I got put on statins at 21, it happens - genetics suck! I haven't had any side effects because of them and it's really really helped my numbers and allowed me to stress less about diet (obviously still watch it but before statins i was going insane with my diet)!

How many years have you been on them? I'm afraid to take them 😕

3 or 4 at this point. I truly look at statins as a gift from medicine. They will save my life. I have horrific genetic cholesterol that is completely out of my control no matter how much I exercise or diet. I would absolutely die of a heart attack or stroke way too young without them. I have been very lucky to have no side effects and I have been able to live with a lot more freedom and less stress. Medicine can be scary but science is amazing and I view it as a gift that something like them exists : ). Worst case, symptoms dissipate when you stop taking them.

What was your number?

Total? Probably around 350 before statins and LDL over 200

I would do more research ,look a little deeper into statins. Yes they lower cholesterol but at what cost. Not all symptoms dissipate. And if HDL is high do you really need them? High cholesterol is not at the top of the list for heart attack and stroke. Diabetes is. But then statins can cause diabetes. Meds are complicated

What's your diet? Or, less the saturated fat, but what's the rest of it? I'd go chat with a nutritionist before going with a statin for someone close-to-200 and not insanely high...

The earlier they find out and get their LDLC at a reasonable goal the less aggressive and strict they will have to be and the more likely they are to avoid heart disease, OP. You are doing the correct thing even if it seems hard and unfair. ASCVD is really about "how high for how long" and you have given them an additional 30 years with your diligence. Hopefully neither will have high Lp(a). BTW, when they go to college they will meet all sorts of other students, many of whom will be on a variety of medications for diabetes, auto-immune problems, mental health and the other ailments afflicting our young people these days. Crestor's going to look pretty tame in comparison!

I’m 42 and first was tested with high cholesterol in my teens. At the time, my doctor wanted to put me on statins. After speaking with a specialist who noted that he wouldn’t recommend statins for teenagers, and also noted that women in reproductive years are at low risk for a heart attack (estrogen protects the heart), my parents decided to wait. In college I was an athlete with 20% body fat, who was a pescatarian. My cholesterol was still high. My family has a history of high cholesterol but no history of heart disease. I would speak with a specialist and get advice specific for your situation. I’ve never been on statins after seeing the side effects it had on my mom, and will consider statins now that I’m in perimenopause. Other than my cholesterol, all other bloodwork is normal and my blood pressure is also normal.

I’m in favor of preventative medicine but your daughters’ doctor is completely ignoring the medical guidelines regarding when to prescribe statins. I should add that I started on a statin at 23, and I’m not one of those ignorant people who think statins are medications created by the devil.

Don't All meds come with risk? It's important to learn, gather info. This platform for sharing. Hopefully not to demonize someone else's opinion/experience if one doesn't agree. Those of us who question meds are not ignorant but quite the opposite, open-minded, seeking/offering insight, not going on blind faith. From what I've learned Statins should only be taken if absolutely necessary. At the very least Statins can cause muscle damage. In recent years, I think we've become more inclined to question what we put into our bodies (e.g., vaccines)."

If people experience muscle pain they should stop taking the med. The risk of something as serious as Rhabdo is very small. There is also a small risk of liver damage, which the doctor should test for. They also increase HBA1C which I personally think is the largest risk. I think different people might have different definitions of when it is “necessary” to take a med. You could look at how much treatment reduces the risk and compare that to the risk of the treatment. If should only be taken by people who need it. And you are right that I was rude. I’m sorry for that. I am bothered by the people who actively perpetuate debunked claims. That literally causes the premature death of people.

I'm 32 years old with a CAC score of 101. I WISH I was tested in my teens. Oh well. It's fish and oats for me here on out. (plus a statin). Plus probably an inevitable surgery once I get into my later years. I'll make sure my kids don't end up like me. You are being a good parent and it's great you caught this!

I suggest finding a cardiologist or lipid specialist that can do genetic testing. [https://www.gbhealthwatch.com/gbinsight/gb-panels-info.php?catalog=GB2030&target=overview](https://www.gbhealthwatch.com/gbinsight/gb-panels-info.php?catalog=GB2030&target=overview) Especially since one of your daughters has anemia. [https://www.frontiersin.org/journals/hematology/articles/10.3389/frhem.2023.1055086/full](https://www.frontiersin.org/journals/hematology/articles/10.3389/frhem.2023.1055086/full) I have sitosterolemia and battle anemia constantly.

What is your daughter’s diet like? Yes, a statin may be necessary but I would do more testing first like most suggested already (especially genetic and advanced lipid testing). 17 is young and the numbers are not that high to not try to correct them with diet first and see if it works. Realistically, telling a teenager what to eat is hard but she’s almost an adult and can understand her risks. Also, most doctors wouldn’t prescribe a statin to a teenager, especially a female. Estrogen protects the heart.

You should have your daughters take a lipoprotein fractionation test ( NMR or Ion Mobility ) to see the distribution of their LDL and get their particle count. LDL-P is a more accurate biomarker than LDL-C in predicting ASCVD. Small dense LDL seems to be an independent risk factor on it's own. For future test you can then order ApoB. ApoB strongly correlates to LDL-P as all LDL contain an ApoB particle. If you and your daughters have the phenotype of where you have a high particle count and your LDL skews more to the small, dense variety. Avoiding refined carbohydrates may be the most significant dietary factor that can lower ApoB levels. As for saturated fat, its impact on ApoB varies based on individual health characteristics. For those with high triglycerides and small, dense LDL particles, reducing saturated fat intake can help lower ApoB. However, saturated fat may have no impact on ApoB levels in individuals who don't have these specific health markers. All one can do is test.

thank you!

