Dr. Leavitt's Blog
I have been told I have high cholesterol. What is normal and how can I get there?
Reaching your cholesterol goal is one of the most important things you can do for your health. Hyperlipidemia, or high cholesterol, is directly associated with increased risk of heart disease, coronary artery disease, stroke, and heart attack.
Your cholesterol level, found through a simple blood test, includes Total Cholesterol, HDL (known as good cholesterol), Triglycerides (a type of fat found in your blood), and LDL (known as bad cholesterol).
Normal range for most adults is Total Cholesterol (125-200mg/dL), HDL (>40mg/dL), Triglycerides (<150mg/dL) and LDL (<130mg/dL).
However, patients with coronary heart disease or diabetes should aim for an LDL of <100mg/dL; patients with diabetes and known heart disease should aim for an LDL of <70mg/dL.
Ways to lower your cholesterol include lifestyle modifications such as eating a heart-healthy diet—reduce saturated fat (especially trans fat) and salt intake, doing at least 30 minutes of physical activity every day—walk, bike, swim, jog, dance—whatever you love to do, do it, reducing stress, not smoking, and getting enough sleep.
Natural supplements, such as Omega 3 fatty acids from fish oil, vitamin E, and antioxidants will help. Also, various medications can lower blood cholesterol levels. The types of medications include statins, selective cholesterol absorption inhibitors, resins (also known as bile acid-binding drugs), fibrates, and niacin.
For the best possible results, you should sit down and talk with your family doctor. Discuss your specific cholesterol goals and how to reach them.
At Leavitt Family Medicine, we are here for you, for all your medical needs. We welcome your questions and comments; Please let us know how we can help you today!
It seems the older I get, the more I keep forgetting. What can I do to find out if I have Alzheimer’s?
Alzheimer’s dementia and memory loss in general are very common areas of concern for patients in my clinic. Many have family members or friends who have Alzheimer’s dementia and want to do everything they can to avoid memory loss. Several types of blood tests are available to check for memory loss.
Genetic risk factors, including the apoE gene, E4, can be tested for Alzheimer’s dementia. Other risk factors for memory loss include sleep apnea, depression, alcohol or drug abuse, certain types of cancer and cancer fighting treatments, smoking and cerebral vascular disease.
High homocysteine levels can indirectly lead to memory loss, as well as low estrogen levels in women and low testosterone levels in men. It is important to sit down and talk with your family doctor to discuss and assess your memory loss, to make sure you are utilizing preventative measures, such as controlling high blood pressure and diabetes, and to help prevent any further memory loss.
At Leavitt Family Medicine, we are here for you, for all your medical needs. We welcome your questions and comments; please let us know how we can help you today!
I’ve been told I have high blood pressure. What is normal blood pressure and what can I do to get there?
High blood pressure, or hypertension, is elevated arterial blood pressure in your system.
Normal blood pressure is <120/80mmHg.
Prehypertension is 120-139/80-89mmHg.
Stage 1 hypertension is 140-159/90-99mmHg.
Stage 2 hypertension is >=160/100mmHg.
Persistent hypertension is one of the risk factors for stroke, myocardial infarction, heart failure, and arterial aneurysm, and is a leading cause of chronic kidney failure. Moderate elevation of arterial blood pressure leads to shortened life expectancy.
Dietary and lifestyle changes can improve blood pressure control and decrease the risk of associated health complications, although drug treatment may prove necessary in patients for whom lifestyle changes prove ineffective or insufficient. Here are some excellent ways to lower your blood pressure:
- Eliminate or effectively handle stress
- Reduce salt intake
- Eat a heart-healthy balanced diet
- Get 30 minutes of exercise every day
- Get quality sleep
- Take an aspirin (81mg) each day
- Drink plenty of water
Medicine can serve as a temporary way to keep your blood pressure normalized until your lifestyle changes serve to lower blood pressure on their own. Be sure to sit down and talk with your family doctor about getting your blood pressure to normal. It can add years to your life and life to your years!
At Leavitt Family Medicine, we are here for you. We welcome your questions and comments; Let us know how we can help you today!
My doctor started me on a statin drug for high cholesterol, but I've heard about bad side effects with this type of medicine. Is there anything else I can try?
In treating high cholesterol, there are many factors to consider. Treatment depends on which part of the cholesterol is high (LDL, HDL, Triglycerides, Total Cholesterol), how high it is, and what your cholesterol goals are. Statins are the most commonly prescribed drugs for treating high cholesterol. In my practice I prescribe them for patients with very high total cholesterol and very high LDL, commonly known as ‘bad cholesterol’.
One possible side effect of statins is rhabdomyolysis, which is the breakdown of muscle tissue. Patients who experience a severe muscle cramp, should discontinue the medication immediately. Statins can also lead to liver damage, therefore, blood tests are needed every three months when statin therapy is initially started to monitor liver function.
