OT: Statins

[RUboston]

I had a recent physical and my bad cholesterol was high. The doctor said I'm at an increased risk of a cardiovascular event and recommended a statin (Crestor). I'm Turning 63 in August. I've been fortunate with my health to date and have never taken any medication. I've been reading up on statins and the pros and cons and side effects. I will also be improving my diet and exercising more, although my diet is pretty good and I do hit the gym 3-4 times a week, but do more weights than cardio.

Anyone care to share their experience with the use of statins?

 

[RUforJERSEY]

I've been taking Rosuvastatin nightly for multiple years now. Very tiny pill. All I can say is that my cholesterol numbers are way down. I haven't noticed any side effects that I can tie to the medication.

 

[Rhuarc]

Take the statin. It could most definitely be a life saver.

 

[Knight Shift]

I had a recent physical and my bad cholesterol was high. The doctor said I'm at an increased risk of a cardiovascular event and recommended a statin (Crestor). I'm Turning 63 in August. I've been fortunate with my health to date and have never taken any medication. I've been reading up on statins and the pros and cons and side effects. I will also be improving my diet and exercising more, although my diet is pretty good and I do hit the gym 3-4 times a week, but do more weights than cardio.

Anyone care to share their experience with the use of statins?

Did your doctor check your A1C and glucose levels and consider if you are insulin resistant and at risk for diabetes? There is an insulin resistance test.

This is a very informative 25 minute discussion. Peter Attia is a longevity doctor, and he has the guru of statins on his staff, Dr. Thomas Dayspring.

In short, if you start and experience muscle soreness, you may want to consider other alternatives. You could try ezetimibe (zetia), which has a completely different mechanism of action to lower cholesterol. Usually, zetia is paired up with a statin to help decrease LDL.

Also, did your doctor have an apoB test done? If you listen to the podcast, apoB is the most important cholesterol number.

In my experience, many family doctors robotically prescribe statins without having complete information. They are happy to write a script and push pills.

 

[Scarletnut]

My cardiologist is on the cutting edge. He's been a proponent that everyone should be on a statin for cholesterol management and a multitude of off label benefits. I've been on Rosuvastatin (Crestor) for about 20 years even though my numbers were never elevated. Now they're incredibly good and a I had a recent calcium score of zero. I'm a retired MD and I'm a believer that the benefits of statins far outweighs any negatives.

 

[RUboston]

Did your doctor check your A1C and glucose levels and consider if you are insulin resistant and at risk for diabetes? There is an insulin resistance test.

This is a very informative 25 minute discussion. Peter Attia is a longevity doctor, and he has the guru of statins on his staff, Dr. Thomas Dayspring.

In short, if you start and experience muscle soreness, you may want to consider other alternatives. You could try ezetimibe (zetia), which has a completely different mechanism of action to lower cholesterol. Usually, zetia is paired up with a statin to help decrease LDL.

Also, did your doctor have an apoB test done? If you listen to the podcast, apoB is the most important cholesterol number.

In my experience, many family doctors robotically prescribe statins without having complete information. They are happy to write a script and push pills.

Thanks, I'll check it out.

 

[tom1944]

I've been taking Rosuvastatin nightly for multiple years now. Very tiny pill. All I can say is that my cholesterol numbers are way down. I haven't noticed any side effects that I can tie to the medication.

Same for me. I just started 6 months ago. No side effects blood work is good.

 

[Retired711]

Some people suffer bad side-effects from statins, and so it's important to start with a small dose. I have been taking atorvastin for years. It has no side-effect that I know of and it works well for me. If I were you, I would give it a try.

The glucose issue mentioned above is important, and everyone should have an A1C regularly. If your reading is "prediabetic," then it's important that you take steps to reduce your A1C level. But the issue has nothing to do with cholesterol.

