Letrozole and Increased Cholesterol Levels

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

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!

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.