Additional effective treatments include other classes of cholesterol drugs and omega-3 fatty acid supplements, which not only help lower total and LDL cholesterol but can also raise the HDL or good cholesterol. Statins are very good drugs for lowering cholesterol, but there are other types of medicine to help regulate cholesterol when statins cause serious side effects.
Talk to your family doctor and work together as a team to create the best plan to reach your cholesterol goals. It’s important to tailor your treatment to what works best for you and your specific cholesterol needs.
At Leavitt Family Medicine we are here for you. We welcome your questions and comments; Let us know how we can help you.
I have been reading about early-onset dementia. What exactly is it?
Early onset dementia is a disorder that is usually hereditary in nature. It is typically seen in patients before age 55. Alzheimer’s dementia usually occurs after the age of 65. Geneticists have mapped out several different types of gene sets for Alzheimer’s dementia. Genetic testing is now available to test for this disease.
Symptoms of Alzheimer’s dementia include subtle memory failure, confusion, poor judgment, language difficulties, and agitation. There are several effective medications, along with lifestyle modifications and natural therapies, that can slow the progression of the disease and newer therapies are currently under investigation.
According to both the Mayo Clinic and Harvard Medical School there is no evidence to date that early-onset dementia has any more rapid progression than regular onset Alzheimer’s. Patients with either early-onset or Alzheimer’s dementia can live a long, productive, and active life.
Your family doctor can check for both types of dementia with a simple mini-mental status exam. Be sure to sit down and have a good discussion with your family doctor about any symptoms you have.
At Leavitt Family Medicine, we are here for you. We welcome your questions and comments; please let us know how we can help you.
I am hearing a lot of talk about Vitamin D3; why is it important to check my level?
In recent years, there has been an increase in Vitamin D deficiency. Studies report that nearly half of the U.S. population suffers from lack of Vitamin D. So why is having enough Vitamin D important? Without enough Vitamin D, calcium in our diet cannot be absorbed, thus leading to osteomalacia in adults, and rickets in children, both of which are bone thinning and deforming disorders.
Lack of Vitamin D has been linked with depression and immune system dysfunction. So if you’re the person who is always catching the latest cold/sinus infection/24 hour bug going around, Vitamin D deficiency may be to blame.
The prefrontal cortex of the brain is also affected by Vitamin D deficiency, leading to poor planning of complex cognitive behaviors and decision making. Vitamin D can help slow the progression of Alzheimer’s dementia by helping the immune system fight dangerous amyloid proteins.
Making sure you have enough Vitamin D can improve muscle function and help prevent diabetes and cancer (most notably pancreatic cancer). Vitamin D levels can be checked with a simple blood test. Make sure that your active Vitamin D level is checked (25-hydroxy-cholecalciferol). If your levels are low, a Vitamin D3 supplement is now recommended at 2000 IU per day according to the National Institute of Health. Blood levels are then usually checked every 3 to 6 months to track your progress, making sure you reach the optimal level for your health. Be sure to sit down and talk with your family doctor about how to reach your Vitamin D3 goal.
At Leavitt Family Medicine, we are here for you. We welcome your questions and comments. Please let us know how we can help.
Q. As I have gotten older I notice I bruise easier than I use to. Sometimes I'll have a bruise on my arm and not even remember bumping it on anything. Is this something to be concerned about?
A. Many times people will wonder, "Now when did I do that?" as they look at a dark blue mark on their arm. If you bruise easily, you are not alone. As we age, bruising can become more common. One reason for this is because skin tends to thin with age. Sun damaged skin bruises easily and genetics can take some of the blame--some families just tend to bruise easier than others. Also, some medications, such as blood thinners, gout medicine, arthritis medications, and steroids, can result in bruising easily.
Usually bruising easily isn't a sign of anything serious, but sometimes it indicates another problem that may require a professional medical care.
Bruises are caused by the breakage of blood vessels under the skin. When a blow to the area causes these vessels to break, blood leaks out and causes the "black and blue" appearance we call a bruise. The harder you're hit, the darker and larger the bruise will be, but sometimes even little bumps can cause significant bruises.
Sometimes bruising easily is a symptom of a lack of vitamins or problems with clotting. If you have never bruised easily before but suddenly find yourself dealing with a myriad of bruises, you may want to call your family doctor. The same is true if your bruises are especially painful or tend to be large and you can't remember bumping yourself. Bleeding elsewhere (nose or gums) in addition to bruising also points to the need for medical attention.
At Leavitt Family Medicine, we are here for you. We welcome your questions and comments. Feel free to contact our office for an appointment with any medical problems you may have. .