Heart & Cardiology/cholesterol

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Question
My daughter, 30, was just diagnosed: very low vit d, subclinical hypothyroid, and cholesterol 268 with ldl of 168. hdl 65 and trig of 150.  She was given vit d, synthroid, and Lipitor.  The Lipitor caused muscle pain (in 10 days) so now she is on gemfibrozil.  Seems to me zetia would make more sense.  Do you know why the internist picked gemfibrozil? Is there a chance when her vit d and thyroid are normal, her cholesterol will be lowered? Thank you!

Answer
Hi, http://myheart.net/articles/high-blood-cholesterol-what-do-the-new-guidelines-sa

The short answer to your question is, I am not sure why the internist picked gemfibrozil—usually Lipitor at 20-40mg a day or Crestor at 10-20mg a day is very well tolerated. However, to be perfectly honest with you, I am not sure why your daughter was put on a statin (Lipitor) in the first place. Based on the information you provided, your daughter is not one of the groups of people who would benefit from starting a statin. Given her age and a LDL of 168, the recommendation for her would be a healthy diet, regular exercise, weight control, and avoidance of tobacco products.
Additionally, her vitamin D levels and thyroid levels should be treated and corrected to normal before final determination of her blood cholesterol levels. Yes, as you said, when her vitamin D levels and thyroid levels return to normal then her cholesterol will most likely be improved. If her cholesterol numbers improve, that is great for her, but another viewpoint  is that starting her on a statin (Lipitor) is a little premature at this point. I have not seen your daughter or taken a history and physical so there may be parts I'm not aware of, please discuss with your physician to ensure the reason behind the treatment is fully understood,

Hope that was helpful,  

Heart & Cardiology

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Mustafa Ahmed MD

Expertise

Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

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Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

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http://blog.myheart.net

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Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

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MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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