Doctor’s battle with bad cholesterol

Doctor’s battle with bad cholesterol
After a mild heart attack three months ago, Dr Jerry Tan changed his diet and turned to a new treatment option known as PCSK9 inhibitors to tackle high levels of bad cholesterol. Photo: Dr Jerry Tan
Published: 4:00 AM, September 6, 2017

Ophthalmologist Jerry Tan (picture) knows well the potential deadly effects of unchecked high cholesterol. Despite an active lifestyle and keeping to a healthy body mass index, the 60-year-old eye surgeon has had trouble controlling his higher-than-average cholesterol levels over the past decade.

At around 200 mg/dL, his total cholesterol level was within the borderline high range.

He tried several types of cholesterol-lowering medications, including statins, but could not tolerate the side effects which included severe muscle pain.

“After taking statins, for example, I ached so badly from head to toe. While rare, I read that there was also a possibility of dying from this particular side effect. I didn’t think it was wise to continue taking medication that caused me to experience such a severe reaction,” said Dr Tan, who runs a private practice at Camden Medical Centre. Both his parents have high cholesterol.

He eventually resorted to omega-3 supplements, reported to increase good cholesterol levels and lower bad cholesterol levels.

They helped maintain his cholesterol levels until last year, when he noticed his bad cholesterol numbers going up.

Three months ago, Dr Tan suffered a mild heart attack and required four stents to prop open his clogged arteries.

While LDL (low-density lipoprotein) cholesterol levels should ideally be kept under 100 mg/dL, high-risk groups like heart attack sufferers are usually advised to bring LDL levels down even lower to prevent a second heart attack, said Dr Peter Yan, consultant cardiologist at Gleneagles Medical Centre.

For some patients, lifestyle changes and standard medications may not be sufficient, he said.

“For example, statins, at maximum dose, can reduce cholesterol by 50 to 55 per cent.

If you start off with LDL cholesterol level of 200 mg/dL, you can bring it down to 90 to 100 mg/dL. In very high-risk patients, however, this is still not the target ideal of under 50 to 60 mg/dL,” he said.

Hard-pressed to lower his cholesterol levels after his heart attack, Dr Tan turned to a new treatment option known as PCSK9 inhibitors, a new class of drugs that targets and inactivates a specific protein which affects the lifespan of “cholesterol-clearing” receptors on liver cells.

He said it lowered his LDL levels of 240 mg/dL by around 60 per cent.

Dubbing his heart attack a “wake-up call”, Dr Tan has switched to an almost-vegan diet comprising mostly steamed or grilled dishes.

“Surprisingly, I don’t really miss all the oily food like char kway teow so much. I actually enjoy my vegetables and fruits a lot these days,” he said.