Hi, Dr. Moyle,

I have had consistently high cholesterol for over a year now - in the 238 to 240 range. My Triglycerides have been erratic, sometimes above normal,sometimes below.

My doctor refuses to prescribe a statin to reduce cholesterol, even though my diet is good and I walk a lot. What is the thresshold for prescribing statins and are there any risks in not taking them in my case? Also, do the statins cause side effects? (One of my liver enzymes is 20% above normal, though my doctor declines to say whether that is the reason he doesn't want to prescribe a statin drug).

I'd really appreciate your guidance here.

Many thanks and regards.

We generally follow the national cholesterol education program guidelines http://www.cholesterol-tests.com/NCEP_Guidelines.html

together withn a Framingham risk calculator http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof

If you 10 year risk of heart disease is >15-20% this is an indication to treat. An isolated high cholesterol (yours is not particularly high, and you may have lots of good HDL cholesterol amongst it) with no additional risk factors would be unlikely to put you in the intervention range

I hope this helps

Regards

Graeme Moyle