High LDL and Lp(a) management with rosuvastatin
A Patient Story from Last week I consulted on a 50 year old Indian man—main symptoms: fluid retention and poor sleep for several months. Additionally had some abnormal heart tests (main reason for consultation). His LDL was elevated at around 150 and he had a very high Lp(a) at almost 140 (this is very high, normal is less than 30). He had not been on any prescription medications but on about 6-7 supplements by naturopathic providers. Supplement List 1. High dose vitamin D 2. Low dose hydrocortisone 3. High dose Vitamin C 4. Other vitamins including E and K 5. Vitamin B complex 6. Couple of other medications
My assessment: 1. Fluid retention was happening from a combination of things including low dose hydrocortisone 2. Sleep issues were being made worse by high dose Vitamin D (vitamin D levels were high) 3. He did not know about the high cardiac risk from Lp(a)——risk rises to very high levels at this level of Lp(a) along with an elevated LDL My intervention 1. Stopped Hydrocortisone 2. Stopped Vitamin D 3. Started Rosuvastatin 5 mg daily, and emphasized importance of lowering LDL very aggressively (down to less than 70) Learnings for all 1. Natural is not necessarily safe (Vitamins ADEK can cause syndromes of toxicity in higher doses) 2. Please carefully evaluate your supplement list and make sure your doctor knows what you are taking 3. Learn about your heart disease risk and use appropriate medication to GET TO TARGET on your LDL (less than 100 for most Indians, less than 70 with Diabetes and Known heart disease or very high risk)