OT: Statins

[megadrone]

My biggest problem with the statins, other than not being able to handle them, was the exit plan. No one could answer the question "What's the plan for me to NOT have to take these." it's treating the symptom and not the problem.

I have a similar issue with my BP medications. It seems to be just acceptd that you go on these medications forever. I want an exit strategy!

 

[Retired711]

I agreed to take 5mg of statins just to stop the VA from pestering me. My LDLs went way down, but so did my HDLs, such that my ratio of LDLs to HDLs was much higher. I have always thought I would be OK as long as my ratio was under 3.5. I always thought LDLs are like marshmallows and HDLs are like bbs, the HDLs removing the slow moving LDLs as they flow through arteries. Please tell me if I have been misinformed all these years. I am 83 with good blood pressure and low pulse rate. I run? up a 25 yard concrete spillway (the only hill in the area) 20 times every other day and do light weights. I consider that interval training and as long as I don't get short of breath, I feel like I am good to go. I have exercised my whole life and so far so good. My cholesterol has been elevated (230?) for as long as I can remember. I have been taking fish oil for about 6 months, will have all blood work done during my next annual physical in Sept. and consider taking a low dose statin. My attitude is that I am grateful for being able to do what I do and not to fix anything that isn't broke. I appreciate all the information provided in this thread and feel like I will be well equipped to make a good decision pending the results of my blood work in Sept. Thank you.

My impression is that doctors put less weight on the ratio than they used to, and that they think that HDL levels stop being important when they reach a certain level. Talk to your doctor and see what he thinks. It's great that you do so much exercise. High intensity interval training is currently considered the best exercise, although I'm sure few guys your age could do what you do. You might want to pay for a cardiac CT scan; it will give you an idea of whether your arteries are getting clogged and therefore how important your cholesterol level is.

I'm benefiting from this thread too!

 

[Knight Shift]

I agreed to take 5mg of statins just to stop the VA from pestering me. My LDLs went way down, but so did my HDLs, such that my ratio of LDLs to HDLs was much higher. I have always thought I would be OK as long as my ratio was under 3.5. I always thought LDLs are like marshmallows and HDLs are like bbs, the HDLs removing the slow moving LDLs as they flow through arteries. Please tell me if I have been misinformed all these years. I am 83 with good blood pressure and low pulse rate. I run? up a 25 yard concrete spillway (the only hill in the area) 20 times every other day and do light weights. I consider that interval training and as long as I don't get short of breath, I feel like I am good to go. I have exercised my whole life and so far so good. My cholesterol has been elevated (230?) for as long as I can remember. I have been taking fish oil for about 6 months, will have all blood work done during my next annual physical in Sept. and consider taking a low dose statin. My attitude is that I am grateful for being able to do what I do and not to fix anything that isn't broke. I appreciate all the information provided in this thread and feel like I will be well equipped to make a good decision pending the results of my blood work in Sept. Thank you.

I'm not a doctor and don't play one on TV or here, but 83 years old and running up 25 yard spillway 20 times every other day is damn impressive, plus the weights. My mother was in a similar boat (minus the sprints. At 88 yo, her total cholesterol was at the same place it had always been- around 275, but HDL was 105, and LDL was 156 and apoB was 119--that number alone would give many cardiologists a heart attack. At 76, her family doctor wanted to put her on a statin, and she refused, asking "what the hell for?". She passed away at 96 years old, never having been on a pharmaceutical product for more than a couple of weeks.

We each have to make our own choices. My estimation is that women (at least in our family) have high HDL, and while it is incorrect to say HDL is the "good cholesterol", a high HDL is beneficial.

Have you talked to your doctor about a CCTA to check for the presence of soft plaque? The second podcast I posted above has a great discussion on the advances in CCTA technology. One of the concerns my mother had with taking a statin is the possible cognitive side effects alluded to here, and at 76, she did not want to take a chance. She beat the odds, but everyone has a different case and story.

 

[Retired711]

My biggest problem with the statins, other than not being able to handle them, was the exit plan. No one could answer the question "What's the plan for me to NOT have to take these." it's treating the symptom and not the problem.

I have a similar issue with my BP medications. It seems to be just acceptd that you go on these medications forever. I want an exit strategy!

Why must there be an exit strategy? If, heaven forbid, you were diabetic, you might well have to take insulin indefinitely. There doesn't need to be an exit strategy so long as a med is helping you and not hurting you.

