Let talks about statins

For those on statins (cholesterol lowering drugs)this may be of interest, for those who arent and dont plan to be, you may want to skip this and go on to the latest trail report . Some commons names for statins are Zocor, Lipotor & Crestor

I did a similar post on Whiteblaze recently and got a lot of feedback. The latest report on statins and exercise may be of interest to hikers

http://well.blogs.nytimes.com/2012/03/14/do-statins-make-it-tough-to-exercise/ confirms my experiences.

For background, I have tried numerous statin drugs with somewhat predictable side effects over the years. I have tried the various work arounds and they generally work well to get my numbers in line but the side effects are numerous and significant and impact outdoor activities. Unfortunately, I expect I have a genetic predisposition for low HDL so whenever I get my blood screened, I am flagged as someone who needs statins. These do have great value to some folks and I dont advocate stopping them without discussing it with your doctor, but I do want to flag that some of the side effects are written off by many as old age or past overuse and a reason to cut back on activity levels. Do note, the majority of folks do take them with out significant side effects, so good luck if you are in the majority.

Here are the symptons that are easy to write off. They all take a while to develop so its hard to do a direct correlation

Sore muscles after exercise/hikes, this really impacted my kayaking a few years back as I couldnt paddle for more than an hour

Swelled feet after a hike to the extent that its painful to walk, I know one person who was getting close to filing for disability as he couldnt walk until he went off statins

Joint issues, symptons are similiar to carpal tunnel or tennis elbow

Short sleep patterns, basically wake up after three or four hours and cant get back to sleep

Mental acuity issues (usually with elderly folks)

There are recent studies that link statins to higher incidence to diabetes

Unfortunately the medical industry is predisposed to hustle statins as wonder drugs as they are quite profitable for the drug companies and I expect there is some tie in of the profits to the medical industry. Somewhere buried in the fine print are warnings about side effects but usually the doctors underplay them. Its just easier to hand the patient some new drugs to counteract the side effects from the statins then figure out that its the statins than cause them.

There are alternative therapies but they are not as quick or effective as statins, usually slow release niacin and drugs to drop triglycerides plus the ubiqitous "life style changes".

By the way for older women, cholesterol screening has a poorer correlation with first cardiac events than an alternaitve test called "precise CRP test". It measures the realtive amount of inflamation in the blood vessels and assigns a value to it. Not many doctors use it as standard cholesterol screening is part of the generally recognized level of care so it would be an extra test.

I highly recommend reading

The Last Well Person How to Stay Well Despite the Health-Care System

Nortin M. Hadler

A controversial skewering of how doctors and the medical industry turn healthy people into patients.

He explains quite clearly how drug companies pay for the studies and how the epidemiologists mine and massage the data in such a way as to turn people into patients. Not just with regards to statins. Re-thinking aging is another book of his that makes you think.

I found the body aches and muscle pains were way too much to tolerate. My count isn't super high. I try to exercise regularly and that helps. I ach when I exercise but I ach more when I don't. Losing weight makes the biggest difference and is the greater challange. I may have to have my taste buds cauterized.

If you only have a low HDL and your total and LDL cholesterol are normal, a statin may increase your HDL but not by much. statins are more for lowering you total and LDL. If I have a patient with normal total and LDL and low HDL, I recommended diet and exercise and do not give a statin. The cardiac CRP, at least in my geographic area of practice, is not a commonly ordered test. I do not think evidence based medicine is on board with this test yet. I use the framingham score sheet to give me an idea of a patient's cardiac risk. If a patient cannot tolerate a statin, there are other medicines to try but they are not well tolerated from a GI standpoint and need to be taken more than once a day. Fiber can make a difference. I have my patients use metamucil to help lower cholesterol. products like benefiber are not as helpful. If you cannot tolerate any lipid lowering medication its important to reduce other cardiac risk factors; normal weight (also have your provider do a waist to hip ratio), normal BP, don't smoke, regular exercise, low fat diet.

Carol, considering, or in spite of, genetic influences, do you think a totally plant-based diet has a favorable impact on one's lipid profile? Have you looked into it?

I myself am not a vegan but we try to plan and eat 1-2 vegan meals a week.

peakbagger said:

Sore muscles after exercise/hikes,

Swelled feet after a hike to the extent that its painful to walk,

Joint issues, symptons are similiar to carpal tunnel or tennis elbow

Short sleep patterns, basically wake up after three or four hours and cant get back to sleep

Mental acuity issues (usually with elderly folks)

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CRAP. I got all those NOW and I'm not on any statins .

My doc's been trying to get me on statins for a few years and I was recently retested. Total went from like 290 a couple years ago to 208 and Hdl went from 48 to 52, so the TC/HDL ratio went from 6 (bad) to 4 (okay). I haven't even been trying that hard but my older son is vegetarian now so there's less meats being eaten. I'd rather keep watching what I eat, skipping the Pink Slime, get the exercise, eat a baby aspirin, etc. If I was on statins and developed any of those side effects, I think I'd personally end up worse off.

This calculator seems useful; http://hp2010.nhlbihin.net/atpiii/calculator.asp

I'm at 5% risk. I need to redo this with my old numbers and see where I was at.

