Last month I started taking stats because I have irritated arteries. My cholesterol is now 2.5, having fallen from 4.1 to 4.3 since I started taking statins.
I’ve read that people with Alzheimer’s have very low cholesterol, and people with the highest blood cholesterol live the longest. Is this correct? I am 81 years old.
David Wittern, Knoll, Bristol.
You touched on a controversial topic. Yes, there are some people who experience high cholesterol levels in old age and remain healthy. But they are an extraordinary minority.
For the vast majority of people with high cholesterol, the safest option is to manage this with a statin.
Several studies have shown that these medications can reduce the plaque that coats the arteries and prevent further buildup.
Recently, there is also evidence that they may help reduce inflammation, another factor in heart disease.
Yes, there are some people who experience high cholesterol levels in old age and remain healthy. But they are an extraordinary minority
It’s true that our bodies need some cholesterol – it plays a role in producing hormones like testosterone, for example.
But the traditional view is that in healthy people, it is best to keep levels below the total (i.e. good HDL and bad LDL, as well as other blood fats) of 5 mmol/L (mmol/L), with the LDL level below 3 mmol/L. .
If the patient has coronary artery disease or has had a stroke or heart attack, the lower the better.
To address your anxiety about Alzheimer’s disease, contrary to popular belief, the brain does not need cholesterol for healthy function, and there is no evidence that low cholesterol (whether natural or caused by medication) contributes to dementia of any kind.
Known risk factors for dementia are high blood pressure, obesity, hearing loss, depression, type 2 diabetes, lack of physical activity, smoking, social isolation, and low educational attainment.
The latter may be related to the effect on the brain’s reserve – the brain’s ability to compensate for changes caused by disease.
Together, these factors contribute to a third of dementia cases. It is closely related to lifestyle and can be changed.
Known risk factors for dementia are high blood pressure, obesity, hearing loss, depression, type 2 diabetes, lack of physical activity, smoking, social isolation and low educational attainment.
The biggest risk factor is aging. Genes can also play an important role in two common forms of the disease, Alzheimer’s and frontotemporal lobe dementia. The former affects memory and the latter our judgment in social situations.
The second, more common type of disease – vascular dementia – can be caused by the inversion of the arteries in the brain. It may lead to symptoms of memory loss similar to those seen in Alzheimer’s disease.
High levels of cholesterol in the blood are a major cause of this form of the disease. Lowering cholesterol with effective treatments, such as statins, is critical to reducing the risk and progression of disease.
I hope these comments were helpful and will make it clear, along with confirmation from your GP, that a higher cholesterol level will not lead to a better outcome.
I’ve had a ball muscle for two years. Medical examinations did not reveal anything undesirable, but they are very disturbing. I have a persistent cough but no reflux or difficulty eating. I will be glad if you can help.
Mrs. Erin Bell, Hook.
What you’re describing is a common but poorly understood disorder known as globus sensation, in which you feel like you have a lump or tightness in your throat.
The problem accounts for about 4 percent of referrals to ear, nose, and throat (ENT) clinics.
In most cases, including yours, investigations confirm that there is no underlying condition such as gastroesophageal reflux disease, in which stomach acid rises into the throat and mouth. There are many theories about the cause of globe sensation, ranging from the brain’s misunderstanding of feelings in the esophagus, to the abnormal functioning of the esophageal muscle.
Anxiety and other psychological problems can also contribute.
The sensation of discomfort is always worse when saliva is swallowed only, but is less pronounced with food or drink. Fortunately, it is not painful.
When it comes to treatment, low doses of tricyclic antidepressants are helpful in some anxiety patients, for example.
However, I think this is unwise at your age (80 years), as there is an increased risk of side effects such as dizziness, urinary retention, dry mouth, constipation and blurred vision.
Similarly, the anticonvulsant drug gabapentin was found to be effective in a study that included a small group of patients with this disorder, but the same warning of side effects applies, as well as the risk of nausea.
Older patients are more likely to experience side effects than younger age groups.
In general, I tend to avoid prescribing complex medications for a condition that, while unpleasant, is not dangerous.
Your longer post indicates that you have also experienced a long-standing stuffy nose, postnasal drip (where mucus builds up in the back of the nose and throat) and a cough.
This suggests to me that you have an inflammatory condition that affects your airway and sinuses. These are usually caused by allergies.
Nasal sprays that contain steroids are usually prescribed to treat these. I suggest you discuss this with your GP. I don’t think these symptoms are the cause of the globe feeling.
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Responses should be taken in a general context and always consult your doctor about any health concerns.
From my point of view… it’s time to stop circumcision of children
I was shocked by a recent report from Australia of a young boy who died after circumcision.
It’s a story that should serve as a warning about the dangers of unnecessary surgery. In recent years, I’ve seen more than one patient with a near-fatal pulmonary embolism (a blood clot in the lung) after a trivial cosmetic surgery.
Newborn circumcision is considered by many to be a form of genital mutilation, and at least it should be considered unnecessary cosmetic surgery.
There are those who say the procedure reduces the risk of penile cancer, however there is no indication that preventive surgery for breast cancer in children is a good idea.
Circumcision was used in prehistoric times as a means of marking and identifying captive warriors who were then enslaved. It later developed into a religious or cultural ritual.
The view in modern medicine is that the child’s basic right to “physical integrity” trumps the rights of the parents, yet the practice continues.
All physicians must advocate abandoning this unnecessary and risky surgery on behalf of boys, just as it has been achieved for female circumcision.