High cholestrol medication and the FAA

[DonMuncy]

Can someone with experience in this area tell me what happens when your doctor puts you on medication for high cholesterol. Do you just tell the AME you are taking it and he OKs it. Does he require documentation from your doctor about whether it is stabilized. Medical records? Lab results?

[BigTex]

Don,

 

Here's what I have on Cholesterol medications...

 

Cholesterol / Lipid Management - Most medications used in the treatment of hyperlipidemia or the management of cholesterol are approved by the FAA. 
Some of the medications, such as Caduet, Lescol (Fluvastatin) & Colestid (Colestipol), require detailed favorable documentation.
This includes but may not be limited to: 

• Caduet (Amlodipine Besylate + Atorvastatin Calcium)
• Colestid (Colestipol)
• Crestor (Rosuvastatin Calcium)
• Lescol (Fluvastatin)
• Lipitor (Atorvastatin)
• Lopid (Gemfibrozil)
• Mevacor (Lovastatin)
• Niacin (Nicotinic Acid)
• Pravachol (Pravastatin)
• Precose (Acarbose)
• Questran,Cholestyramine, Locholest, Prevalite (Cholestyramine Resin)
• Tricor (Fenofibrate)
• Vytorin (Ezetimibe / Simvastatin)
• WelChol (Colesevelam Hydrochloride)
• Zetia (Ezetimibe)
• Zocor (Simvastatin)

Here's a link: http://www.leftseat.com/medcat1.htm

[DonMuncy]

Thanks Gary, I had seen the list and figured it was not too big a deal. I just wanted to know whether one would be wise to get a letter from his physician, or whatever, before he went for his exam.

[Danb]

Don I did not need a letter for the meds for cholesterol meds..but when I went on high blood pressure meds, I get a letter from the cardiologist along with BP readings for a certain time..I've been on disqualifying pain meds still sometimes for spinal disease

and I put them down and tell the Dr I never fly whose and use them after surgery or when hit with episodes, I had a difficult time coming free , now my medical is next month and who knows I may fail..my AME moved from De to Fla and I kept him and am flying to Aflac fo my physical..good luck..

[John Pleisse]

Lipitor, 20mg..............15 years. Not an issue.

[Tommy]

Anti-lipids medications are generally well tolerated and have relatively benign side-effects. Certainly minimal risk of pilot incapacitation whilst taking these medications. The most common serious (still rare) issue is some statins (inc Lipitor) can cause myositis (inflammation and break down of your muscle cells) and deranged liver function test. 

 

So it's prudent to

 

1) report any new medications (and in this case, the chance of you being grounded is close to 0%) to your AME 

2) report any muscle pain to your family doc

3) regular check of your liver function test (simple and cheap blood test) once you are on this medication (your family doc should be organising this)

 

Cheers

 

ps. I am a qualified DAME in Australia (equivalent of US AME) 

pps. combination of ezetimibide with a statin (eg. Vytorin) has been shown to be more superior than statin alone without causing any statistically significantly more side effects. 

[carusoam]

Simvastatin...

It's better to control the cholesterol than having a heart attack.

I have found the AOPA section on approved medicines and their live advice quite helpful.

Getting old isn't getting as difficult as it used to be...

In the event of an actual heart attack they can help you with getting a class III, Special Issuance.

If you have the good fortune to have meds that alter your heart rate, you would want to get used to them first. Too high of a dose can cause diseyness after standing or pulling some higher Gs.

If you lose a significant amount of weight, check with your doctor to maintain the proper dose.

This is advice I wish I had years ago. Hope it is helpful to somebody out there avoiding the doctor for the wrong reason.

Best regards,

-a-

Tommy, You are awesome quick to return some expertise to MS!

Vytorin helped pay my kids' way through college. Go Schering Plough!

[Bob - S50]

I use Atorvastatin (Lipitor) and list it on physical application every year.  No special handling required.

 

Bob

[Robert C.]

I use Atorvastatin (Lipitor) and list it on physical application every year.  No special handling required.

 

Bob

Ditto

[ryoder]

I'm not a doctor but if I only had high cholesterol and not also high bp I would consider aggressive lifestyle changes to see if diet and exercise can control it. I lift weights and eat a low fat high protein low carb diet. My wife eats the same way and our cholesterol numbers are awesome. My bp numbers aren't awesome though and that runs in the family. Maybe I got lucky with cholesterol but I hear that high intensity training helps with it.

[Bob_Belville]

I'm not a doctor but if I only had high cholesterol and not also high bp I would consider aggressive lifestyle changes to see if diet and exercise can control it. I lift weights and eat a low fat high protein low carb diet. My wife eats the same way and our cholesterol numbers are awesome. My bp numbers aren't awesome though and that runs in the family. Maybe I got lucky with cholesterol but I hear that high intensity training helps with it.

I'm not a doctor either, but I think choosing your parents is more of a factor than diet for blood cholesterol. I eat a 4 egg omelette every morning.  My last physical was typical: Cholesterol 158; Triglycerides 81; HDL 62; LDL 80. Target values: <200; <150; >45; <130. (I'm 71, 5'8, 215# and do not get enough exercise, almost no aerobic.) 

