Extremely high calcium score at 42 - is there any positive here??

Thank you. I’ve had lots of bloodwork done but can’t find any Lp(a) result, so I don’t think it’s been tested. Just reading up on it now; does seem like something to check for (just not sure what to do if it were to be high - looks like no formal treatment yet developed?)

Out of curiosity, do you also have a high CAC score? Thanks again for the suggestion.

That is a positive note, no question. I'm glad to hear you've successfully made the changes and feel healthy. Interesting about Prozac too. I've also thought about getting on one of those to deal with this. A little worried about the reported weight gain side effects, just given how bad extra weight is for this condition.

I'm wondering if you have had any repeat CAC testing or if there are any other metrics/tests you're using to monitor the situation? This is one of the things I'm trying to figure out -- if I take the statin and make the dietary changes, how will I measure if I'm actually improving my heart risk? This is complicated by the apparent tendency of statins to actually raise CAC by calcifying soft plaque. So in my case, I could do the right things for the next few years and still see a big jump in my CAC score, I think. So what other metrics are there? I guess LDL levels? The cardiologist I saw this week spoke confidently about a low LDL number reducing soft plaque. But can I measure that? Do you?

This situation is getting more upsetting and alarming for me. It has now been two weeks since my cardiologist gave me the 397 calcium score and put me on a statin (20 mg crestor).

As I’ve said previously, I am extremely alarmed at just how high this number is. *Any* calcium at my age (42) is unusual; this level, from what I can tell, is virtually unheard of. The second cardio I saw told me he can’t recall ever seeing it this high in someone as young as me.

That said, both cardios agreed with the same basic approach of statin use and improved diet. And I’ve spent the last two weeks trying to put that into action and calm myself by telling myself I was taking smart steps that would benefit my prognosis.

The problem now is that I am clearly not tolerating the statin. I know this because of exercise. I had already been running before the calcium test - 4/5x per week, a 3.1 mile loop. I had no trouble doing it at all, actually looked forward to the jogs for stress relief etc. But literally the day after taking my first statin dose, this run — previously an utterly routine thing — was transformed into an epic struggle. My time was 5 minutes slower and every stride felt like I was fighting my body. It wasn’t muscle pain; more like I just had extremely tired/heavy muscles everywhere in my body. I run much slower and yet amd sweating 3x as much as before. When I get back I am utterly drenched and drained. It’s a mostly flat route but there is a quick uphill, which I had previously zipped up. Now I can barely get to the top, and I’m basically waking to do it. I hoped initially I’d get used to the statin and this would subside. It hasn’t. Today was the worst day yet. My strides got shorter and shorter as I fought my body to keep moving. Finally I just had to stop. I can’t remember the last time I actually needed to stop running like that.

I am writing this hours later and my body just feels tired. I’m typing this on my phone and both arms feel heavy with fatigue. They basically feel like they would if I’d done intense weight and resistance training — but I didn’t do anything like that. I just tried to jog. Same thing with the rest of my body. My neck and shoulders feel like they would if I’d been lifting and carrying heavy equipment all day, but I’ve done nothing like that.

I am deeply concerned — terrified, to be honest — that not only is my calcium score so outrageously high, but my body seems to be rejecting the treatment.

For what it’s worth, I suspect this may be thyroid related. My thyroid tests are normal but in my early 30s I began experiencing hypo-like symptoms — stubborn weight gain, muscle turning to fat, loss of hair on legs, fatigue, paresthesia etc. Most doctors shrugged it off because the testing was normal, but one specialist suggested what he called “thyroid resistance.” Basically that I test normally but am clinically hypo. This would be a very rare condition. He treated me with ultra-high-dose T3 (cytomel) and for 6 months it worked - weight down, energy up and —- notably now — my total and LDL cholesterol both dropped dramatically. Like to the level we’re aiming to get at with the statin. But then the T3 just stopped working and I returned to baseline. The endo was baffled but suspected that receptors had down-regulated. Since then I’ve tried T3 on and off, and at best I can get a response for a few months before it turns off again, and I need to then stay off it at least 2-3 months to get it going again.

What does all of this have to do with my calcium score? I see that hypothyroidism is linked strongly with coronary plaque. And that it apparently is much more likely to cause bad reactions to when people take statins.

So that’s where my head is now. I think I am in a very rare situation medically. For complicated reasons, I got some form of “thyroid resistance” in my early 30s and I suspect it set my body to start accumulating plaque. Perhaps the T3 temporarily stopped the process while it worked, but the T3 unfortunately only works sporadically at best. And now this thyroid resistance is causing my body to react powerfully and negatively to the statin.

