Husband, wife seek answers

Dear Dr. Gott: First, my doctor wanted me to take a statin to lower my cholesterol, but I declined because of the side effects. I tried using your recommendation of niacin instead. I am an 84-year-old man in fairly good health, and, after three months of therapy, my figures are:

• Triglycerides — From 115 to 63.
• HDL — From 70 to 95
• LDL — From 137 to 126.
• Total weight — Went from 230 to 234 (I believe mainly due to the large increase in my HDL).

I would appreciate your opinion on how effective the niacin has been.

Second, my 82-year-old wife had a mild stroke four years ago and now sees several small spots in both eyes. The stroke did not seem to do any other damage, so her doctor concluded that they were on her brain rather than in her eyes. Lately, she has become tired all the time and has no energy. Her blood work is normal, and she doesn’t have a thyroid problem. Any ideas?

Dear Reader: At age 84 and with a total cholesterol of 230, I would not worry. In my opinion, you did not need a statin drug and were correct to refuse it. Your numbers were within normal limits, given that you had a high HDL level (good cholesterol) to begin with.

On the niacin, your total went up because of the astounding increase to your HDL. You can stick with the niacin, but I don’t see it as necessary.

The only reason this would not hold true is if you have a cardiac condition, such as a prior heart attack or stroke, in which case you should be under the care of a cardiologist, who still would likely be impressed by your numbers.

Now, to your wife, a stroke can cause several different types of visual problems, such as blurred or double vision. Seeing several spots is not typical. This sounds like floaters, which are the shadows of undissolved particles of the gel-like vitreous fluid that fills the eyeball.

I urge your wife to be seen by an ophthalmologist for testing and diagnosis. If these spots have not affected her vision and have remained fairly constant for the past four years, chances are they are harmless. However, sometimes spots and floaters may signify vitreous detachment that may lead to blindness.