Should healthy people take statins?
Q. I am a very healthy woman, not overweight, with total cholesterol around 200. I have no history of heart disease in my family.
In spite of all this, I would be put on statins if my doctor were to follow the new heart guidelines. There is no way I would take statins at this point, not with everything I know about them.
What troubles me is the ever-growing tendency to prescribe more and more medications for Americans. We are responsible for our own health, and we have to educate ourselves about the pros and cons of anything we take.
A. Key to the new guidelines is the "CV Risk Calculator." This spreadsheet requests answers to nine questions about age, race, gender, cholesterol, blood pressure, diabetes and smoking. Even a healthy person like you, with good numbers and no history of heart disease, could be a candidate for statins depending on age and blood pressure. Some estimate that the new guidelines could double the number of people on such drugs to more than 70 million.
A healthy Mediterranean-style diet and an exercise program could be as effective as statins without the side effects (JAMA Internal Medicine, Oct. 28, 2013). To learn more about the pros and cons of medications and how to control cholesterol, blood pressure and other risk factors without drugs, you may be interested in our book "Best Choices From The People's Pharmacy" (online at www.PeoplesPharmacy.com).
Q. I had a lumpectomy 15 years ago. The scar still itches and is painful at times. Do you know of any remedies?
A. One implausible-sounding approach is the original-formula hemorrhoid ointment Preparation H. Readers of this column have used this product to help heal bedsores, soothe dry, cracked fingers and relieve the itch of surgical scars. One woman wrote years ago that the burning and itching from a heart-surgery scar drove her crazy until she applied old-fashioned Preparation H to it.
Since then, Preparation H has been reformulated in the U.S. It no longer contains the live yeast cell derivative (LYCD) that may have contributed to its healing power. A study in diabetic mice found that LYCD dramatically improved healing of skin wounds (Journal of Burn Care and Rehabilitation, March-April 1999).
Preparation H is still sold with LYCD in Canada. LYCD is referred to as BioDyne. Several outlets import this product and offer it online.
Q. I recently learned through testing that I have borderline low testosterone. My doctor suggested medication, but the possible side effects concern me. Are there natural ways to increase testosterone levels? I am 66 and not overweight. I exercise regularly and take Crestor.
A. Statin-type drugs like Crestor can lower testosterone levels (BMC Medicine, Feb. 28, 2013). You might ask your doctor whether adding medication to counteract this possible side effect is warranted. A new study suggests that testosterone replacement therapy increases the risk of heart attacks and strokes (JAMA, Nov. 6, 2013).
Some research indicates that a low-carb diet that leads to weight loss may improve sexual and urinary function (Journal of Sexual Medicine, October 2011). You will find more natural recommendations in the forthcoming book from John La Puma, M.D. It is called "Refuel: A 24-Day Eating Plan to Shed Fat, Boost Testosterone and Pump Up Strength and Stamina."
In their column, Joe and Teresa Graedon answer letters from readers. Write to them via their website: www.PeoplesPharmacy.com. Their newest book is "Top Screwups Doctors Make and How to Avoid Them."