 

[T2Kplus20]

I had a recent physical and my bad cholesterol was high. The doctor said I'm at an increased risk of a cardiovascular event and recommended a statin (Crestor). I'm Turning 63 in August. I've been fortunate with my health to date and have never taken any medication. I've been reading up on statins and the pros and cons and side effects. I will also be improving my diet and exercising more, although my diet is pretty good and I do hit the gym 3-4 times a week, but do more weights than cardio.

Anyone care to share their experience with the use of statins?

Statins are one of the most magnificent medical breakthroughs of the past several decades. They have saved countless millions and millions of lives. Crestor has extraordinary data behind it. I assume you will start with 10mg and go from there. 10mg and 20mg doses are very well tolerated (40mg is also available, but the large majority of patients don't need that much).

https://www.crestor.com/hcp

 

[Knight Shift]

Thanks, I'll check it out.

You may want to consult a board certified lipidologist. I have seen Dr. Spencer Kroll in Marlboro, and he is very good. In my case, while my cholesterol is "high", I had a coronary artery calcium test (CAC) and a CCTA (with contrast) about 5 years ago. I had zero calcium and zero soft plaque. I will get the test again in a year or two to see where I am at with plaque formation. There are some people who have high cholesterol who do not develop ASCVD. But without the extra information/tests, one might consider that this is playing Russian roulette to do nothing. In my case, as of now, my feeling was that I am in otherwise good health, I exercise, eat a clean diet and all of my other blood markers, including inflammation markers (hsCRP and others) were low.

A board certified lipidologist will conduct a more complete review than most family doctors who don't understand (or care to understand) the many nuances.

https://www.healthgrades.com/clinical-lipidology-directory

 

[T2Kplus20]

I've been taking Rosuvastatin nightly for multiple years now. Very tiny pill. All I can say is that my cholesterol numbers are way down. I haven't noticed any side effects that I can tie to the medication.

Statins do a wonderful job with lowering LDL, but it's pretty well established that statins also contain powerful anti-inflammatory properties that provide extra protect from cardio events and issues. That's why the clinical trial data for statins is so amazing.

For example:

https://www.crestor.com/hcp/crestor-clinical-trials/atherosclerosis

https://www.crestor.com/hcp/crestor-clinical-trials/additional-clinical-studies#title-341a39d56c

 

[T2Kplus20]

Some people suffer bad side-effects from statins, and so it's important to start with a small dose. I have been taking atorvastin for years. It has no side-effect that I know of and it works well for me. If I were you, I would give it a try.

The glucose issue mentioned above is important, and everyone should have an A1C regularly. If your reading is "prediabetic," then it's important that you take steps to reduce your A1C lvel. But the issue has nothing to do with cholesterol.

Lipitor/atorva is the granddaddy of all statins and has the generated the most CV data. Crestor has been proven to be a little more powerful in terms of LDL reduction, but lacks a few of the studies that Pfizer did for Lipitor. Can't go wrong with either product.

 

[T2Kplus20]

My cardiologist is on the cutting edge. He's been a proponent that everyone should be on a statin for cholesterol management and a multitude of off label benefits. I've been on Rosuvastatin (Crestor) for about 20 years even though my numbers were never elevated. Now they're incredibly good and a I had a recent calcium score of zero. I'm a retired MD and I'm a believer that the benefits of statins far outweighs any negatives.

^^^^^ Hard to top this post. Great stuff!

 

[RUBOB72]

Read up and follow your doctor’s advice up to a certain point. Example and possibly an exception. When I was a daily runner until age 62 my blood pressure still would occasionally fluctuate. Usually highest was 130/ 90 . Weight was 205 at 6’1/4” . Mind you I have been taking BP meds since age 35 ( hydrochlorothiazide) HDL and LDL were in a good acceptably range. Cholesterol was usually 178-190 max good not great by 2025 standards . Over the past 7 years my weight is the same at age 75… cholesterol and lipids very good…. I recently underwent a complete heart work up which shows no heart damage, arterial issues nor anything heart related. Beth Israel cardiologist was very pleased and said that you currently show nothing indicating being long term BP med user. This same cardiologist is the one who put me on a 2nd BP med almost 8-9 years ago. The reason a skip beat in my heart which my father, brother and I were all identified as genetically similar. The drug Metoprolol succinate with the other 2 … works for some I’m told not for all. Now after that speech I better sit down and rest. Happy Memorial Day to all to all those who lost a loved one and those Veterans who have served our Great Nation. Many wonderful things in the system for medical helping all.