 

[Loyal_2RU]

Grapefruit juice is a problem with *many* common meds because it slows the liver's ability to get rid of the med and so it leads to bloodstream levels that are higher than they should be.

I hope a solution can be found to your memory issues -- I would find that very frightening.

That's why i went on repatha

 

[LETSGORU91_]

My biggest problem with the statins, other than not being able to handle them, was the exit plan. No one could answer the question "What's the plan for me to NOT have to take these." it's treating the symptom and not the problem.

I have a similar issue with my BP medications. It seems to be just acceptd that you go on these medications forever. I want an exit strategy!

BP and cholesterol med reduction plan: exercise, follow a heart healthy diet, maintain a good body weight, reduce sodium intake, stress reduction, sleep better. Society in general has gotten lazy and wants magic pills to fix everything without dedicating themselves to a healthy lifestyle. If that all fails or you are at very high risk, meds would then be indicated.

 

[LETSGORU91_]

, and while it is incorrect to say HDL is the "good cholesterol", a high HDL is beneficial.

HDL is a good cholesterol. It's responsible for picking up LDL and transporting it back to the liver where it can be broken down and flushed from the body. Higher HDL levels are associated with lower mortality rates and a reduced risk for cardiac disease. It's good.

 

[Scarletnut]

BP and cholesterol med reduction plan: exercise, follow a heart healthy diet, maintain a good body weight, reduce sodium intake, stress reduction, sleep better. Society in general has gotten lazy and wants magic pills to fix everything without dedicating themselves to a healthy lifestyle. If that all fails or you are at very high risk, meds would then be indicated.

The vast majority of the cholesterol problem is not dietary but genetic. The statins reduce the cholesterol your body produces. The dietary cholesterol is really insignificant.

 

[LETSGORU91_]

Why must there be an exit strategy? If, heaven forbid, you were diabetic, you might well have to take insulin indefinitely. There doesn't need to be an exit strategy so long as a med is helping you and not hurting you.

Pancreatic insufficiency (insulin need) versus modifiable risk factor modification (to eliminate/reduce meds) are two completely different things. Plus, medications come at the risk of adverse side effects.

 

[LETSGORU91_]

The vast majority of the cholesterol problem is not dietary but genetic. The statins reduce the cholesterol your body produces. The dietary cholesterol is really insignificant.

Yes, liver production is the majority culprit of blood cholesterol. But citing numbers from Columbia U, Cleveland Clinic, Harvard say 20-30% comes from the diet. That's not insignificant. If you care to read an interesting book on plant based diets, Caldwell Esselstyn delves into drastic improvements in cholesterol numbers with this strict dietary regimen. Perhaps dietary modifications can also change the way our liver functions as well, thereby reducing the production of cholesterol.

 

[Retired711]

Pancreatic insufficiency (insulin need) versus modifiable risk factor modification (to eliminate/reduce meds) are two completely different things. Plus, medications come at the risk of adverse side effects.

All medications come at the risk of adverse side effects. That's why one should build up slowly on any medication. Sometimes risk factors can be modified enough to eliminate the need for medication. But sometimes they can't. If the med helps and is not causing adverse side-effects, there is no need to insist that there be an exit strategy.

 

[Section124]

My biggest problem with the statins, other than not being able to handle them, was the exit plan. No one could answer the question "What's the plan for me to NOT have to take these." it's treating the symptom and not the problem.

I have a similar issue with my BP medications. It seems to be just acceptd that you go on these medications forever. I want an exit strategy!

I am on HBP medication since 2009 and asked the same questions as you. For an exit strategy I went into a major exercise routine and was in the greatest shape of my life. I was convinced this was the solution. Based on that, I tried to wean myself off them but ended up light leaded and dizzy. I realized that for me HBP was hereditary and I would never get off them. I hate having to take them but better to do so than end up with a heart attack/major stroke and not be able to care for my family. I do it for them. Not me.

 

[LETSGORU91_]

All medications come at the risk of adverse side effects. That's why one should build up slowly on any medication. Sometimes risk factors can be modified enough to eliminate the need for medication. But sometimes they can't. If the med helps and is not causing adverse side-effects, there is no need to insist that there be an exit strategy.

OP mentioned treating the symptom and not the problem so he could potentially reduce/eliminate cholesterol AND BP meds. I offered some suggestions. My point was a large portion of society is not willing to go the route of risk factor modification and would rather pop pills. All medications have side effects as per their label, from minor to potentially major. I would rather put in some effort to reduce my risk factors and potentially avoid medications now and in the future. I side with the OP. I did mention if all else fails, meds would be indicated.