I’ve run this by the cardiologist. Obviously it’s a set of factors he’s never heard of before so I don’t think I’m going to get very far with him. But I can honestly say as I type this that I’ve never been more frightened in my life. I believe my body is fundamentally broken in a way that has caused dramatic early coronary calcification and that will prevent “normal” treatments from working. I believe a heart attack is coming any minute. I will be one of the stats of people who die of this in their 40s. My life is near its end. I can’t believe how fast it all went and that this is where it’s all ended up.

I'm going to make this point one more time then drop it. My former cardiologist is Dr. Agotsen, aka the creator of the Agotsten score aka the CAC. My current cardiologist worked directly with him for five years before the commute became too tiresome.

Both of them have seen higher CAC scores and did not consider them any kind of death sentence. Data is data but a data point is just one point. It's the overall collection of data points, and the importance of connecting the dots intelligently to make a meaningful pattern, where the art and science of medicine come into play.

The answer to the original question is: Yes. Value the CAC as an early warning signal and take whatever steps seem intelligent to mitigate chances of it increasing. I mean, what else can any of us do with any possible health glitch?

I once made a comment to Dr. A. about all of the people who have bypass and other surgeries, suggesting that medicine is lacking. His rejoinder was, logically defensible, 'we call that confirmation of medical advances.' Then cited a client who is still working and playing tennis, in his mid-90s, despite a first-ever heart attack in his 30s.

If you need help with taking positive steps without panicking, get it. Overthinking is not an asset in situations where it becomes an additional source of stress. Which, as we know, has a systemic effect on the body.

steveny,

The Brits would consider our common circumstances ... and stand tall, then say, "Right."

Meaning ... we are where we are. Your experience with statins may be an issue - but, you may be a bit psychosomatic. You may also need to weigh your desire to run several times a week against what you are experiencing. A different circumstance - when I had to get a hip replaced at age 50, I stopped running, stopped playing tennis, etc. Did not have to, but the wear on the new joint would gave caused early wear. A trade off.

I suspect your cardiologist is following a standards of care approach ... they are aware of the data and understand, given you have no symptoms, that you are only moderately at risk.

So, parsing this - your next step is a stress test? Better with echo? Maybe change statins? (I have had no effects that I can feel from atorvastatin) There are several options ... and several approaches to dosing.

I'm going to make this point one more time then drop it. My former cardiologist is Dr. Agotsen, aka the creator of the Agotsten score aka the CAC. My current cardiologist worked directly with him for five years before the commute became too tiresome.

Both of them have seen higher CAC scores and did not consider them any kind of death sentence. Data is data but a data point is just one point. It's the overall collection of data points, and the importance of connecting the dots intelligently to make a meaningful pattern, where the art and science of medicine come into play.

The answer to the original question is: Yes. Value the CAC as an early warning signal and take whatever steps seem intelligent to mitigate chances of it increasing. I mean, what else can any of us do with any possible health glitch?

I once made a comment to Dr. A. about all of the people who have bypass and other surgeries, suggesting that medicine is lacking. His rejoinder was, logically defensible, 'we call that confirmation of medical advances.' Then cited a client who is still working and playing tennis, in his mid-90s, despite a first-ever heart attack in his 30s.

If you need help with taking positive steps without panicking, get it. Overthinking is not an asset in situations where it becomes an additional source of stress. Which, as we know, has a systemic effect on the body.

Greatly appreciate the perspective, especially given your first hand experience with Agatston.

Reading all of the lit that’s available on line on it is a deadening experience. Just one medical journal after another saying that the CAC score is:
* Peerlessly accurate and virtually never prone to error
* By far the strongest available predictor of future cardiac events - so strong that it will single handedly increase someone with an otherwise normal blood panel’s risk by a factor of 5x or 10x or even more depending on how high the score is

To read all of that and know that I have a 397 at 42 is just something I’m really struggling with. And to now be feeling absolutely wiped out by the statin that is supposed to help me here is putting my mind in darker places still.

Greatly appreciate the perspective, especially given your first hand experience with Agatston.

Reading all of the lit that’s available on line on it is a deadening experience. Just one medical journal after another saying that the CAC score is:
* Peerlessly accurate and virtually never prone to error
* By far the strongest available predictor of future cardiac events - so strong that it will single handedly increase someone with an otherwise normal blood panel’s risk by a factor of 5x or 10x or even more depending on how high the score is

To read all of that and know that I have a 397 at 42 is just something I’m really struggling with. And to now be feeling absolutely wiped out by the statin that is supposed to help me here is putting my mind in darker places still.