 

[RUBOB72]

There is a belief by many informed cardiologists that negative markers are offset by positive ones. The LDL - HDL being one where aerobic exercise does have benefits in order to avoid more meds. .

 

[wheezer]

I had a recent physical and my bad cholesterol was high. The doctor said I'm at an increased risk of a cardiovascular event and recommended a statin (Crestor). I'm Turning 63 in August. I've been fortunate with my health to date and have never taken any medication. I've been reading up on statins and the pros and cons and side effects. I will also be improving my diet and exercising more, although my diet is pretty good and I do hit the gym 3-4 times a week, but do more weights than cardio.

Anyone care to share their experience with the use of statins?

When I was in school they taught us,that your diet Alone won't fix the problem, that your body makes,the,cholesterol.
The drugs work by interrupting your body making it

As,other have said, exercise, both cardio and weights help

 

[Jackson206:)]

63. Just started Crestor 3 months ago. Was extremely reluctant to do so. On no other meds. Cholesterol dropped from 300 to 185. LDL dropped from 215 to 111. No side effects. Good luck.

 

[T2Kplus20]

63. Just started Crestor 3 months ago. Was extremely reluctant to do so. On no other meds. Cholesterol dropped from 300 to 185. LDL dropped from 215 to 111. No side effects. Good luck.

Congrats!

 

[Retired711]

When I was in school they taught us,that your diet Alone won't fix the problem, that your body makes,the,cholesterol.
The drugs work by interrupting your body making it

As,other have said, exercise, both cardio and weights help

Your body makes cholesterol - which is necessary -- but eating a lot of saturated fat or trans fat will cause the body to make too much. So eating better is a big help; as you say, so is exercise.

 

[dfr1966]

I've been on them for almost 25 years, no side effects and my levels have remained healthy. Currently on Atorvastatin 20 MG. I do maintain a healthy diet as well.

 

[Scarlet Engineer]

A few points.

1. High ApoB is the better measure of risk from cholesterol, not LDL and certainly not total cholesterol level.

2. ApoB cholesterol is just one of three key factors that work together to cause cardiovascular disease - the others are arterial inflammation (measured by C-reactive protein and has A1C as a precursor), and blood pressure.

3. The standard American diet (“SAD”) which is high in refined carbohydrates, fructose and processed foods is a major cause of CVD and diabetes risk. Not saying this is an issue for you. But it was for me.

 

[Knight Shift]

A few points.

1. High ApoB is the better measure of risk from cholesterol, not LDL and certainly not total cholesterol level.

2. ApoB cholesterol is just one of three key factors that work together to cause cardiovascular disease - the others are arterial inflammation (measured by C-reactive protein and has A1C as a precursor), and blood pressure.

3. The standard American diet (“SAD”) which is high in refined carbohydrates, fructose and processed foods is a major cause of CVD and diabetes risk. Not saying this is an issue for you. But it was for me.

Did adjusting your diet get your apoB to the desired level?

 

[Knight Shift]

There are two other classes of pharma products that lower cholesterol pcsk9 inhibitors and bempedoic acid, a pro drug. However, both are much more expensive than statins.

https://my.clevelandclinic.org/health/drugs/22550-pcsk9-inhibitors

https://www.mayoclinic.org/drugs-supplements/bempedoic-acid-oral-route/description/drg-20484223

 

[RUboston]

I'll be talking with my doctor this week and looks like I'll start. Once you start a statin do you remain on it indefinitely?