 

[Rhuarc]

BP and cholesterol med reduction plan: exercise, follow a heart healthy diet, maintain a good body weight, reduce sodium intake, stress reduction, sleep better. Society in general has gotten lazy and wants magic pills to fix everything without dedicating themselves to a healthy lifestyle. If that all fails or you are at very high risk, meds would then be indicated.

It would be wonderful for everyone to live a stress free or stress reduced life. However, it's not very realistic unless you don't have to work and have rich people money so you don't have to deal with common problems. Sure, stress can be self-inflicted, but I would wager that daily stress levels just keep on rising in the future as it becomes more difficult to thrive in society.

 

[Retired711]

OP mentioned treating the symptom and not the problem so he could potentially reduce/eliminate cholesterol AND BP meds. I offered some suggestions. My point was a large portion of society is not willing to go the route of risk factor modification and would rather pop pills. All medications have side effects as per their label, from minor to potentially major. I would rather put in some effort to reduce my risk factors and potentially avoid medications now and in the future. I side with the OP. I did mention if all else fails, meds would be indicated.

I wasn't reacting to the OP. I was reacting to the person who said he wouldn't take the meds because there wasn't an exit strategy. We are in agreement that it makes perfect sense to avoid meds if you can. But it doesn't make sense to avoid meds just because there's no guarantee that you will ever get off them.

 

[yessir321]

My biggest problem with the statins, other than not being able to handle them, was the exit plan. No one could answer the question "What's the plan for me to NOT have to take these." it's treating the symptom and not the problem.

I have a similar issue with my BP medications. It seems to be just acceptd that you go on these medications forever. I want an exit strategy!

Not to be blunt but there’s an obvious exit strategy called death. It hits us all but that’s kinda the point of these drugs, they delay that sometimes by YEARS and that’s so worth it.

For example my father who had a quadruple bypass and a stroke back in 2021, there’s no shot he would be here to see his grandson’s lacrosse game that he was last week without the ongoing drugs he takes including statins.

 

[Knight Shift]

HDL is a good cholesterol. It's responsible for picking up LDL and transporting it back to the liver where it can be broken down and flushed from the body. Higher HDL levels are associated with lower mortality rates and a reduced risk for cardiac disease. It's good.

Stephan Guyenet says it well. I sort of agree with you, but if you listen to the godfather of lipidology, Thomas Dayspring, he will go off on one using the term "good cholesterol."

 

[Knight Shift]

Yes, liver production is the majority culprit of blood cholesterol. But citing numbers from Columbia U, Cleveland Clinic, Harvard say 20-30% comes from the diet. That's not insignificant. If you care to read an interesting book on plant based diets, Caldwell Esselstyn delves into drastic improvements in cholesterol numbers with this strict dietary regimen. Perhaps dietary modifications can also change the way our liver functions as well, thereby reducing the production of cholesterol.

Having used different diet levers (increased saturated fat or increased "crappy" carbs), I can increase/decrease my LDL by 20-30% or more.

 

[Scarlet Engineer]

Stephan Guyenet says it well. I sort of agree with you, but if you listen to the godfather of lipidology, Thomas Dayspring, he will go off on one using the term "good cholesterol."

Interesting note and a matter of pride to all of us - Dr. Thomas Dayspring got his bachelors degree from…Rutgers, and got his MD from UMDNJ which of course is now part of the Rutgers Medical School.

 

[Knight Shift]

Interesting note and a matter of pride to all of us - Dr. Thomas Dayspring got his bachelors degree from…Rutgers, and got his MD from UMDNJ which of course is now Rutgers Medical School.

Have interacted with him on X. He is very personable and very passionate about lipidology. Loves to teach and explain the mechanistic action of lipid particles and treatment. Great guy.

 

[RUBOB72]

all I can say is this. I was on statins after my heart attack in Jan of 2020. They worked well for a year and then the side effects hit, and hit hard. Debilitating joint and muscle pains started in my knees any the end of spring they were all the way up to my neck. I thought I was going to die. Got off the statins and am very successfully controlling my numbers with diet. But it took until the fall of 23, almost a year and a half for the pains to gradually disappear. So I will just say to stay vigilant and watch for the side effects. I hope they never come.

A question for those statin users. How many have had negative symptoms after a period of taking a statin drug ? Did a professional M.D. diagnose your issue or did you alone stop taking the drug? I do believe diet is key but that should start very early in life. Did you ever smoke? Drink alcohol in excess? Were you overweight? Did you exercise after quitting the statin drug? Not sure the drug was the only reason for your arthritic type pain.

