Author Topic: statins?  (Read 1847 times)

Pedaldog

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statins?
« on: July 06, 2013, 12:36:02 am »
My cholesterol levels have been a bit high for a few years. About 3 years ago I started on the Statins, Simvastatin or Atorvastatin. I didn't associate it at the time but back then I just about stopped cycling, all physical movement due to Really bad muscle and joint pains. In February of this year I read about some of the side effects of statins and it suddenly clicked with me so I stopped them immediately. Within a month I was in less pain and had started some small journeys by bike or trike. Things are less than perfect but I feel there is improvement happening slowly even now. I saw mthe diabetes clinic a week or so back and they did all the blood tests and I got the results a few days ago. Cholesterol is still a bit too high and my doctor tells me that Aruvostatin has been found to be more tolerable by people in general than the others and he wants me to try them at 5mg a day. I did some checking on the internet and the general information from most sources is that they can still have many severe side effects that are the same as I had before or worse!  I don't know what to do now.  I am scared to take them, the pain was so terrible that I fear it coming back. Do I take them and risk the fact that, if I do get the problems, stopping them again would still mean a slow recovery again, a matter of months of pain before I could walk or ride at all really?
Any advice would be really appreciated, thanks.

Re: statins?
« Reply #1 on: July 06, 2013, 10:59:07 am »
My level was a bit high a few years ago, but I didn't want to take statins due to the possible side effects - it's your choice, not the doctor's!

Found I could lower the ch level by avoiding cakes for a few days before the test! I think trans fats are the ones to avoid, used widely in commercial (as opposed to home made) products.

I have read that some studies have found that statins, while reducing ch levels, do not actually reduce mortality rates.  I strongly suspect statins are simply a money spinner for the drugs industry.

hellymedic

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Re: statins?
« Reply #2 on: July 06, 2013, 02:50:41 pm »
My mother stopped her statins due to muscle pain. She moderates her diet and her cholesterol is on the high side of normal. At 77, she doesn't really have to worry about dying young.
I am disappointed that a major side effect has had so little publicity.

If your cholesterol is very high despite having a 'good' diet and there's a strong family history of heart disease, it might be worth trying another statin. I would not bother otherwise.

Re: statins?
« Reply #3 on: July 06, 2013, 03:09:50 pm »
The rate of serious side effects from statins is pretty rare, maybe about 0.1%. More likely with high doses (80 mg) of simvastatin.

(Anecdotally, my experience is that a good proportion of patients who attribute pains to their use of statins have other equally likely causes of pain).

Have your liver function results etc. been abnormal?

I have read that some studies have found that statins, while reducing ch levels, do not actually reduce mortality rates.

That's not my understanding of it. Statins certainly do improve outcomes for those with existing coronary artery disease and are also, overall, likely to be of benefit in those without CAD who are at high risk of developing it. That'll be those who smoke, are diabetic, have a strong family history, have high cholesterol levels, renal disease etc.

On the other hand, if you don't have much in the way of risk factors, then the choice is yours.

For those who have muscle pain and abnormal liver function that is due to use of a particular statin, it is true that they can often be totally fine on a different statin. So your doc isn't spinning you a yarn there. It's a matter of considering your overall risk profile.

Just as an aside, the interesting thing about statins is that even when they fail to reduce cholesterol by much, they still show benefits in many studies. So that's pretty much the opposite of orienteer's remarks. Best to make use of the Cochrane database etc. 

interzen

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Re: statins?
« Reply #4 on: July 06, 2013, 03:25:44 pm »
Interesting.
So far I've not experienced any side-effects from taking statins (20mg simvastatin, daily) but having said that I have to take so many other medications that any side-effects I did have were probably lost in the noise anyway (eg. rectal anarchy as a result of the metformin/gliclazide double-whammy and various pains in the lower back region due to herniated L4/L5 discs)

A couple of data points for you:

My father is Type 1 diabetic but doesn't take statins - they interacted rather badly with the myriad other drugs he takes so he was taken off them. Even so, and despite also having hyperlipidaemia, he's managed to keep his total serum cholesterol in the 'high normal' range  through control of his diet. Or, more likely, my mother's control of his diet ...

