How can I reduce high cholesterol from AIs?

Posted by coco46 @coco46, Jan 28 4:02pm

Has anyone had success with reducing cholesterol that's become elevated from taking AIs, besides from taking additional drugs like statins?

I have ended up with high cholesterol from the AI I am taking, it's nearly doubled from what it was pre-cancer/treatments. Total is 222 and LDL is 135, at least my HDL is in the good range 69.
My PCP wants me to start on a statin but I said no, I have enough horrible pills to take that cause way too many side effects, I am not adding another one to the mix. I have already been on a heart healthy diet for years, which hasn't helped. Has anyone had success lowering it with any particular diet change or from any supplements?

Interested in more discussions like this? Go to the Breast Cancer Support Group.

gldilli | @gldilli | Feb 8 2:49pm

In reply to @gldilli "@coco46 My Primary suggested the Zetia. I’m currently taking a vit K (100 mg) and D3..." + (show)

@gldilli to clarify, I have been taking Zetia for a couple of years now. Just as background, I am 66 and didn’t have high blood pressure or high cholesterol prior to my cancer diagnosis in 2021.

coco46 | @coco46 | Feb 8 7:16pm

I am going to do some research on the Zetia, it sounds better than taking statins. I especially like seeing that it's not something that has to be weaned like statins. I do want to first try some of the natural stuff, like the K and I also just found something talking about artichoke leaf extract being beneficial for lowering cholesterol and even possibly having some anti-cancer properties. It really is frustrating having to deal with additional health problems being brought on from treating cancer. If I had to take AIs for a few years, I would have just stopped taking them by now but I have to take them for the rest of my life. So I really need to sort something out without making things worse with a continued snowball effect of new health problems.

myoga | @myoga | Jun 30 1:49pm

I never had cholesterol issues until i took anastrozole. My LDL went pass 100 and my triglycerides went to 158. My diet was mainly vegetables and fish and I exercised 5 days a week. So the reason for high cholesterol must have been anastrozole. When my onco switched me to exemestane, it went back down without any extra effort. Interestingly my triglycerides went down to 70 ish! My feeling is that AIs are powerful drug and diet and exercise do nothing to counter their side effects. If you can change to exemestane it might help. But the catch is how you tolerate it. If you tolerate anastrozole, stay with it. I heard that anastrozole is very effective in reducing the tumor size. My PA told me that during Covid time doctors prescribed anastrozole when surgeries were halted.
We are caught between a rock and a hard place! Good luck to us all.
@coco46, I’m sorry you have to deal with these at the prime of your life. I wish you all the best.

mistymar | @mistymar | Jul 1 1:07pm

In reply to @wews "I am 71 and have been taking letrozole an AI since last April. I have been..." + (show)

@wews

I am 71 and have been taking letrozole an AI since last April. I have been taking a good quality red rice yeast for many years with good success. I am primarily vegetarian but eat fish and lots of grains, vegetables, beans and nuts and fruit. I exercise and lift weights. I recently met with a cardiologist/oncologist who did more in depth blood work to look at the size of the LDL blood cells - so more details about them carrying plaque to my heart. My total cholesterol was 204, the LDL was 122 and the HDL 63 and the triglyceride was 90. I had a calcium score of 19. I have a family history of congestive heart failure and arrhythmia issues. I live in atrial tachycardia and sometimes afib - 4 ablations haven’t addressed the issues. So I am on a beta blocker metoprolol and eliquis. This new cardiologist put me on Lisinopril to ease any burden on my heart since my echo with strain showed a slightly low ejection fraction of 45-50 instead of 50-55. Now because of the bloodwork she wants me to take a statin. She said my my LDL should be under 70 and because I live such a healthy lifestyle already and am already taking 1800 IU of red rice yeast, this is important to take a statin. I am so fearful of side effects. But I know the AI can increase your cholesterol and I don’t want to have plumbing cardiac issues. I have another 4 years and three months on letrezole. I am torn about what to do and was leaning against taking them but my family and other medically knowledgeable people are urging me to try them to see what happens.

I am so relieved to hear that I am not the only person who doesn’t want to take them. It is bad enough that I had breast cancer. Now the treatment is creating other issues which require new treatments? I feel like it is all too much.

So my question is for those of you taking statins how long did it take to have issues? Do you know anyone who hasn’t had muscle aches? I already have joint pain from the AI. How can we distinguish which drug is causing what issue?

Has anyone seen a physician that looks at everything and helps you determined how to proceed?

My oncologist and rheumatologist also wanted me to take prolia and I said no to those drugs too. I am lifting weights and taking Algie cal plus and eating more bone healthy foods.

Jump to this post

@wews just saw this but I was put on statin due to elevated levels (of everything) before the breast cancer. I started to show mild symptoms at about 6 weeks that I didn’t really correlate to the statin. Just muscle cramps. Got really bad by 3 months - every night between midnight/12:30 would get horrible cramps in my legs - get up and walk and stretch for 20 minutes or more to even begin to get relief. But by that time, I was going through treatment - had surgery and prepping for radiation when oncotype came back positive and had to decide on chemo. Talked to brother and mentioned this and he suggested it could be the statin (he’s tried every one there is and couldn’t take them). Stopped and within 48 hours all the cramps stopped, in a few weeks, even with the chemo, I was stronger. But Dr wanted me back on so I did and after a month ended up at cardiologist because of problems which turned out to be the statin. So stopped and refused anything else (recc was Zetia). Started berberine because next bloodwork showed elevation in ldl and borderline A1c. 6 months later all were normal even on the Anastrazole. LDL went up to 125 on exemestane but my reading indicates it will happen and as long as mild, doesn’t need treatment and will normalize once off the ai. So I’m holding (now at 115) without treatment.

wews | @wews | Jul 1 2:10pm

In reply to @mistymar "@wews just saw this but I was put on statin due to elevated levels (of everything)..." + (show)

@mistymar Since I wrote this I spoke with my cardiologist and she took me off the statin and put me on zetia. I have had no issues with it and my cholesterol went down significantly. She is happy with where things are now. Maybe you could try zetia - it works differently than statins and doest have the same impact.

prarysky | @prarysky | Jul 2 1:23pm

Zetia sounds like a real game changer for anyone who has problems with statins. Although I have had no known bad side effects on a statin, Zetia sounds like an overall safer drug than statins. I asked my cardiologist if I could switch from a statin to Zetia, and he said no. Medicare would only cover it if I had problems with a statin or it was ineffective. He also said that statins remain the first line of treatment simply because they have a much longer track record of effectiveness and Zetia is the new kid on the block.