 

[patk89]

Statins have prolonged the lives of countless people since they came out. Genetics is the reason why some people have high calcium scores and are at much higher risk while others who appear unhealthy have zero calcium. Look at your family. How did people die and at what age? Early death from heart diseases that runs in your family indicates that you are high risk and should be proactive in using meds. If everyone on both sides live into their 90's, you won the lottery and are highly likely to do the same.

 

[Retired711]

Statins have prolonged the lives of countless people since they came out. Genetics is the reason why some people have high calcium scores and are at much higher risk while others who appear unhealthy have zero calcium. Look at your family. How did people die and at what age? Early death from heart diseases that runs in your family indicates that you are high risk and should be proactive in using meds. If everyone on both sides live into their 90's, you won the lottery and are highly likely to do the same.

Gentics play a significant role, but are not the only cause. That's why lifestyle and diet are important.

 

[patk89]

Gentics play a significant role, but are not the only cause. That's why lifestyle and diet are important.

Agreed. Just pointing out that there are 300 lbs people with zero calcium/artery blockages and there are 140 lbs marathon runners with significant blockages. Same age. Never indicated that they are the only cause, those are your words. If your family all lives to be 100, and you shoot heroin, you are not going to make it.

 

[Retired711]

Agreed. Just pointing out that there are 300 lbs people with zero calcium/artery blockages and there are 140 lbs marathon runners with significant blockages. Same age. Never indicated that they are the only cause, those are your words. If your family all lives to be 100, and you shoot heroin, you are not going to make it.

You wrote: "Genetics is the reason why some people have high calcium scores and are at much higher risk while others who appear unhealthy have zero calcium." I'm glad we agree that statement should not be taken as indicating that genetics is the only cause.

 

[RUInsanityToo]

My biggest problem with the statins, other than not being able to handle them, was the exit plan. No one could answer the question "What's the plan for me to NOT have to take these." it's treating the symptom and not the problem.

I have a similar issue with my BP medications. It seems to be just acceptd that you go on these medications forever. I want an exit strategy!

Unfortunately there's only one exit strategy.....

 

[RUforester72]

One of my first lessons at RU in forestry was this:

Phenotype is a function of heredity and environment and the interaction of heredity and environment. Thank you Doctor Ben Stout.

 

[RUboston]

As usual, this board comes through! Thanks for all the helpful information, including free MD advice.

 

[Dpgru]

My biggest problem with the statins, other than not being able to handle them, was the exit plan. No one could answer the question "What's the plan for me to NOT have to take these." it's treating the symptom and not the problem.

I have a similar issue with my BP medications. It seems to be just acceptd that you go on these medications forever. I want an exit strategy!

I agree completely. If you read my post earlier I suffered from serious side effects from the statins, and I mean serious. It took close to one and a half to two years for the pains to finally dissipate after I stopped the statins. The Dr, research on the net with places like Mayo Clinic and other reputable medical institutions, etc, were of no help. There is nothing out there to help you recover from these drugs it the treatment goes south on you as it did with me.

 

[RU848789]

I agree completely. If you read my post earlier I suffered from serious side effects from the statins, and I mean serious. It took close to one and a half to two years for the pains to finally dissipate after I stopped the statins. The Dr, research on the net with places like Mayo Clinic and other reputable medical institutions, etc, were of no help. There is nothing out there to help you recover from these drugs it the treatment goes south on you as it did with me.

Interesting. Most people see muscle pain diminish soon after discontinuing the statin, like my wife has had to do for several statins, or by reducing dose if on a higher dose (that worked for me - my doc had me go from 10 mg to 20 mg of Crestor and I started having moderate myopathy, so I went back to 10 mg and haven't had any issues since and my bloodwork is now all in the normal range). I wonder if you had the fairly rare autoimmune reaction noted in the link which can last for months or years and can be difficult to treat (steroids and/or immunosuppressive drugs - did you try those?).

https://en.wikipedia.org/wiki/Statin-associated_autoimmune_myopathy

 

[megadrone]

Interesting. Most people see muscle pain diminish soon after discontinuing the statin, like my wife has had to do for several statins, or by reducing dose if on a higher dose (that worked for me - my doc had me go from 10 mg to 20 mg of Crestor and I started having moderate myopathy, so I went back to 10 mg and haven't had any issues since and my bloodwork is now all in the normal range). I wonder if you had the fairly rare autoimmune reaction noted in the link which can last for months or years and can be difficult to treat (steroids and/or immunosuppressive drugs - did you try those?).

https://en.wikipedia.org/wiki/Statin-associated_autoimmune_myopathy

Yes, my muscle pain/soreness went away immeidately. I was more concerned with what statins might have been doing to my liver, given how they work.