The last paragraph of the NYT article has important implications for those who have been diagnosed with arteriosclerosis:

.
For those, balancing the need to slow/stop the progression of arteriosclerosis vs. potential muscle impairment may be the issue which is most pressing.

I think going vegan can make a difference. Tofu is a cholesterol free food but it does have fat. You have to watch the products made from soy though. I found a great chorizo sausage at trader joes that was made from tofu but it was loaded with fat. Some of the other "meat" products that are made with tofu are also high in fat. Eating the least processed food makes a difference. You need to read labels. You have to watch how much oil you cook/bake/roast/saute your veggies in and if you are eating salads, the amout of fat in the dressing. But veggies, rice, quinoa, wheat berries, couscous are all low fat foods. I am 98% vegetarian and my cholesterol is not as good as I would like (all the numbers are normal) but my downfall is cheese which is loaded with fat. You get a great deal of sat fat from meat and dairy becoming vegan and eliminating that can make a big difference.

Right now, I really pay attention to what I eat (read the omnivores dilemma and starvation seems like a good thing). I make alot of things from scratch so I can control the amount of fat, salt etc in the food. and best of all no preservative, artificial flavorings and colorings.

One thing you need to pay attention to, alcohol can raise your triglyceride levels. especially beer.

daxs said:

One thing you need to pay attention to, alcohol can raise your triglyceride levels. especially beer.

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double cr@p.

I was just doing research today on this very topic. I heard something on the news several days ago about the dangers of statins and I could not find it on the web. I did find this. http://www.mayoclinic.com/health/statins/CL00010
I also recommend a book by Dr H Gilbert Welch from Dartmouth Hitchcock. Overdiagnosed-Making People Sick in the Pursuit of Health.
http://www.amazon.com/Overdiagnosed...1997/ref=sr_1_1?ie=UTF8&qid=1331853461&sr=8-1

I have enough muscle and joint issues without compounding them with statins. I hope to die a "happy hiker" in as much as that is humanly possible.

There is much variation amoungst individuals. I believe keeping track of food intake with a journal and periodic blood tests is the only way to determine what is proper for each individual. I take a small amount of lipitor every day and it does not have untoward effects on my aches and pains. Lipitor has lowered my LDL, BUT lowering my wheat flower intake is extremely important in lowering my triglyceride levels.

According to my doctor my high triglyceride levels are my biggest problem. Unfortunately for me, wheat flower is the toughest thing to scroupulously avoid in my diet. Booze is another problem with my diet and my triglyceride levels but in my best efforts to record and control my intake levels it doesn't seem to be as significant as wheat flower. Your Milage Will Vary!

Neil said:

Carol, considering, or in spite of, genetic influences, do you think a totally plant-based diet has a favorable impact on one's lipid profile? Have you looked into it?

I myself am not a vegan but we try to plan and eat 1-2 vegan meals a week.

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You mean you're switching from beer to olive oil as a beverage? Or are you maintaining beer is vegan again?

I had an Indian friend, vegetarian all his life, who had a big problem with cholesterol and also was intolerant of statins.

My pescetarian spouse curses every time she sees my moderately-meat-based lab results. We agree on one thing when it comes to cardiovascular health: she should have done a better job of picking her ancestors.

Chip said:

double cr@p.

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I'm guilty....but I have to say being happy and stress free or low stress make as big a difference as exercise and nutrition.


Don't worry bee happy.

sardog1 said:

My pescetarian spouse

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I had to look that one up! Thanks for expanding my vocabulary.

Paradox said:

There is much variation amoungst individuals. I believe keeping track of food intake with a journal and periodic blood tests is the only way to determine what is proper for each individual. I take a small amount of lipitor every day and it does not have untoward effects on my aches and pains. Lipitor has lowered my LDL, BUT lowering my wheat flower intake is extremely important in lowering my triglyceride levels.

Click to expand...

I also am not experiencing any of the side effects that have been mentioned.

There are alternatives to Statins, such as Zetia, and Niacin, as well as diet changes. (Of course, every treatment seems to have plus/minus factors). I'm not a doctor, so do your own research....

My cholesterol levels are all 3 low so I asked my MD if I should eat more trans fats to bring them up, he didn't think so and his advice to improve just "good" levels was to eat almonds

Today I talked to a doc who said that in palliative care they usually continued heart medicines as they made the patient feel better, the exception was cholesterol medicines that often made the patient feel worse

In my experience, zetia gives very modest decreases in total and LDL cholesterol. I usually cannot get patients cholesterol levels in normal range with just zetia. Niacin is better for lowering triglycerides. Unfortunate side effect of naicin is facial flushing. Taking a baby ASA or advil an hour before the niacin is helpful. OTC formulations of niacin are really not effective. As paradox pointed out, cutting out simple carbs from your diet can lower your trigs. I actually have very few patients who get myalgias and arthralgias with statins. Genetics plays a much bigger role than diet. unfortunately for women, our cholesterol levels start to rise and our risk of caridac disease increases to the same level as men once we go through menopause. Endogenous estrogen really helps us. Exogenous estrogen does not.

Nothing will make me give up bourbon. Except needing a new liver... lol

Great thread.
Does know how long it takes the body to rid itself of a statin drug once the statins are no longer taken?
Also, to avoid some of the side affects mentioned by Peakbagger, can one switch between various types of cholesterol medications ?