I'm Type 2 diabetic and am currently, amongst other things, simvastatin - generally, my serum cholesterol levels have dropped off pretty sharply since I modified my diet (a while ago) and started ramping up the exercise levels for next year's silly bike adventure (more recently). On the one hand, it's debateable whether or not I should be taking them but on the other I know what I'm like and still have a tendency to go off the rails, especially when the Bipolar Express puts in an appearance.

Broadly speaking, I'd go along with helly - more out of personal experience than any in-depth medical knowledge (I may have a PhD, but I'm not a medical doctor); certainly if you have the self-control and willpower to keep your diet in check then stop the statins and see how you get on - I'd still be inclined to have regular blood tests, statins or not (I'm currently on a 3-monthly review cycle at the moment, with full blood-work including LFTs etc. done every year - YMMV, though)

hellymedic

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Re: statins?
« Reply #5 on: July 06, 2013, 03:26:26 pm »
I read somewhere that around one in four patients get muscle pain on statins; that's not 'rare'.
The muscle pains are insidious and often occur in those who expect a few aches and pains (the 'mustn't grumble' elders), which does not make this problem 'minor'; it just means it's under-reported.

Re: statins?
« Reply #6 on: July 06, 2013, 05:25:31 pm »
I recall taking statins (name forgotten) when the Doctor reported narrowing of the arteries during a heart test. I stopped when my muscles became weak but no pain was experienced. So I am still breathing after ten years or so have passed and would not take statins again. I recall a thread by someone at C+ Forum titled "Statins are killing me"
I wonder if that was correct?


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Re: statins?
« Reply #7 on: July 06, 2013, 05:47:26 pm »
Highly unlikely; they probably meant the pain was unbearable.

'dog, what were your cholesterol readings?
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Pedaldog

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Re: statins?
« Reply #8 on: July 06, 2013, 10:19:36 pm »
To be honest I don't know the actual cholesterol level as it was a telephone call from the nurse that just said "They're a Bit Higher than they should be" and I suppose ought to have delved a bit deeper into the subject. I decided to have a go and took a single 5mg Rosuvastatin last night, equivalent to 20mg dose of Simvastatin so I'm told, and have been in a fair bit of pain with weakness already today! I will Not take any more of them and just make some effort in sorting my health out a bit in other ways. Like Interzen I am on such a huge list of other drugs that one more worry is just a bit too much. I suppose Dyette an Eksersyze might have to be looked at!

Re: statins?
« Reply #9 on: July 06, 2013, 10:22:15 pm »
Odd. Mine are well past the "bit higher and they should be" and the doctor is tentative about prescribing statins. Trying diet first.
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Pedaldog

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Re: statins?
« Reply #10 on: July 06, 2013, 11:11:51 pm »
I think I'll try the diet (shudder!) thing first and see how it is in a month or so, make a decision from there. I suppose the current pain might be slightly Psychosomatic due to the Worry I had about things turning bad again.

barakta

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Re: statins?
« Reply #11 on: July 07, 2013, 12:00:50 am »
I have a diabetic friend who found the docs got very paranoid about cholesterol and his were 5.1 which in a non diabetic would have been OK.  He refused statins and tried diet adding lots of oats and pomegranate juice which apparently helped.  I'm sure there's "cholesterol reducing foods" which can be looked up.

Re: statins?
« Reply #12 on: July 07, 2013, 12:10:44 am »
I read somewhere that around one in four patients get muscle pain on statins; that's not 'rare'.
The muscle pains are insidious and often occur in those who expect a few aches and pains (the 'mustn't grumble' elders), which does not make this problem 'minor'; it just means it's under-reported.

A 5% incidence of myalgia is the highest figure (from a specific study I think, rather than a review of multiple studies) that I can recall offhand. But yes, underreporting is entirely possible.

I think I'll try the diet (shudder!) thing first and see how it is in a month or so, make a decision from there. I suppose the current pain might be slightly Psychosomatic due to the Worry I had about things turning bad again.

For people not known to have heart disease, when cholesterol levels / profile are not unusually adrift, and in the absence of a list of risk factors for heart disease as long as your arm, the usual advice is to try control via diet and lifestyle first. But you need to get personal advice on that from a medical professional that knows your history.

