Lower Cholesterol without raising a1c

I had a bad reaction to atorvastatin last year a month after a heart attack. My liver enzymes soared and I had crazy headaches and wound up back in hospital for observation. Previously no heart issues, no meds at all. The lipidologist suggested Pravastatin in a low dose, 20 mg. My LDL initially went to 57 but now is back up to 70, but liver seems fine. Ezetmibe is suggested for additional protection but I’ve got digestive sensitivity and that drug relies on small intestine. So complicated! We’re monitoring, cardiology is leaning toward trying Repatha if we can’t keep it low.

@ezjersey719 thank you. I will ask my doctor about that. Hope you do ok

Hi @laurensb. There are several cholesterol-lowering medications besides atorvastatin that some people use if they’re concerned about blood sugar, but the best choice really depends on the reason your doctor wants your cholesterol lowered further.

Could you share a little more about your situation? Did your doctor recommend additional treatment because of your Lp(a), or do you have a history of heart disease, a high coronary artery calcium score, diabetes, or another cardiovascular risk factor?

Also, was your Lp(a) reported in mg/dL or nmol/L? Those units aren’t directly interchangeable, so it helps to know which one your lab used when interpreting the result. My understanding is LP(a) typically doesn’t change so I am wondering if your two measurements were measured differently, so apples and oranges.

Hopefully members who have experience balancing cholesterol treatment and blood sugar can share what has worked well for them.

Very interesting…as we age, balancing conditions, meds and lifestyle is challenging…fix one thing and the meds can cause another problem….and some mixes of meds are very hard on the body…. My docs take great care with meds—take the most necessary/effective and take care with dosages ! Some basic lifestyle changes with diet/exercise can be very important- reduction of stress is very important to all of us. Obsessing too much over test #s is a stress we don’t need ! Let a good doc interpret impacts on your overall health and treat accordingly.

@jlharsh I converted 100 nmol/L to 40 mg/dL to make the readings comparable. I have family history of cardiac issues but none so far for me. I have read that being post menopausal can raise lipoprotein (a)

You will need to ask your doctor. The measurements were changed recently. I too had a big rise in my LPa score and freaked out. Ask your cardiologist. There are many MANY more tests to look at cardiovascular health than the simple things used for guidance to the general public. Your numbers sound great!

Update - no medication required at these levels given no plaque. Will continue to monitor. Thanks for the help.

Talk to your doctor about Rosuvastatin. It has been the only statin drug that lowered all the numbers that count.