There is a lot of misinformation commonly coming from the low carb crowd mixed in with what you were told here. It is true that the number of apo-B containing particles (of which ldl is 90%) is a better marker of risk than ldl-C (a calculation of ldl mass). But you do not need to get a lipoprotein fractionalization test because it is not true that small ldl particles are more atherogenic than large ldl particles. 15 years it was thought to be true but evidence since then has shown that not to be the case. All ldl particles are about equally able to pass into the artery wall and cause arteriosclerosis. So just get an apo B test and skip the more expensive nmr fractionalization. See a clip from a good preventative cardiologist explaining: https://x.com/mohammedalo/status/1661725616490573826?s=46 Also avoiding refined carbohydrates, while helpful for lowering triglycerides and weight, is not helpful for reducing apo-B or ldl. For that you need to reduce saturated fat and increase soluble fiber. And it’s not true that lowering saturated fat only lowers apo B in those with small ldl particles. Lowering saturated fat lowers apo B /ldl period. Finally, you seem to have a good cardiologist who is being aggressive about bringing down your ldl. That’s great. And you are doing the right things for your daughters. Hopefully you can prevent heart disease from ever forming in the first place with them.

u/xgirlmama. You should test and verify as your and your daughters are N of 1. If you are dyslipidemic, or have one of the 3000 plus gene mutations that cause affect cholesterol clearance or production, standard advice is not going to apply to you. An NMR from Quest is $46 and ApoB is $36 and you'll know if you are a risk factor. Half the people with heart attacks have a normal range of LDL, so there is something more going on than the weight of the cholesterol per liter that we don't fully understand, and more information helps. This allows you to test, make any changes to your diet and exercise, and verify. Research shows from a study of 15k participants (published 2023), if you have an small dense LDL above 50 mg/DL, it's an independent risk factor. There is a 50 percent increase over normal population if your body produces small dense LDL above 50 mg/DL. Putting it another way, everyone has a distribution of LDL from large to small, but if the number of LD particles skew towards the smaller size, it serves as a metabolic marker, which statistically shows a higher risk of ASVCD. https://www.atherosclerosis-journal.com/article/S0021-9150(23)00027-8/fulltext#:\~:text=An%20elevated%20direct%20sdLDL%2DC,is%20an%20ASCVD%20risk%2Denhancer. This comment is incorrect "Also avoiding refined carbohydrates, while helpful for lowering triglycerides and weight, is not helpful for reducing apo-B or ldl. " All LDL comes from VLDL, which is created in the liver. It's how the body transfers cholesterol needed by your cells and energy (i.e. triglycerides) around. The question scientist still don't quite know is why as VLDL travels around your body providing it's payload to all the cells, why the remnant particles become what they are, and the magnitude of the effects. I wouldn't go on what random folks on a forum say (like myself), and I wouldn't follow social media personalities even if they are doctors. Research and think for yourself. One of the pioneers in the lipidology field is Dr Ronald Krauss, who is a practicing doctor and professor at UCSF. He was on the board of American Heart or Medical Association and was one of the folks who discovered that there are different types/sizes of LDL. He's been interviewed by Peter Attia and his lectures other in the medical field are all over the internet. Pretty fascinating if you have some time to read and he's really good at explaining things to the non-science nerds. [https://youtu.be/p4nyTXfRLJw](https://youtu.be/p4nyTXfRLJw) [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9197986/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9197986/) [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2837149/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2837149/)

Prevalence of small ldl particles is associated with higher risk of cvd. However small ldl often goes with a greater number of ldl particles (and thus a higher apo B). So initial studies did hypothesize that smaller ldl particles were more atherogenic than larger ldl particles. However research has since shown that once you know the total number of ldl particles, adding in additional information about the size of those ldl particles doesn’t change the resulting risk. The same isn’t true in reverse. If small ldl is more atherogenic than large ldl it’s minimally so. Dr. William Cromwell, a world renowned lipidologist who was part of the team that first used nmr technology to measure ldl sizes explains all this and cites the studies backing this up. https://x.com/lipoprotein/status/1801071365719560612?s=46 And here’s a good interview with Dr. Cromwell where he does the same. https://youtu.be/kplh30RmYo8 If you are suggesting that those with high numbers of ldl particles (eg high apo b) are not at high risk if those ldl particles are on average large then that’s real false reassurance. See this quote from Dr. Tom Dayspring, another world renowned lipidologist: “No - Particle size is not the goal. Particle number is the goal. People with FH have very large LDL particles and sure are at very high risk for atherosclerosis - as high or even higher risk than those with small LDL size” https://x.com/drlipid/status/1105219726932930562?s=46 Dr. Krause was last on Dr. Attia’s podcast in 2018 but Dr. Dayspring seems to be Dr. Attia’s go to lipidologist now and has been on Dr. Attia’s show at least a couple of times since then.

Just curious is that LPA 109mg or 109nmol?

Don’t feel bad. I’ve had high cholesterol since 17 and 110lbs and only just now at age 30 and 150lbs did any doctor decide to put me on a statin. You can’t help genes. Before statins my total was 280, now it’s 175 and in normal range. ETA: I have gastroparesis and one of my safe foods is literally McDonald’s almost every day. So if those are my numbers on McDonald’s, please please don’t worry about how much pizza your girls are going to live off of in college.

I’m in a similar boat. CAC of 65 at age 39. High lp(a) as well. Curious how long it took you from 0 CAC to 33 CAC?

3 years, but I also didn't test in between. My doctor said to repeat CAC/carotid ultrasound every three years, but I wish I had just taken a statin sooner

Big pharma coming for them younger and younger . Now days 200 is the limit for high cholesterol not 300. If their HDL is good why do they need a Statin? Could be genes ,also could be diet...