Letrozole and Increased Cholesterol Levels

ThinkingPositive

I have been taking Letrozole for 11 months now. Started in Feb 2015, August 2015 was diagnosed with osteoporosis in my lower spine and osteopenia everywhere else. So now I am taking Letrozole plus Actonel, vitamin d3 and calcium. Had my cholesterol tested in December. My cardiologist just called me with my results saying i have high cholesterol (never had it before). Cardiologist wants to put me on medication and low fat diet. I really don't want to jump right away into taking another medication. I also take blood pressure medication for high blood pressure which I have had for years. I gained 10 pounds in the 11 months I am on letrozole.

My total cholesterol is 220, range says it should be less than 200

LDL (bad) is at 134, the report says the range should be less than 130.

HDL (good) is at 68, range should be greater than 48

My Cholesterol / HDL Ratio is 3.2, range should be less than 5.0

Has anyone had any similar experiences with Cholesterol increase because of the Letrozole??

Thinking maybe If I change my diet and try to lose the 10 pounds maybe I won't need medication? Or does it not matter, the letrozole will keep it high no matter what??

Any advise or experiences would be greatly appreciated.

MelissaDallas

I personally would try diet before I agreed to the meds. Your total is not very high and your ratio is good and your good cholesterol is good. Walking or other exercise sometimes helps more than diet.

Lily55

Yes my cholesterol went up when I as taking letrozole and back down again when I stopped.  I am on Anastrozole now and cholesterol has gone up 40 points!! So I think it is a known side effect

Kicks

There hasn't been any changes in my total cholosterol or HDL or LDL in at least 20 yrs - 6 of those yrs I've been on Femara/letrozole. My total is high, however, it is my HDL that is very high while LDL is low so no worry. (Don't remember the exact numbers from 6 mths ago and will be having new blood work next month before my 6 mth checkup.)

I have not gained any weight on Femara/letrozole and do not have any BP issues either.

We are each unique and come into BC TX differently health wise (and age). It's to be expected that our bodies will each react differently. For me - the only 'health issues' I brought to IBC DX/TX were arthritis in upper spine and osteopenia. 'Everything' that developes as we continue to age can not totally be 'blamed on' TX - might have developed anyway over time as we age. My arthritis has gotten worse (expected anyway), my osteopenia is now osteoporosis (expected as I have a huge family HX of it). Since DX, my thyroid has decided it doesn't 'like' to 'work' as it should - again this has been something expected all my life as there was radiation to my throat when I was 1 1/2 yrs old after tonsils removed (was common practice year ago).

Point is - while certainly TXs can and sometimes do cause health issues - not everything that ever happens to use after/during any TX is not ALWAYS a direct result of the TX.

ThinkingPositive

Thanks for your responses. I am off to see my MO tomorrow for my 3 month followup, Hoping he will have some input into this and guide with some information for when I meet with my cardiologist.

cp418

I can't remember if I had posted this link somewhere about cholesterol link to hormone positive breast cancer. However, since this topic comes up so often here is the link with a diagram of metabolism.

http://www.integrativeoncology-essentials.com/2013...

http://science.sciencemag.org/content/342/6162/109...

There is an entire topic about elevated cholesterol levels in the next complementary forum.

https://community.breastcancer.org/forum/79/topics...

ChiSandy

220 total cholesterol, taken by itself, is high--but only mildly so. 134 LDL isn’t optimal, either. But factor in that nice high 68 HDL, as well as your 3.2 ratio, and I definitely think your doctor is overreacting. There has been a plethora of research in recent years stating that not only is high HDL more cardioprotective than high LDL is harmful, but also that (especially in women who have suffered no cardiovascular “events”) neither high LDL nor high total cholesterol are predictive of future heart attacks or strokes. And though diet can work wonders, it’s NOT “low-fat” that is the gold standard: it’s low-carb that works better. (Not necessarily “no”-carb, high-fat or Paleo--low-carb allows almost all non-starchy veggies, low-to-moderate-glycemic-index fruits, low-lactose dairy and high-fiber legumes and whole grains--it’s even possible, albeit not easy, to find a way to do low-carb vegetarian and perhaps even vegan). The villain in high serum lipid levels? Triglycerides. High “tris” go hand-in-hand with increased glucose levels, insulin spikes, insulin resistance and especially inflammation. It isn’t arterial plaque alone that causes heart attacks: it’s “friable” (fragile, easily “broken”) plaques that inflammation causes to break off and cause heart attacks and strokes. And even without high triglycerides, sugars and simple starches promote inflammation.

I would be very, very wary of starting a statin if your tris are normal, your HDL high and your LDL mostly large-and-fluffy-particle (and your ratio indicates it might be). You can ask for a lipid panel that measures particle size, but it may be an unnecessary expense--my husband the cardiologist (32 yrs. experience) says the ratio of triglycerides to HDL is an accurate predictor of LDL particle size--the smaller the ratio, the likelier your particles are larger. It’s the small, dense particles that are the most “atherogenic” as well as highly inflammatory. Statins carry their own side effects--the most common being elevated blood glucose and a1c levels, taking normal individuals into the prediabetic range and prediabetic &/or metabolic-syndrome people into Type 2 diabetes (which in itself is a major cardiovascular risk factor). And most oral Type 2 drugs.....raise LDLs! Why start a vicious circle? And a small but not insignificant number of people on statins get severe large-muscle pains which can be a precursor to a potentially fatal syndrome called rhabdomyolysis--the breakdown of muscle, including heart muscle. (I was on Lipitor for 6 weeks--but not only did it spike my glucose and a1c levels but also gave me severe thigh aches--my doctor discontinued it, I kept eating low-carb and I’ve been fine ever since). Of course, you’ll also need to control your blood pressure regardless of whether you take a statin.

Ask your doctor to compute your Framingham score, which calculates the percentage of probability of a cardiovascular “event” over the next 10 years. If you know your LDL, HDL, glucose and BP numbers, you can plug them and your age, sex, BMI/weight, smoking and drinking history into an online calculator. My doctor found my score was only 6. The recommendation for statins is usually for people scoring >8 (sometimes even 10). Show your doc your score (assuming it’s 8-10 or less) if you don’t want a statin!

ThinkingPositive

ChiSandy...you provided me with more info than my MO did today!!!! I don't want to take any more meds than I am already taking. He suggested that I talk to my cardiologist and tell him I want to try diet and exercise first and then retest. He also said a very low % of people taking letrazole have increased cholesterol and it's probably not from the drug. I find that hard to believe since so many of the side effects that are listed for the drug I have. My triglyceride level was 90 and the reference range says it should be less than 150 and my non-HDL cholesterol whatever that is is 152 .don't know what all that means but maybe could help out there.

labelle

The only time I had high cholesterol was when I my thyroid levels were off. My GP wanted me on statins, but my endo said once my thyroid levels were stabilized and in normal range my cholesterol would probably go back down. It did. Before taking anything for the high cholesterol be sure your thyroid levels are within normal range. Low thyroid can apparently cause high cholesterol levels to show up on tests.