Dr. Lisa Hudgins Answers Your Questions About Cholesterol Treatment

Dr. Hudgins answered: There are four published and properly conducted studies of four different statins in 706 children ages 8 to 18 with LDL cholesterol levels of at least 160 mg/dL treated with drug or placebo for 1-2 years. There were no serious side effects, including effects on the liver. Four children had temporary elevations in liver function tests that went away after stopping the drug. In adults, serious problems in the liver are rare and reversible upon stopping the medicine. Since children are less likely to take other medications and to drink alcohol, they are probably at a lower risk of liver problems. Nevertheless, while on a statin, they should have a blood test for liver function every 4-6 months or if they develop persistent or severe nausea, vomiting and/or pain over the liver.

Robin, from Horsham, Pa., asked: My daughter has hereditary high cholesterol. She has been on Zocor 10mg since she was 10. She is now 15 years old and since she started menstruating her dose has been put up to 20mg. I understand most studies are done on boys. What studies are being done concerning girls/women?

Dr. Hudgins answered: Of the 706 children treated for 1-2 years with statin or placebo, only 46 were premenstrual females, but there were many more older, menstruating females. The onset and the characteristics of the menses and blood levels of various sex-related hormones were not affected. There is a need for additional studies in premenstrual females and pre-pubertal males. In adults, the drug is equally safe and effective in males and females.

Karen from Merrill, Wis., asked: My husband had a heart attack at age 40. His brother was 43 when he had one. My nephew died of a massive heart attack at age 42. My two sons, age 19 and 16 have had several checkups with cardiologist due to their family history. My eldest son: LDL 120; HDL 38; trig 202; total 198. Middle son: LDL 99; HDL 33; trig 78; total 148. They will have a recheck this month. Question, if my eldest sons results don't change a lot, would you suggest talking to the dr. about statin meds?

Dr. Hudgins answered: It is likely that your husband has a similar lipid pattern that is common in "metabolic syndrome" or "prediabetes." What were his risk factors for the heart attack? Your sons have low HDL levels and the eldest high triglycerides (assuming a 12 hour fast before the blood test). Are your husband and sons overweight? If so, weight loss, a reduction in dietary saturated/trans fat, sugars, refined starch and increased physical activity will lower the triglycerides (and LDL) and raise the HDL. Stopping cigarettes, if used, will help. Be sure that blood sugar and liver function are normal. I would emphasize this approach and not recommend statins for LDL levels this low.

Gina from New Bern, NC., asked: My concern mainly is with the health benefit of giving kids statins. I took Zocor and Tricor for about 5 years and now I have what could be severe liver problems, and the first thing my doctor did was take me off of the Zocor and the Tricor. So is it really safe to give children statins?

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