Figured I’d post an update. Went in for the stress test today and passed it with no issues. An. Echocardiogram was also taken that apparently looked normal.

None of this was much comfort to me, obviously, since the stress test only detects blockages and most heart attacks are from spontaneously ruptured plaques. And there is no change to the fact that I have a *lot* of plaque.

Talked with the cardiologist in his office after. He remarked again how surprised he is to see such a calcium score given all of my bloodwork. I told him I fear that the extremely high CAC level at my age coupled with an absence of just about any abnormal lipid levels makes me very nervous that there’s something driving this (thyroid resistance?) that goes beyond the usual explanations and will make it unresponsive to the usual treatment. I continue to respond very poorly to the Crestor. Can’t describe adequately how drained by body feels 24/7 now. I tried to run again today; this was a breeze just a few weeks ago. Now I’m struggling after just a few blocks, feet barely shuffling forward, had to cut the distance in half. This kind of response I believe is common with hypothyroidism.

Basically, I suspect that my body has some type of resistance to thyroid hormone. This is the opinion of the endocrinologist I’ve been seeing for years. It has made me functionally hypothyroid without the blood levels you’d get with it. So I have the right circulating amounts; my receptors just don’t/won’t process them, and supplementation will get me nowhere. And now I am discovering that hypothyroidism is a major player in developing and accelerating atherosclerosis. And that it also is heavily implicated in non-response to statins. So my body’s resistance to thyroid hormones has opened the floodgates to artery plaque, and it is also I suspect preventing the typical treatment from working.

We took a blood draw today to see if the 3 weeks I’ve been on the statin actually has meaningfully lowered my LDL. If it has, that will obviously be encouraging. Maybe it would be enough for me to put up with this fatigue, if I know it’s getting the job done. But even if it does lower my LDL, I’ll still be haunted with doubt:
* Given that my lipid profile really isn’t that bad to start with (LDL 107, HDL mid-80s), is it really realistic to think that just knocking LDL under 70 is going to dramatically change the equation for me when it comes to arterial plaque?
* Since CAC will rise with statin use and is not a good gauge to measure the progress of treatment, how will I actually *know* that I’m successfully reducing my risk even if LDL comes under 70? Do I just take it on faith that it’s working? Are there any other metrics to use?