Managing High Cholesterol: Should You See a Family Doctor?

What are the types of cholesterol medications and the relevant outpatient departments?

Due to stretching, I experienced pain from my back to my chest, which has occurred twice with an interval of about a year.
I went to the hospital for a check-up, and my heart showed no abnormalities, but my cholesterol was over 300, which was said to be hereditary.
Since 2017, I have been taking Lipitor, which reduced my cholesterol to the standard value of 199.
However, in 2020, I discovered that my liver enzymes were elevated, and the doctor switched me to Livalo.
Despite this, my cholesterol remained above 237.
The doctor advised it was just for maintenance.
Recently, I have been experiencing post-nasal drip and have been taking ENT medication for over two months, swallowing more than 800 pills, but the post-nasal drip has not improved.
During this time, I intermittently forgot to take Livalo 3-5 times, and my cholesterol spiked to 303.
The cardiologist mentioned that this was likely due to forgetting to take my medication, and because there were too many patients, I couldn't ask further questions in less than two minutes.
Therefore, I would like to know if I should continue taking Livalo and whether I should switch to a family medicine doctor or consult a different specialty.

2683, 50~59 year old female. Ask Date: 2022/01/17

Dr. Chen Bozhang reply Family Medicine

Hello! Please be sure to take your medication as prescribed.
If you need to reassess your health condition and medication usage, it is recommended to visit a cardiology or family medicine outpatient clinic at another medical facility.
Thank you!

Reply Date: 2022/01/17

More Info

Managing high cholesterol, particularly when it is hereditary, can be a complex process that requires a multi-faceted approach. Given your situation, it is essential to understand both the medical and lifestyle aspects of managing your cholesterol levels effectively.

First and foremost, it is crucial to recognize that familial hypercholesterolemia (FH) is a genetic condition that leads to significantly elevated cholesterol levels, particularly low-density lipoprotein (LDL) cholesterol. This condition increases the risk of cardiovascular diseases, including heart attacks and strokes, at a younger age. Therefore, regular monitoring and management are vital.

In your case, you mentioned that your cholesterol levels have fluctuated, with a recent reading of 303 mg/dL. This is concerning, especially since you have a history of elevated cholesterol and liver enzyme levels. The fact that your cholesterol was previously managed with medications like Vytorin (which contains ezetimibe and simvastatin) and later switched to Lipitor (atorvastatin) indicates that you have been under medical supervision. However, it seems that adherence to the medication regimen has been inconsistent, which can significantly affect cholesterol control.

Given your elevated cholesterol levels and the history of high liver enzymes, it is advisable to consult with a family doctor or a primary care physician who can provide a comprehensive evaluation of your health. A family doctor can coordinate your care, monitor your cholesterol levels, and assess any potential side effects of your medications, especially considering your liver function. They can also help you understand the importance of medication adherence and the impact of lifestyle choices on your cholesterol levels.

In addition to medication, lifestyle modifications play a crucial role in managing high cholesterol. This includes adopting a heart-healthy diet rich in fruits, vegetables, whole grains, and healthy fats while reducing saturated fats, trans fats, and cholesterol intake. Regular physical activity is also essential; aim for at least 150 minutes of moderate-intensity exercise each week. Weight management is another critical factor, as losing even a small amount of weight can help lower cholesterol levels.

You mentioned experiencing symptoms like back pain and nasal drip, which may not be directly related to your cholesterol levels but could indicate other underlying health issues. It is essential to address these symptoms with your healthcare provider, as they may require further investigation.

If you find that your current cardiologist is unable to provide the time and attention you need for your concerns, transitioning to a family doctor may be beneficial. Family doctors can provide a more holistic approach to your health, considering all aspects of your medical history and lifestyle. They can also refer you to specialists, such as a cardiologist or an endocrinologist, if necessary.

In summary, managing high cholesterol, especially hereditary forms, requires a comprehensive approach that includes medication adherence, lifestyle changes, and regular monitoring. Consulting with a family doctor can provide you with the support and guidance needed to effectively manage your condition and address any other health concerns you may have. Remember, proactive management is key to reducing your risk of cardiovascular disease and maintaining overall health.

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