[mooniac15u]

I'm not a doctor but if I only had high cholesterol and not also high bp I would consider aggressive lifestyle changes to see if diet and exercise can control it. I lift weights and eat a low fat high protein low carb diet. My wife eats the same way and our cholesterol numbers are awesome. My bp numbers aren't awesome though and that runs in the family. Maybe I got lucky with cholesterol but I hear that high intensity training helps with it.

 

Aerobic exercise typically has a bigger impact on blood pressure.

[mooniac15u]

I'm not a doctor either, but I think choosing your parents is more of a factor than diet for blood cholesterol. I eat a 4 egg omelette every morning.  My last physical was typical: Cholesterol 158; Triglycerides 81; HDL 62; LDL 80. Target values: <200; <150; >45; <130. (I'm 71, 5'8, 215# and do not get enough exercise, almost no aerobic.) 

 

 

There is certainly a genetic component to cholesterol levels but there is also a significant correlation between BMI and serum cholesterol concentrations.

 

Also not that kind of doctor. I have a Ph.D. in chemistry with a focus on medicinal chemistry

[fantom]

I'm not a doctor either, but I think choosing your parents is more of a factor than diet for blood cholesterol. I eat a 4 egg omelette .)

What the heck are in those omelettes, Bob?

Although your numbers are good, they are but one factor.

We can't do anything about who our parents are, but we are in total control of what we eat, how much serious exercise we get and how balanced our lives are.

Less time on MAPA and MS; more time at the gym.

[Bob - S50]

I'm not a doctor either, but I think choosing your parents is more of a factor than diet for blood cholesterol. I eat a 4 egg omelette every morning.  My last physical was typical: Cholesterol 158; Triglycerides 81; HDL 62; LDL 80. Target values: <200; <150; >45; <130. (I'm 71, 5'8, 215# and do not get enough exercise, almost no aerobic.) 

I tend to agree.  When I taught aerospace physiology in the Air Force, we taught (right or wrong) that you could generally only control you cholesterol levels about 10% by diet and exercise alone.

 

We had two extremes in our squadrons.  We had one guy who probably did not have an ounce of fat on him, ran every day, ate carrots and celery for lunch and had a total cholesterol level around 300 (sort of like Jim Fixx).  There was another guy who was well on his way to becoming the Pillsbury Doughboy and his total was about 135.

 

Although I have no easy way to know, about 2 years ago my total was about 200 to 220, marginally high.  I went on Lipitor.  I had some other medical issues last year when I would normally get my physical so we did not do the testing.  This year I went in for testing and my total was 154.  However, what muddies the water is that like Ryoder, I've been on a low carb diet and have lost about 4 gallons of 100LL (25 pounds) since the previous test.  I do not know how much of the drop in total cholesterol was due to diet/weight loss (exercise is not a factor... trust me) and how much is the medication.

 

Bob

[mooniac15u]

I tend to agree.  When I taught aerospace physiology in the Air Force, we taught (right or wrong) that you could generally only control you cholesterol levels about 10% by diet and exercise alone.

 

We had two extremes in our squadrons.  We had one guy who probably did not have an ounce of fat on him, ran every day, ate carrots and celery for lunch and had a total cholesterol level around 300 (sort of like Jim Fixx).  There was another guy who was well on his way to becoming the Pillsbury Doughboy and his total was about 135.

 

Although I have no easy way to know, about 2 years ago my total was about 200 to 220, marginally high.  I went on Lipitor.  I had some other medical issues last year when I would normally get my physical so we did not do the testing.  This year I went in for testing and my total was 154.  However, what muddies the water is that like Ryoder, I've been on a low carb diet and have lost about 4 gallons of 100LL (25 pounds) since the previous test.  I do not know how much of the drop in total cholesterol was due to diet/weight loss (exercise is not a factor... trust me) and how much is the medication.

 

Bob

 

Exercise itself may not directly impact serum cholesterol but it may have a secondary impact by altering body fat percentage.  Adipose tissue has a very high capacity for cholesterol storage and that cholesterol is in equilibrium with serum cholesterol.  Basically, excess cholesterol is stored in fat and fed back into your bloodstream.  If you decrease your body fat you decrease the capacity for cholesterol storage.

[Marauder]

A fatty discussion! I have weighed over 290 twice in my life. And in both cases, my cholesterol level never got above 180. That said, both times (and my current situation) after losing the weight my cholesterol dropped to the 150 range with exercise and diet. So, I think you can influence it a little but if you are prone to high cholesterol, I think you are stuck with it.

[Bob_Belville]

A fatty discussion! I have weighed over 290 twice in my life. And in both cases, my cholesterol level never got above 180. That said, both times (and my current situation) after losing the weight my cholesterol dropped to the 150 range with exercise and diet. So, I think you can influence it a little but if you are prone to high cholesterol, I think you are stuck with it.

That's my anecdotal experience as well. I topped out at 255 for a year or 2 (I'm 5'8), Cholesterol never got as high as 180. I got on the omelette kick several years ago. My thought process was to avoid carbs to lose weight with a perverse second reason to see if 4 jumbo, double yolk eggs every day raised cholesterol. It didn't. I make my omelette in a big cast iron pan with olive oil, butter, extra sharp cheddar, several large mushrooms, and a couple of very hot peppers. Starts the day right.