New Medications to Bring Cholesterol Levels WAY Down.

Were you aware that there are two new medications approved to treat high cholesterol levels? Traditionally, patients and physicians have relied on the statin class of medication to lower LDL or “bad” cholesterol levels. The most well known of these is Lipitor (you may have seen the commercials). The newer medications are delivered by injection and are in a class called PCSK9 inhibitors.
The new PCSK9 inhibitors can achieve LDL levels far lower than can be achieved by even the highest intensity statins. Whereas one might expect to lower an LDL to under 100mg/ml or under 70mg/ml with Lipitor, studies show that the PCSK9 inhibitors can achieve LDL levels below 25mg/ml. In one study 9% achieved levels under 15mg/ml!
But we must need some cholesterol in the body, right? It must serve some function and, correctly, some researchers are concerned that very low levels of LDL could adversely affect the production of sex steroid hormones and adrenal hormones which rely on cholesterol.
However, a recent study (http://www.onlinejacc.org/content/69/5/471) analyzed 5,234 patients treated for up to 2 years and examined the occurrence of adverse events. There was no increase in a wide variety of conditions including neurologic, memory, kidney, liver or diabetes. However, the authors did see (pun intended) an increase in cataracts among those patients with LDL levels below 25mg/ml.
So is there such a thing as ‘too low’ cholesterol? Other than the risk of cataracts, so far there does not seem to be a downside.

Cases of Colorectal Cancer Increasing Among Young People

After decades of declining colon and rectal cancer rates, data published last week shows that these diseases have been increasing among young adults. Colon cancer rates have increased 2.4% annually among adults in their 20s and 1.0% among those in their 30s. For rectal cancer, the increase is even more dramatic: 3.2% among those in their 20s. For those born around 1990 the rates of colon cancer are more than two fold greater (2.4 times) than those born around 1950. Rectal cancer is over 4 fold greater (4.3 times) for those born around 1990 as compared to those born around 1950. – See more at: http://www.santamonicaprimarycare.com/blog/#sthash.11HBb8yb.dpuf
So the question, of course, is why the dramatic rise after decades of declining rates?
When I discuss colon and rectal cancer risks with patients, I often refer to two classic epidemiologic studies. The first study was done by Armstrong and Doll in 1975. It compared incidence and mortality rates for 27 cancers in 23 countries and correlated these with a variety of dietary habits and other variables. Dietary variables, particularly meat and animal protein consumption, was strongly associated with cancers of the colon and rectum. Further, these investigators confirmed prior data suggesting a protective effect of fiber consumption.