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At 76, no cardiologist is willing to give me a CT calcium test
I have a family history of inherited elevated lipids (one of two siblings , younger, passed away two years away of what is being assumed is either a heart attack or stroke.) I'm the only member of my immediate family never to have taken statins.
My lipids are quite variable (at present, somewhat elevated cholesterol and markedly elevated triglycerides), but I'd still like to have this test for information purposes. The last lipid specialist refused ( as with all previous), that "at your age" you're bound to come back with a high calcium score, so why bother?).
When he warned me my insurance wouldn't even cover it, I said I'd pay out of pocket but he was unmoved.
I see plainly on this site that there are quite a range of scores (also that people my age are being tested), and I'd like to know where I stand. After all, I haven't had any diagnostic testing about whether I have any blockages, apart from a recent CT scan (done for other purposes) which, as previous, spoke of "moderate blockages".
I was diagnosed for the first time at age 25 with very elevated lipids and since then my lipid profiles have been coming back with variable results, sometimes quite elevated (especially triglycerides). Two decades ago, the head of Johns Hopkins lipidology told me we have "familial hyperliproteinemia" and that nothing could be done apart from - maybe - behavioral changes: avoid carbs (especially refined) and alcohol, lose weight and exercise.
I did all four and my lipids improved dramatically. Since then I've done my best to stay slender, (a bit of yoyo there), exercise and minimize/avoid carbs and alcohol.
Of the four, weight and carb avoidance seem to factor most in my lipid test results. My cardiac issues so far as I know, are paroxysmal AFIB (Xarelto) and occasional unprovoked tacchycardia, once for three weeks.
I WOULD like to have the CT calcium test (arterial calcium has showed up on Xrays) as the least invasive check for blockages, but as reported, no one is willing. Is this unusual? Are my local doctors behind the times - or ahead?
Thank you.
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May I ask you your credentials in this field - why I should accept your scoring of my lipid profile instead of the lipidologist who reported commented to me?
Per this lab's standards, my triglycerides are only slightly above cut off for "borderline high" therefore not "very high" per you. This is admittedly too high but I know it's a function of diet - I react strongly to carbs. My previous panel (when I wasn't overdoing carbs) scored me at 85 .
Furthermore, my HDL is "normal" not "high"., while my total cholesterol is 209 - only 9 above "normal" (200) while 201- 239 is "borderline high" at this lab, mitigated by the HDL score.
Statins are not risk-free by any means - certainly not to be taken to treat a single elevated results (triglycerides) when they can be treated by a lifestyle change - diet.
My blood pressure is quite variable but averages about 115/62.
I think you are quite an alarmist - especially undesirable as stress is one of the most damaging lifestyle factors. (I notice you didn't comment on my lipoprotein (A) score - extraordinarily healthy.)
My only certain cardiac risk factor is my arrhythmia, for which I take Xarelto and Metoprolol PRN. That said, I WOULD like to know how much plaque build-up exists in my arteries as my cholesterol was quite high even when I was in my 20s. I suspect that was because of the special diets I tried for weight loss after gaining 20 lbs for no discernible reason.
I learned soon after my thyroid had conked out and began taking Synthroid - 2 mg at first (high). However, I ate per calorie counting for some time (organ meats and whole grains, more sweets than were good for me) trying to lose weight because of the weight gain. Overall OK, but not for a carb-sensitive person. I also wasn't attending to side effects (I ate so many raw carrots, I developed carotenemia!).
Unfortunately, there really isn't any way to get rid of pre-existing plaque - the main reason, some tests (like CAC and C+reactive protein) aren't approved by insurance. They reason there's no sense in testing for something for which there is no treatment. (Nonetheless, I'm eating as healthy as I can, plus the exercise and low weight maintenance - NOT easy for me!) I also take numerous anti-oxidants, including niacin. All that is to make sure I make the best lifestyle choices, calculating cost-benefit risks.