 

[Dpgru]

Interesting. Most people see muscle pain diminish soon after discontinuing the statin, like my wife has had to do for several statins, or by reducing dose if on a higher dose (that worked for me - my doc had me go from 10 mg to 20 mg of Crestor and I started having moderate myopathy, so I went back to 10 mg and haven't had any issues since and my bloodwork is now all in the normal range). I wonder if you had the fairly rare autoimmune reaction noted in the link which can last for months or years and can be difficult to treat (steroids and/or immunosuppressive drugs - did you try those?).

https://en.wikipedia.org/wiki/Statin-associated_autoimmune_myopathy

Yes, my muscle pain/soreness went away immeidately. I was more concerned with what statins might have been doing to my liver, given how they work.

When I read megadrones post in which he said there was no exit plan that resonated with me. My reaction to the statins was admittedly very extreme and probably rare. The joint and muscle pain started in both knees went up to the hips across the lower abdomin then elbows, shoulders across the collar bone to the neck. They started in March and I finally stopped the statins after three different types on sept 2. The pains started to subside almost immediately But maybe because of the severity it took a long time until I was completely free of pain. Now, the serious pain was done in about three months but after that it was a long time before I was back to normal. The pains also didn’t leave everywhere. They started in the knees and worked their way up. The last month was mostly neck pain, like a constant stiff neck. The lack of an exit plan baffles me because it seems that they really don’t know what causes the pains and they don’t fully understand the difference in severity. Thus, they don’t have a plan for helping people out. God bless the ones for whom the drug works. For me, never again.

 

[Rutgers1976]

Been on Atorvastatin for >20 years. I'm 70. 10 mg. every other day. Works like a charm with the numbers. Not aware of any side effects.

 

[Knight Shift]

 

[herdof3]

you should also get a Calcium Score Test. It measures calcified plaque in your arteries. You can have high cholesterol levels and still have low calcium scores

 

[RCBeta79]

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.

Yes. lower calf muscle spasms (sometimes severe) can be a side effect of Statins.
Cardiologists always recommend diet and exercise to lower cholesterol....but sometimes suggest taking CoQ10, Red Yeast Rice, and Flush Free Niacin if Statins cause muscle spasms (Mayo Clinic has done clinicals with good results in lowering cholesterol).

Your muscles need some cholesterol, and LDL plays a role in muscle growth and strength.
Cholesterol is important for the health and function of muscle cells including maintaining cell membranes and enabling signal transduction.

 

[ashokan]

I agree completely. If you read my post earlier I suffered from serious side effects from the statins, and I mean serious. It took close to one and a half to two years for the pains to finally dissipate after I stopped the statins. The Dr, research on the net with places like Mayo Clinic and other reputable medical institutions, etc, were of no help. There is nothing out there to help you recover from these drugs it the treatment goes south on you as it did with me.

You can try nattokinase (from fermented soy) and its on Amazon/Ebay

"Natto, known for its high vitamin K content, has been demonstrated to suppress atherosclerosis in large-scale clinical trials through a yet-unknown mechanism

Natto, a traditional Japanese food made from fermented soybeans, is a rich source of vitamin K2 and has been repeatedly shown to benefit the cardiovascular system"

https://www.nature.com/articles/s41598-023-48562-y

 

[Knight Shift]

Yes. lower calf muscle spasms (sometimes severe) can be a side effect of Statins.
Cardiologists always recommend diet and exercise to lower cholesterol....but sometimes suggest taking CoQ10, Red Yeast Rice, and Flush Free Niacin if Statins cause muscle spasms (Mayo Clinic has done clinicals with good results in lowering cholesterol).

Your muscles need some cholesterol, and LDL plays a role in muscle growth and strength.
Cholesterol is important for the health and function of muscle cells including maintaining cell membranes and enabling signal transduction.

Red yeasr rice contains the same active ingredient as statins

 

[tom1944]

We might all be changing to Verve-102 soon.

I will try to link an article

 

[T2Kplus20]

Been on Atorvastatin for >20 years. I'm 70. 10 mg. every other day. Works like a charm with the numbers. Not aware of any side effects.

Congrats! Miracle medications for many.