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Dr. D.J.
Dr. D.J., Board Certified Physician
Category: Medical
Satisfied Customers: 19899
Experience:  MD
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RA-Sha

Customer Question

I did a Lifeline Screening Exam in 2011 and my carotid artery test came back as follows: Fairly low to moderate amount of plaque build up, not affecting blood flow velocities. However, the velocities fell below 110 cm. per second, which is in normal range. (left side normal, right side mild). This was done in a church hall be a mobile group of screeners. Should I believe this number? My cholesterol is high but I have had muscle injury (high MK) while on Lipitor. I have been off all cholesterol meds since. My doctor said if anything showed up on this test, she would start me on Crestor, once very 3 days.
I'm concerned about more drug side effects. She says all my numbers are okay except for the LDL and that if my Doppler were normal, I could stay off all meds. I am skeptical of the Lifeline Screening results because of the technicians. Should I believe it or have my cardiologist do another Doppler to confirm? Is the plaque reversible? If there is plaque in my carotid, does that surely mean that other arteries in the body have plaque as well? What can be done about the plaque? I am a 59 yr old female in good health, good weight , no high BP and exercise by playing tennis once or twice a week. Should I get the CT scan or another Doppler or just take the Crestor? I would appreciate your input. Thanks.
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. D.J. replied 11 months ago.

Mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

Mysticdoc :

Hello,

Mysticdoc :

Thanks for your question.

Mysticdoc :

Some degree of plaque build up is expected with aging process.

Mysticdoc :

Doppler study is more accurate than the life line screening.

Mysticdoc :

And the screening showed only mild problem not affecting the normal blood flow.

Mysticdoc :

A repeat doppler can be done to confirm the result after discussing with your cardiologist.

Mysticdoc :

The other blood vessels also can be affected in mild degrees as expected with aging.

Mysticdoc :

But this should not be concerning given your active life style.

Mysticdoc :

Statin intolerance is a problem.

Mysticdoc :

And crestor is not an exception.

Mysticdoc :

Other cholesterol lowering medications like niacin, exetimibe can be tried to lower LDL if required.

Mysticdoc :

However, your test is not very concerning.

Mysticdoc :

Nothing needs to be done for mild plaques.

Mysticdoc :

For significant plaques angioplasty can be done to remove the plaques.

Mysticdoc :

But this is not required in this stage.

Mysticdoc :

Best wishes,

Customer :

LDL is 164. Cardiologist told me that Crestor, given once every 3 days, has time to be washed out of my system between doses. My primary wanted to give me Lipitor "again" in a low, low dose OR Pravacol, which he claims had lower side effects. Seems my two docs disagree on the drugs of choice. which of those choices would you choose in this case (outside of your before mentioned drugs)?

Customer :

I am familiar with Niacin, but not Exetimibe. Please expand on that drug.

Customer :

Are you still there?

Expert:  Dr. Thomas, MD replied 11 months ago.
Hello from JA
exitimibe acts by decreasing cholesterol absorption in the intestine.
Here is some FDA information.
http://www.drugs.com/ezetimibe.html

In fact moderate plaque is not good, but common in your age group.
Exercise, correct diet, and lowering the LDL while rasing the HDL can effectively reverse plaque.

See any book by Dean Ornish on this subject.

Plaque build up clearly can be arrested, and reversed in some cases if you are strict.

In any case, the other expert is off line...I will be glad to follow up as needed.

You might in fact not need meds at all, I can advise you further if you give me your exact numbers.

OK. If you have further questions or details, use reply to expert.

Otherwise please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.

Expert:  Dr. D.J. replied 11 months ago.
Hi there,
I wanted to reply to your question on ezetimibe.
Ezetimibe inhibits cholesterol absorption from your intestine thereby lowering cholesterol including LDL level.
Your LDL 164 is not that high.
The goal should be around 100 since you do not have any other medical condition.
Ezetimibe does not affect the muscles.

Best wishes,
Customer: replied 11 months ago.

Here are my numbers. Your further interpretation and response regarding drugs is appreciated. Thanks.

Kathy

Expert:  Dr. D.J. replied 11 months ago.
Hi Kathy,
I am sorry for the confusion above.
Since you have not got my post above, I will report the information again on Ezetimibe.
Ezetimibe inhibits cholesterol absorption from your intestine thereby lowering cholesterol including LDL level.
Your LDL 164 is not that high.
The goal should be around 100 since you do not have any other medical condition.
Ezetimibe does not affect the muscles.

Best wishes,

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