Sometimes I slack off but mostly my lab results are acceptable. - even good. FWIW those lifestyle choices are very important for my overall health, including brain and retinas (would never have guessed the latter)! My brothers who took statins for their higher lipid scores, are/were both obese. As I may have mentioned, one brother who had the most cardiac issues (stents, mild heart attack before 40) finally passed away recently presumably from either a heart attack or stroke. However, he had developed rhabdomyalysis leading to kidney damage . That' was especially worrying as our father died of kidney failure.
Everything has its trade-offs.
I will ask (don't remember whether or not I already I asked him). Afraid he'll just say ask a lipidologist. Sometimes labs and other scripts aren't transferable across state-lines.
Can't hurt to ask, though.
realitytest - you don't need to consider my comments - at all. It is up to you.
It sounds like you think you have it handled.
"Statins are not risk-free by any means – certainly not to be taken to treat a single elevated results (triglycerides) when they can be treated by a lifestyle change – diet."
Uh, statins are designed to reduce cholesterol, not triglycerides.
The fact that you spouted an outright fabrication should cause you to reassess your situation.
There is no "a little high" in lipids. And the comparison numbers you spout are from a different era, the new guidelines from forward thinking cardiologists would have recommended total ldl about 1/2 your present reading.
So your 209 is not barely over, its 75-100 points over.
Wake up.
What are your sources for your assertions about safe cholesterol and ldl levels? Who are these "forward thinking cardiologists"?
I only know to go by the lab norms where my blood was analyzed. (And not only for lipids but all lab work)
How do you come by your so authoritative contradictions of those standards?
I send out an appeal to other CONNECT members to comment on this internecine controversy! Please help.
Does anyone know if the Mayo Clinic approves of this business of patients' over-riding lab standards provided when ones blood lipids are analyzed at a given lab - to judge their lipid health according to some other "higher" research .
What do lab standards mean anyhow, if patients are to disregard them when adjudging their results as "H"(high) or "L" (low)? As far as I know, one is paying not only or a given number or score for a particular test, but its acceptability in a population study according to the experts at that lab. I am hereby being told to disregard lab standards in interpreting the health/illhealth of my lab scores.
I appeal to patient advocates at Heart & Blood to comment on this recommendation. It's serious business if such recommendations are being promulgated on this site. I'm not asserting anything but standard practice.
Your attitude towards my honestly presented stats of my most recent liid profile (also lipoprotein (A) ) is extremely insulting and condescending. I've tried to respond to your comments without stooping to your level of discourse, but it needs to be referenced.
For a single instance, you referred to my comment about the utility of statins in lowering triglycerides as "an outright fabrication".
What th-? It seems you are implying I am actually LYING about a scientific assertion. What in the hell would I get out of that? I don't care what you think or who you are (unless you have more credentials than you've presented), but that's really far out.
Furthermore, a cursory online glance checking the utility of statins in lowering triglycerides, shows there is at the very least considerable professional agreement in prescribing statins' to lower triglycerides.
Is this another area in which your expertise surpasses that of numerous researchers?
https://www.google.com/search?q=are+statins+to+reduce+triglycerides%3F&oq=are+statins+to+reduce+triglycerides%3F&aqs=chrome
https://www.aafp.org/pubs/afp/issues/2007/0501/p1365.html#:~:text=Statins%20have%20an%20important%20role,by%2020%20to%2040%20percent.
https://emedicine.medscape.com/article/126568-treatment
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1 Reactionwhy dont you ask the next ten cardiologists if they think your 209 is "a little high"?
Then come back and whine some more
Hello,
My husband and I are 80 and 72 respectively. We are both on statins and our cardiologist follows us closely. I don’t blame you for being concerned. I do think you should find another cardiologist. Maybe they’re thinking that since you’re on Xerolto that would prevent clots, but I’m not a doctor so who knows.
I'm a Cleveland Clinic patient and have had zero difficulty getting a CAC test done. It's a widely-accepted test, and done fairly routinely, so maybe there's some other, non-obvious reason, that your cardiologist isn't prescribing it?