did not mention anything about secondary prevention for those with established heart-disease.

I am considering a food supplement called 'fruit flow' as a replacement for the aspirin.

In the meantime, to help your RA and inflammation in general, consider these supplements:

- curcumin (active compound in tumeric)

- 1 teaspoon daily of Ceylon (true) Cinnamon (I put it in my breakfast tea).

Here are 7 anti-inflammatory spices:

Turmeric.

Cayenne.

Ginger.

Cinnamon.

Cloves.

Sage.

Rosemary.

Source: blog.bulletproof.com/best-a...

One last thing, LDL-C is not the best indicator of cardiovascular disease risk. Instead the measure of LDL-P (particle number) is. You need to get a blood test called 'NMR Lipoprofile' which will provide you with this, and other, very important values. If your LDL-P is low and your LDL-C is high, the LDL-P value is more important:

Source: ncbi.nlm.nih.gov/pmc/articl...

If your LDL-P is also high then you have to address it through dietary and lifestyle changes.

If you wish to ask me any questions you can messages me privately.

I hope this helps you with your health issues.

Good luck.

P.S. I do not have Familial Hypercholesterolemia. My current blood metrics prove it and the diagnosis was not based on a specific test but simply on my elevated cholesterol that met a guideline value used by the medical system. Do not accept all advice from doctors at face value. Do your own research and seek second opinions including those from a high quality naturopathic doctor.

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Not been on cholesterol support for a while but just read your advice on how important eating the right food is, much of what I’ve read and adopted and am very impressed at the time you take to give such good advice and would like to say thanks.

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Thank you very much Stu - your reply and gratitude are greatly appreciated.

Good health to you my friend!

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Good health to you too. You have covered a lot of good advice I have read over the last 2 years since being diagnosed with CHD at 46. I have yet to come off statins due to the fear but am convinced they are not the magic bullet to prevent CHD but more a magic revenue stream for pharmaceuticals. From what I have read inflammation plays a big role in CHD and cholesterol is only incidental.

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Right on! Get an NMR Lipoprofile test which provides the most valuable risk-metric LDL-P (particle number) among several other important biomarkers.

I encourage you to read this:

acatoday.org/News-Publicati...

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To be honest I’d rather not know if I had a bad LDL-P number as I’m a terrible worrier; my wife has been through hell since my MI and CHD diagnosis and anxiety that came with the knowledge. Best to follow someone who has done dietary changes to bring that number down. Have you been able to get this number down and what dietary changes did you find made the biggest improvement?

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My LDL-P and the other values provided by this very comprehensive test are in the optimal range.

The dietary and lifestyle modifications which I have documented numerous times on this forum is what helped me achieve these levels.

Whole foods, plant-based diet, with very, very, very low simple carbs (no sugar), and a healthy amount of high quality fats such as: extra virgin olive oil, avocado, nuts, nut butters, Omega 3 fish oil (I also eat wild fish 2-3 days per week) and Medium Chain Triglycerides (MCT) as found in goat and sheep dairy products. I do not indulge in animal fats as found in animal protein. I limit animal protein to lean chicken twice per week and in small quantities - 3 oz or so.

Daily exercise - whether it be simply a brisk walk up to one hour per day, or going to the gym alternating between cardio and resistance training, I exercise daily. The intense exercise is 4-5 days per week.

My cardio is high-intensity interval training also known as 'HIIT'. I do mine on a treadmill only, although it can be achieved many different ways. What I do on a treadmill took me a while to work up to, as it is physically exhausting - I did not start with it from the outset. As you exercise and your body gets into better condition, you tend to push yourself more gradually and increase the degree of difficulty to get a good workout.

The biggest contributor to lowering LDL-P though is - getting rid of all sugars (which means avoiding all processed foods) and simple carbohydrates.

Watch this video:

31 minutes - starts slow but gets better and provides a wealth of information.

Also I strongly recommend that you listen to this podcast and read the accompanying notes:

podcastnotes.org/2018/09/11...

Good luck.

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Fantastic post, everyone should read it. I have a similar journey although not as severe as yours.

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Please share your story for all to benefit by creating a new post.

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PS Fruitflow is one option as is Nattokinase. You could also consider Kyolic Aged garlic

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Thanks for the info Mark.

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Hi I’ve worked in the health food business and would just like to say a lot of positive effects seen from supplements are entirely due to the placebo effect. The only one that I think has science behind blood flow improvement is Ginkgo Bilboa 24/6 however it’s always worth checking side effects of herbals and also contra indications with other meds your taking before talking anything. The problem also with food supplements is also there is generally a lack of efficacy testing as the rules governing food supplements are not as stringent as pharma, not that pharma studies are good either. A lot of studies I saw backing food supplements efficacy were small sample studies usually funded by the manufacturer!

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I should have added that one supplement that I recall being pushed by a manufacturer for blood flow improvement was Cocoa Flavanols. The supplier was Naturex, a French herbal supplier. They had some studies behind blood flow improvement however I did not check if they were small scale studies funded by Naturex so am not recommending this product just letting you know it’s a material possibly worth looking into.

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Thanks for your feedback Stu.

Fortunately the private sector steps in where government fails. Here is a service that provides independent quality assessments of most vitamin and supplement products on the markets:

consumerlab.com/results/

I subscribe to the service and I can tell you their reports are very comprehensive.

I can also tell you that I was never a fan of vitamins and supplements until I had my surgery. After initially moving to a vegetarian diet and tested myself for B12 and found my levels below the reference range, I bought B12 supplements and at my next blood test 6 weeks later, my B12 was back in the range.

Each time I had an issue with blood work metrics and have sought vitamins and supplements, the issues have resolved when I followed up with blood tests.

If you stick with high quality vitamins and supplements, and focus on the basics in terms of vitamins such as B,C,D,E and Fish Oil, there should be no problem. Follow-up testing is important to verify efficacy.

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Yes I agree. My wife was low on D3 and supplements did get her levels back. I had heard that too much antioxidant vitamins (E mainly) had been linked to adverse outcomes albeit it was a documentary on the BBC last year so not sure the source of their information.

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I have read a great deal about vitamin E and antioxidants. I'm not convinced that a 400 IU daily supplement will cause any harm. Reactive Oxygen Species (ROS) are produced daily by the body, most people don't consume enough antioxidants in their diet so a small supplement is likely to help, not hurt.

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Great comprehensive info.... thank you..

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You're welcome.

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Statin is secondary medication after any heart procedure to improve blood flow.

A 12-lead electro cardio gram gives electrical pulse information, stress echo treadmill test.

Then there is echo cardiogram where a ultrasound device is used to look at the shape of the heart.

It is good the specialist found a problem and have given you medication.

You need to listen to your specialist, if one medication is not working then ask to try different medication.

My elder brother went through difficult decision with hear medication, he had stent twice and a heart valve replacement. Always followed the specialists medication list, watching out for free and hidden sugar, eating small portions and daily walk.

Good luck with you life style change.

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There are so many undocumented to statins because they are not recognized and maybe 1% is reported. The cause is not LDL and statins are effective about 1%

This was recently discovered.

todayonline.com/world/bone-... Statins cause mitochondria damage in the muscle tissue and they all cause muscle damage whether you feel it or not.

zoeharcombe.com/2013/10/how...

I think some genetic defects may lead to it. Some say a low fat starvation type diet is the solution but not many can do this and lipids are used for energy in the body. I feel your frustration.

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try 2400mg aged garlic a day

stayinghealthytoday.com/gar...

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