Q. My total cholesterol is 140, my LDL is 55 and my HDL is 47. I am on simvastatin.
My chiropractor believes that my numbers are too low for me to be on medication. He says the brain is made up of cholesterol and we need a certain amount.
I am confused. My doctor thinks these numbers are great and wants me to stay on the drug.

A. This topic is highly controversial. Many physicians believe that the lower the cholesterol, the healthier the heart.
Cholesterol is essential for every cell in the body. It is a building block for hormones like estrogen, testosterone and vitamin D.
Although studies are scarce, there is evidence that low total cholesterol (below 180) is associated with a higher risk of death in older people (Lancet, Aug. 4, 2001; Journal of the American Geriatrics Society, Jul. 2003). In addition, low LDL cholesterol (below 80) has been linked to a higher risk of bleeding stroke (Circulation, Apr. 28, 2009).
For more information on this complex topic we are sending you our Guide to Cholesterol Control with the pros and cons of medications and non-drug approaches. Don’t stop your medicine without discussing this issue further with your doctor.

Join Over 52,000 Subscribers at The People's Pharmacy

  1. JB
    Reply

    mizm is misinformed, Chiropractors are quite well trained in school and in continuing education classes to advise patients on medical questions of this nature. Do a little online research and you will see that this persons Chiropractor was right on with what he/she told this patient about cholesterol.

  2. Greg Pharmacy Student
    Reply

    Fisherman,
    Why the emphasis on lipid scores? LDL has been for sometime the score that was most predictive of heart attack risk. Recently researchers have been looking into markers of inflammation like CRP.
    Studies have shown that those with lower LDL levels fewer heart attacks when taking statins. It’s possible that LDL lowering is a side effect of the medication, but not the cause of fewer heart attacks.
    Researchers and doctors haven’t figured it all out yet.
    So far, no one has said that a proper diet and exercise are bad things.

  3. Fisherman
    Reply

    I had a heart attack in May 2009 and received one stent for a blocked artery. On 9/15/08 my lipids results were as follows: Trigly=203, Cholesterol=203, HDL=33, LDL=129, Chol/HDL Ratio=6.2. Everyone said that’s why I had a heart attack.
    After the attack, I tried statins for 2 months and then stopped. I changed my diet radically, dropping 20 lbs in a month. Along with eating “right” I started taking cholestoff, Red Rice yeast, Omega-3, lots of niacin, flaxseed, B6, B12, folic acid. On 01/29/10, my lipids results were: Trigly=84, Cholesterol=136, HDL=42, LDL=77, VLDL=17, Chol/HDL Ratio=3.2.
    I thought I had found the secret to the fountain of youth. But soon after, on 3/26/10, I began having chest pains and had to get three more stents for blocked arteries. The cardiologist was very upset that I had stopped taking statins. She said that although the natural stuff worked well in bringing down the lipids into normal ranges, the natural stuff did not give my arteries protection against inflammation, which statins do. I now understand that inflammation is the enemy of healthy arteries.
    So now I am left with the question, why then is there such a major emphasis on lipid scores when inflammation is the culprit? NO ONE HAS GIVEN ME A SATISFACTORY ANSWER !!! So I am back on statins.
    PEOPLE’S PHARMACY RESPONSE: KEEP UP THE GOOD WORK ON YOUR DIET. A DIET THAT LOWERS LIPIDS LIKE YOURS ALSO HELPS WITH INFLAMMATION.
    STATINS ARE QUITE APPROPRIATE FOR SOMEONE LIKE YOU WHO HAS HAD A HEART ATTACK. THE DOCTOR IS ALMOST CERTAINLY RIGHT THAT INFLAMMATION IS THE KEY. WE DON’T KNOW WHY THE MESSAGE HAS NOT GONE FURTHER; PERHAPS IT IS BECAUSE INFLAMMATION IS A LITTLE BIT HARDER TO MEASURE. THAT IS WHAT THE JUPITER TRIAL WITH CRESTOR WAS ALL ABOUT.

  4. Greg Pharmacy Student
    Reply

    Some studies have shown that cholesterol lower than 70 mg/dL is beneficial, but the recommending bodies have not lowered their recommendations for goal cholesterol.
    Depending on your risks for heart attack or stroke your goal LDL may be higher than 100 mg/dL

  5. VJM
    Reply

    I have a friend who has high cholesterol and has been taking simvastatin for almost 2 years and now he has decided that he does not need it and is now not taking it, he says that if he’s eating right there is no need to take it, what do think about that?
    PEOPLE’S PHARMACY RESPONSE: WE THINK THIS DECISION NEEDS TO BE MADE IN CONSULTATION WITH HIS DOCTOR. IT IS POSSIBLE TO LOWER CHOLESTEROL WITH DIET AND EXERCISE, BUT IT IS NOT EASY. HE NEEDS TO HAVE HIS CHOLESTEROL TESTED TO MAKE SURE HE IS REALLY “EATING RIGHT” AND CONTROLLING IT WELL.

  6. Greg Pharmacy Student
    Reply

    D. Freeman and others,
    Guidelines say that doctors should treat cholesterol to: Total = 200; LDL 70 to 100; Triglycerides = 150. The LDL is supposed to be the most important.
    While it “seems logical” that a even lower number should be better this has NOT been proven (if it has I’d like to see the study).
    So if your LDL is lower than 70 to 100 mg/dL maybe it’s time to back off the medication.

  7. D. Freeman
    Reply

    My husband had exceptionally low cholesterol (total was 88). We thought that was good until he ended up with liver failure and required a liver transplant which he was fortunate enough to receive. His liver enzymes were high, over 900, and low cholesterol, but no mention was ever made of the dire consequences he would eventually end up with. He received his new liver 9 years ago and is very healthy today even for 75.

  8. mizm
    Reply

    Quite frankly, you should not trust a chiropractor to give you medical advice other than the musculoskeletal system. They don’t have the medical training to make any decision of this kind. Chiropractors can be great for treating certain spinal and musculoskeltal disorders, but it is way out of their scope of practice to be dealing with systemic disorders. Beware.

  9. JB
    Reply

    FDA also issued a warning on March 19, 2010 about simvastatin causing serious muscle problems, including soreness, weakness, and even breakdown of the fibers. People on 80 mg versus 20 mg have been examined and apparently the higher the dosage the more problematic it is. I don’t believe the FDA advisement examined dosages in between. So obviously if one doesn’t need to stay on the medication weaning off of it or getting the dosage as low as possible while maintaining healthy levels would be optimum.

What Do You Think?

Share your thoughts with others, but be mindful of protecting your own and others' privacy. Not all comments will be posted. Advice from web visitors is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. In posting a comment, you agree to our commenting policy and website terms and conditions.