 

[Retired711]

I'll be talking with my doctor this week and looks like I'll start. Once you start a statin do you remain on it indefinitely?

Probably.

BTW, it might be worth while to get a calcium CT. (Insurance usually won't cover the test.) It will give you an idea of how much your arteries are obstructed. The result might well guide your physician in deciding what the desirable level is for you of LDL cholesterol and so it might influence what dose of statin he wants you on. (This was true of me.) The Apo b test discussed by @Scarlet Engineer is also helpful -- but you would probably have to pay for that, too.

And yes, the standard American diet is a problem - a big one. Try to eat as healthily as you can.

 

[WhichReligionIsRight]

I started taking a statin earlier this year at my Doctor’s request. No side effects. Age 63.

 

[Scarlet Engineer]

Did adjusting your diet get your apoB to the desired level?

My ApoB has gone way down but it’s hard to say how much came from diet changes. My A1C has come down, and my hs-crp has come way down. Those two are definitely a result of changes to my diet (low carb, low/no sugar, no processed meats).

 

[Retired711]

My ApoB has gone way down but it’s hard to say how much came from diet changes. My A1C has come down, and my hs-crp has come way down. Those two are definitely a result of changes to my diet (low carb, low/no sugar, no processed meats).

Levels of ApoB, A1C, and hs-crp can all be lowered by diet and exercise. Congratulations on your success!

 

[Loyal_2RU]

My cardiologist is on the cutting edge. He's been a proponent that everyone should be on a statin for cholesterol management and a multitude of off label benefits. I've been on Rosuvastatin (Crestor) for about 20 years even though my numbers were never elevated. Now they're incredibly good and a I had a recent calcium score of zero. I'm a retired MD and I'm a believer that the benefits of statins far outweighs any negatives.

While i agree with this:
1. Use the lowest effective dose
2. Statins made me stupid (id get lost on my home bound commute). That's rare. And some people get joint or muscle pains.

I use repatha, an injectable.
Loyal

 

[50 yd line RR]

Another perspective.

 

[T2Kplus20]

There are two other classes of pharma products that lower cholesterol pcsk9 inhibitors and bempedoic acid, a pro drug. However, both are much more expensive than statins.

https://my.clevelandclinic.org/health/drugs/22550-pcsk9-inhibitors

https://www.mayoclinic.org/drugs-supplements/bempedoic-acid-oral-route/description/drg-20484223

PCSK9's are very powerful, but only an option for those that need more than a high dose statin or can't tolerate it. One of the most fascinating biotech companies today is Verve Therapeutics. They are working on several base editing gene therapies for familial hypercholesterolemia.

Gene therapies are normally saved for rare diseases with no or limited options. Not sure if Verve will be successful.

https://www.vervetx.com/our-programs/our-pipeline

 

[RU848789]

While i agree with this:
1. Use the lowest effective dose
2. Statins made me stupid (id get lost on my home bound commute). That's rare. And some people get joint or muscle pains.

I use repatha, an injectable.
Loyal

My wife has high total and LDL cholesterol and can't tolerate statins, due to significant myopathy (muscle pains/spasms); she has tried all of them with and without zetia, so she is now on repatha, the injectable monoclonal antibody (mAb), which is a PCSK9 inhibitor.

I've been on the 10 mg Crestor dose for several years (and baby aspirin) and between that and lots of exercise and some modest diet changes, all of my bloodwork markers are now in the normal range. Statins don't work for everyone, but as T said, millions have benefitted from them.

 

[T2Kplus20]

While i agree with this:
1. Use the lowest effective dose
2. Statins made me stupid (id get lost on my home bound commute). That's rare. And some people get joint or muscle pains.

I use repatha, an injectable.
Loyal

A good friend of mine was a commercial brand lead at Amgen and launched Repatha. Great product and data for those that need it.