Re: statins?
« Reply #13 on: July 07, 2013, 12:13:45 am »
I'm on 80mg Simvastatin at night and Ezetimibe in the mornings.  I can't say I've noticed any muscle pain (luckily).  My cholesterol when I smoked was in double figures and even after was very high.  Dietary changes in my case have had very little effect.  Even with the Statins I struggle to get under 6 on a fasting test.
For me already stented I think they're essential and thus far have negligible side effects.

We're all different, maybe a change of Statin will see you right.

Pedaldog

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Re: statins?
« Reply #14 on: July 07, 2013, 12:22:35 am »
This will be the Third Statin I have tried. The first two gave me terrible pain and other problems. The GP suggested this one as he says it has a more widely tolerated effect. I think I need to speak to the surgery on Monday and see what the exact levels were. It might be that I am "A bit higher than Normal", as in Normal in my history, but need to take definite action or it might be just the GP being a bit paranoid on my behalf?
The pains in my leg were absolute agony and I had accepted that I was never going to ride again until I was advised by a friend, not medically trained, that I ought to look at the link in Statins effects. The pains eased noticeably and quickly after I went Cold Turkey on the Statins.

AAO

Re: statins?
« Reply #15 on: July 07, 2013, 01:30:43 am »
If you've had a heart attack like wot I've 'ad, Statins are good news, if you can tolerate them. They have a protective function that guard against future attacks.
I do worry that so many people try to second guess what their Doctors are telling them to do by asking people on forums such as this for their views. By all means seek opinions, but be very wary............
In my considerable experience of having all sorts go wrong with me, resulting in several operations over the last six years (I won't bore you with details), the medical people who have dealt with me have - to a man/woman, across many disciplines and three hospitals - been thorough, right in their judgements and very sensitive to any concerns that I have had.

hellymedic

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Re: statins?
« Reply #16 on: July 07, 2013, 01:58:02 am »
Saga don't give references to the 'Dutch study' quoted here http://www.saga.co.uk/health/medicines/statins-case-against.aspx but it certainly seems that more than 5% had problems.
Citing the case of My Mum and Her Mate is of course only anecdata. (Mum didn't consider her general achyness might be due to her statins till she met Her Mate whom she'd not seen for years as they mostly inhabit different countries. Mate told Mum about how her life was much improved after stopping statins...)

Statins are wonderful drugs for those who need and suit them. We sometimes forget they don't suit everyone.

Pedaldog

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Re: statins?
« Reply #17 on: July 07, 2013, 02:29:27 am »
I think I'm in the "Don't suit me" camp. now 26 hours after I took the first one and I am near to tears with the pain in my legs, back and head!

Re: statins?
« Reply #18 on: July 07, 2013, 10:33:15 am »
I think I'm in the "Don't suit me" camp. now 26 hours after I took the first one and I am near to tears with the pain in my legs, back and head!

I'd suggest going to your GP to discuss all of this, PD. As above, it is of course possible that statins are causing this effect but there could also be other reasons. Worth discussion with your GP.  The are blood tests that should be done before starting a statin and during treatment so ensure that you have had those tests. 

Statins (benefits vs risks) and cholesterol levels is a very complex area, especially for people who do not have known heart disease. That's why it's best to get advice on this from your GP or other appropriate person among your contacts with the NHS: they will know your existing history and risk factors and should be able to advise.

Unless your cholesterol is extremely high, it may well be the case that there are other changes that you could make to your lifestyle (exercise, diet, smoking, etc etc) that could provide a reduction in risk that could exceed any benefit from lowering your cholesterol, so there is no need to worry overly if it is the case that this statin causes problems for you.

If it does turn out to be the case that your doc continues to strongly recommend lowering your cholesterol or improving your lipid profile, then I do know that some patients who cannot tolerate one statin can get on perfectly well with another. I also know people who have declined to take statins and managed to lower their cholesterol by other means (dietary changes + exercise + stopping smoking +/- a change of lifestyle to reduce stress from work etc). But unless your cholesterol is very abnormal (usually because there is an inherited tendency to have abnormally high cholesterol), it's probably not worth getting unduly worried about and it's reasonable to focus on other areas that might be improved, especially if you have not had a heart attack, do not suffer from angina, etc.

