My FH Medication Journey
Just before my 30th birthday, I was diagnosed with familial hypercholesterolemia (FH)—a genetic condition that causes high cholesterol levels from an early age due to a mutation in one of several genes involved in cholesterol regulation. Despite knowing for years that my cholesterol levels were elevated, I hadn’t realized it was due to a genetic disorder. Like many, I assumed lifestyle changes alone could control it, especially since I lacked other major risk factors for heart disease.
Hesitant about Medication
At first, I was hesitant to start medication, convinced that diet and exercise would be enough. However, after learning more about FH, I understood that even the healthiest lifestyle wouldn’t be enough to lower my cholesterol to safe levels. My doctor explained that people with FH need medication to prevent early heart disease and that it was crucial to start treatment sooner rather than later . So, into maintaining a balanced diet and active lifestyle, I began taking a statin.
Starting with Rosuvasttin
I’ve been taking a generic form of Crestor (rosuvastatin) for the past seven years with minimal side effects. Crestor is part of a class of drugs called statins, which work by inhibiting an enzyme in the liver that produces cholesterol. Statins like rosuvastatin are proven to lower “bad” LDL cholesterol and triglycerides, while boosting “good” HDL cholesterol . This drug has bffordable and effective, lowering my LDL to around 150 mg/dL—better but still above my cardiologist’s target of under 100 mg/dL.
Adding Ezetibime for Additional Control
To help bring my levels closer to the goal, I added 10 mg of Zetia (ezetimibe) a few years later. Zetia works differently from statins by blocking cholesterol absorption in the intestines. This mechanism complements statins, which primarily target cholesterol production in the liver. Despite this addition, m dropped to around 120 mg/dL, still higher than the recommended range.
Initially, I experienced some muscle pain after starting Zetia, which I attributed to my active lifestyle. However, the discomfort persisted. My cardiologist suggested taking a CoQ10 supplement, which is often recommended for statin users to alleviate muscle-related side effects. I was skeptical, but after a few weeks on CoQ10, the pain significantly lessened.
Starting Repatha to Hit My Target
In January of this year, I added Repatha to my treatment plan. Repatha (evolocumab) is a PCSK9 inhibitor, a type of medication that targets a protein in the liver responsible for breaking down LDL receptors. By blocking this protein, Repatha allows more LDL receptors to remain active, helping the liver clear more LDL from the bloodstream. I self-administer this medication as an injection every two weeks .
Since starting Repatha, my LDL levels havd dramatically to 60 mg/dL, achieving the target my cardiologist and I had aimed for. I continue to take Crestor and Zetia along with Repatha, and this combination has proven to be the most effective approach for managing my cholesterol and reducing my risk of heart disease .
My Current Lifestyle
I am grateful that my health insurance covers these, which have been instrumental in reaching my cholesterol goals. I still focus on eating healthy and exercising. But thanks to the right medication plan, I can now manage my FH with confidence, knowing I’m taking proactive steps to protect my heart health.
Sources
- FDA. (2023). Repatha (evolocumab) Injection, for Subcutaneous Use. Retrieved from https://www.fda.gov/repatha
- CDC. (2021). What is Familial Hypercholesterolemia? Retrieved from https://www.cdc.gov/fh/whatisfh.htm
- American Heart Association. (2022). Managing FH with Lifestyle and Medication. Retrieved from https://www.heart.org/fh-management
- Mayo Clinic. (2023). Rosuvastatin (Oral Route) Description and Brand Names. Retrieved from https://www.mayoclinic.org/rosuvastatin-drug
- Cleveland Clinic. (2022). Ezetimibe: Cholesterol-Lowering Medication Overview. Retrieved from https://www.clevelandclinic.org/ezetimibe-information
- Healthline. (2022). CoQ10 for Muscle Pain in Statin Users. Retrieved from https://www.healthline.com/coq10-benefits