 

[newell138]

I had a recent physical and my bad cholesterol was high. The doctor said I'm at an increased risk of a cardiovascular event and recommended a statin (Crestor). I'm Turning 63 in August. I've been fortunate with my health to date and have never taken any medication. I've been reading up on statins and the pros and cons and side effects. I will also be improving my diet and exercising more, although my diet is pretty good and I do hit the gym 3-4 times a week, but do more weights than cardio.

Anyone care to share their experience with the use of statins?

Sounds like my scenario Just started 20mg of simvastatin 3 days ago. No side effects so far

 

[RUforester72]

I had a recent physical and my bad cholesterol was high. The doctor said I'm at an increased risk of a cardiovascular event and recommended a statin (Crestor). I'm Turning 63 in August. I've been fortunate with my health to date and have never taken any medication. I've been reading up on statins and the pros and cons and side effects. I will also be improving my diet and exercising more, although my diet is pretty good and I do hit the gym 3-4 times a week, but do more weights than cardio.

Anyone care to share their experience with the use of statins?

Taking generic Lipitor for about 25 years. Cholesterol is well below level of concern. No side effects and doc is happy. Blood test annually all good numbers. I’m 74 and I eat well and go to the gym 3days a week.

 

[Scarlet Engineer]

Two important considerations when taking statins:

1. Statins having diminishing returns with dose. Meaning, you will get the most benefit from the first 10 mg of dosage, increasing it to 20 or 40 has less additional impact.

2. When you take statins, you should supplement your CoQ10. That’s a critical enzyme that your body creates. Statins reduce CoQ10 (coenzyme Q10). So supplementing it is a good idea.

 

[Scarlet Engineer]

While i agree with this:
1. Use the lowest effective dose
2. Statins made me stupid (id get lost on my home bound commute). That's rare. And some people get joint or muscle pains.

I use repatha, an injectable.
Loyal

While i agree with this:
1. Use the lowest effective dose
2. Statins made me stupid (id get lost on my home bound commute). That's rare. And some people get joint or muscle pains.

I use repatha, an injectable.
Loyal

Excellent. Repatha is much much more effective than statins. Unfortunately, my insurance plan (United Choice Plus 250) won’t cover pcsk9 inhibitors unless you are taking a statin.

 

[T2Kplus20]

Excellent. Repatha is much much more effective than statins. Unfortunately, my insurance plan (United Choice Plus 250) won’t cover pcsk9 inhibitors unless you are taking a statin.

More likely you need to try a statin first and fail on it (step edit). I don't think PCSK9's require combo use with a statin in their labels.

 

[Retired711]

While i agree with this:
1. Use the lowest effective dose
2. Statins made me stupid (id get lost on my home bound commute). That's rare. And some people get joint or muscle pains.

I use repatha, an injectable.
Loyal

Yes, by all means use the lowest effective dose. (I'm sure you agree that should be true for *all* medications -- they can all have undesirable side effects.) My doctor tells me that for lipitor/atorvastin, the average dose is 80 mg daily. I have gradually worked my way up to 40. I'm on that because my calcium ct convinced my doctor that she wanted to drive my LDL's below 70 if possible.

 

[RU848789]

Lipitor/atorva is the granddaddy of all statins and has the generated the most CV data. Crestor has been proven to be a little more powerful in terms of LDL reduction, but lacks a few of the studies that Pfizer did for Lipitor. Can't go wrong with either product.

Lipitor has been a great drug, but it's not the "granddaddy of all statins. As you know, Merck developed and commercialized the first approved (by the FDA and worldwide) statin, lovastatin (Mevacor), which was approved in the US in 1987. A follow-up to Mevacor, simvastatin (Zocor) was developed by Merck and approved in 1991 (both it and pravastatin were the 2nd statins approved, both in 1991); Lipitor wasn't approved until 1997. I worked on the late stage process development for simvastatin a bit in my first year or two at Merck.
https://pmc.ncbi.nlm.nih.gov/articl...of Alfred,from the fungus Aspergillus terreus.