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I am diabetic since 1993 at 37 years of age. In 2008, I have been attacked by CHD with occlusion of LAD artery which has stunted at that time. I am taking the following medicines from that time: 1- Tab. Metformin 500 mg since 1993 as thrice a day between meals. 2- Insulin Levemir ( Long acting) since 2012 3- Insulin Novo Rapid since 2012 After CHD the following are included: 1- Tab. As car 75 mg at breakfast. 2- Tab. Bisoprolol Hemifuramate 2.5 mg at breakfast. 3- Tab. Clopidogeral 75 mg at night. 4- Tab. Ramipril 5.0 mg at night. 5- Tab. Rusuvastatine 10-20 mg T night. Tab. Vit. B12 1+1+1 off & on. Now my; @ S.Cholesterol 146 mg/dl @ S. Triglyceride 120 mg/dl @ HDL 40 mg/dl @ LDL 167 mg/dl @ SGPT/ALT 110 u/l @ S. Creatinine 1.8 mg/dl @ Hb 12 gm/dl @ ESR 70 mm/1st. Hour @ TLC/WBCs 7100 /Cu.mm @ RBCs 2.97 Mill/Cu.mm @ Platelets 124000 /Cu.mm @ PCV 25.6 % @ Neutrophils 75% @ Lymphocyte 20% @ Monocytes 3% @ Eosinophils 2% I have no any symptom except minor muscle pain. I am taking sugar free diet only vegetables & chicken. I am taking abou 10-glass water since 2008. Now what should I do to lower SGPT, to lower LDL, to increase Platelets etc Dr. Ijaz Sandhu

PAST HISTORY : I am poor, So I can't pay your fee.

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Dr. Salome Zhvania answered : 7 years ago

You are taking 2 blood thiners (antiplatelet medications) - As car and clopidogrel. After stunting you had to take both of them together for just a year, after 1 year just one of them is left in treatment plan-As car or clopidogrel. So, take just As car (75 mg after meal, x1 times a day) and cancel clopidogrel! It seems that your muscle pain and increased ALT, AST (SGPT) is the result of rozuvastatin therapy, you should decrease the dose-take 5-10 mg a day and after 3 months check your liver enzymes-ALT, AST (SGPT). If they are x3 times high above normal, statins should be stopped for some time. For now it's not indicated to stop rozuvastatin, because your LDL is high, in addition you have ishcemic heart diseases and should take statins to the end of life, but dose needs to be adjusted according to liver enzymes. Also, you should have low lipid diet! You should visit your cadriologist regularly!

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