There is a lot of uncertainty and concern among the medical profession about the benefits vs risks of prescribing statins as primary prevention. There is a lot of concern about statins being available over the counter (I don't think they should be). The concerns surround long term effects (there is talk of recommending statins to everyone over 50, so people could be on these for 30 years or more, while never having had cardiac symptoms or events), there is concern regarding possible interactions with other medications, as people who are prescribed statins are likely to be on other medications, and so on.

There is also the debate (and a huge amount of study and data analysis) going on to try to tease out just how significant the benefit actually is; even if there is a benefit, is it actually worth the risk of interactions / side effects / unknown future consequences** to gain an average increase in life expectancy of (random figure) a number of months after taking a drug for (random number) 15 years?

So PD, number 1 is to discuss all this with a doctor that knows you. If you can lower your cholesterol by some other means, that's worth exploring. If you can't, and you cannot lower your cholesterol using drugs, no need to worry unduly. There are probably other changes you can make to your lifestyle that could cause at least as great a drop in your risk of future ill health.

** An example of an unforeseen consequence - very small study, I know, but it's just an example of the sort of thing I'm on about:

http://www.ncbi.nlm.nih.gov/pubmed/23583255

interzen

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Re: statins?
« Reply #19 on: July 07, 2013, 11:32:35 am »
This will be the Third Statin I have tried. The first two gave me terrible pain and other problems.
Whilst three is hardly a statistically sound sample size, this would indicate to me that you just don't tolerate statins - some people do (eg. me), some people don't (eg. my father) and if a single dose is giving you that much grief I'd stop taking them and discuss matters with your GP whilst stating that you're not prepared to try 'another' statin.

This thread got me thinking - in my last lot of test results my cholesterol was 2.8 ... makes me wonder (again) whether or not I should start coming off them.

Pedaldog

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Re: statins?
« Reply #20 on: July 07, 2013, 12:08:14 pm »
This will be the Third Statin I have tried. The first two gave me terrible pain and other problems.
Whilst three is hardly a statistically sound sample size, this would indicate to me that you just don't tolerate statins - some people do (eg. me), some people don't (eg. my father) and if a single dose is giving you that much grief I'd stop taking them and discuss matters with your GP whilst stating that you're not prepared to try 'another' statin.

Whe I say "Third Statin" I mean the third course of a different type of statin by the way not just three doses! The last one I was on for over three years and my health went below ground on them all!
Thanks for all the input and I am going to follow Comrade Pluckski's advice and see the Doctor this coming week. I think one of the reasons that he is heavy on me about them is that I have had Two T I A's in the past four years and that is obviouslt a worry on the Heart thing. I'll speak and decide from there.
Thanks again  all that have posted here.

Re: statins?
« Reply #21 on: July 07, 2013, 12:09:45 pm »
Simon,I presume you mean an LDL level of 2.8. That's healthy and normal (mine is 4 after drastic diet changes).
In your case it might mean the statins are working.
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Re: statins?
« Reply #22 on: July 07, 2013, 01:17:29 pm »
I have had Two T I A's in the past four years and that is obviously a worry on the Heart thing. I'll speak and decide from there

Good plan. Given that you do have a history, then, of cardiovascular disease, and at least one other risk factor (diabetes as per your OP) then the evidence for benefit from statins is much, much stronger. Pretty clear reduction in risk of vascular events for those who have had previous TIA or stroke but no known heart disease, and also reduction in risk of stroke for those with existing coronary artery disease.

Interestingly the benefits of taking statins for prevention of stroke / TIA are independent of cholesterol levels, i.e. it's not simply a matter of getting cholesterol levels down as the risk reduction occurs anyway when taking the drug.

Wowbagger

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Re: statins?
« Reply #23 on: January 09, 2019, 07:55:03 pm »
Thread resurrection!

As a result of a whole load of cardiac tests just over a month ago, an angiogram revealed that I have some ("mild-to-moderate") blockage of the coronary arteries. The specialist has said "he would appreciate it if your kind GP starts you on aspirin 75mg once a day and atorvastatin 40mg once a day". On the strength of this I have made a doc appointment for next Wednesday to discuss this. So far as I can recall, throughout this whole procedure no one has commented on my cholesterol levels during the course of recent tests and I have made pretty significant changes to my lifestyle since joining Slimming World, and have lost over 2 stone.

I'm not keen on taking a load more tablets and I will make absolutely certain that the doctor is sure its a good idea in the light of recent developments.
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