Public Discussion about Statins
I was thinking of a common editor’s question: what’s new here?
I look at the statin issue as falling into three categories. I think the third, below, is what is new (or just being gradually admitted, yet grudgingly):
1) Is cholesterol the villain? The medical community is debating whether it is or isn’t with fresh eyes. Evidence is coming out that sugar is much more of a villain than cholesterol (and fats). But this can be an amorphous and contentious debate.
2) Are statins effective in reducing CVD (cardiovascular disease), extending lives, preventing stroke or heart attack recurrences? More studies show that the benefits are minimal and only for folks with CVD disease, not for the otherwise healthy. I have a NNT/NNH study I can refer to. I also know that cardiologist Dr Barbara Roberts has researched this a bunch. There is also the relative risk vs absolute risk deception. Relative risk makes the benefits appear significant when they are minimal. At the same time, risks are presented in absolute risk terms, making the risk appear minimal.
3) What are the side effects of statins? Are doctors warning patients? Looking for symptoms? Admitting that the side effects are long term?
Statins Adverse Effects (AEs)
This last area is what I find new and most disturbing and wishing that my doctor knew. Most people who think of side effects think of that long warning sheet we get whenever we get an Rx. We think that some annoying thing might happen (constipation, runny nose, sleepiness…). but that when we stop the Rx the side effects go away.
3a) the statins adverse effects are significant, varied, and can occur several years later. The main four are myopathy, neuropathy, diabetes, and cognitive impairment. Since they are varied and often occur months later, they don’t get reported well. I’m sure lots of reporters looking at diabetes prevalence in the US conclude that we’re really all just getting fatter and that’s it. But studies show more than that (I show a big one by Tricare on diabetes and statins on my useful references page).
3b) the AEs are often long lasting or permanent, especially if you are on a low dose or have other conditions and don’t notice gradually weaker muscles or gradually increasing blood sugar over a few years. When you stop the statins your diabetes doesn’t resolve, your muscles and/or nerves may not recover.
3c) Doctors (and patients) are very uninformed. I use my case as an example.
First of all, I was given statins around 1998 when I was 42. I was on the lowest dose. I had no risk factors, no family history, no diagnosis. It was just for a marginally elevated LDL number.. I don’t recall any warnings discussed with me at all. These days at least the TV commercials mention muscle pains. Doctors must warn patients and give them a full reward vs risk discussion.
First of all, I was given statins around 1998 when I was 42. I was on the lowest dose. I had no risk factors, no family history, no diagnosis. It was just for a marginally elevated LDL number.. I don’t recall any warnings discussed with me at all. These days at least the TV commercials mention muscle pains. Doctors must warn patients and give them a full reward vs risk discussion.
Secondly, it is thought that CoQ10 and vitamin D can help dampen the side effects since statins reduce CoQ10 and vitamin D in our cells. It wasn’t until two years after I was hospitalized with keg pains in 2012 (age 55) that my Doctor even suggested CoQ10 or measured my vitamin D (it was 15, way low).
Thirdly, if statins are prescribed doctors should monitor patients proactively. In my 15 years on statins the only times I went to see my GP (besides checkups) was for my events, every year or two, of muscle pains, tendinitis, or costochronditis (chest muscle, tendon pain). Each time I was only advised to take Advil or got to a course of Physical Therapy.The same neglect happened regarding my increasing blood sugar. I turned 50, was exercising daily, was under 200 lbs, eating well, yet my fasting blood sugar was increasing each year. There was no thought of the statin as a cause by my doctor.
Thirdly, if statins are prescribed doctors should monitor patients proactively. In my 15 years on statins the only times I went to see my GP (besides checkups) was for my events, every year or two, of muscle pains, tendinitis, or costochronditis (chest muscle, tendon pain). Each time I was only advised to take Advil or got to a course of Physical Therapy.The same neglect happened regarding my increasing blood sugar. I turned 50, was exercising daily, was under 200 lbs, eating well, yet my fasting blood sugar was increasing each year. There was no thought of the statin as a cause by my doctor.
Fourthly, when I complained vigorously about my muscle pains in 2012, my Doctor agreed to take me off statins for two weeks to see if it helped. I now know that that was ridiculous, True that the statin chemical leaves the blood in a few days, but you’d need to stop for months to see if any recovery is possible.
My goal:
I’m not looking for any vindictive or alarmist agenda or personal gain. Victory for me would be having medical school lectures held and public warnings written that speak about statins AEs. Statins may have a place for certain people. OK. But, consider my points above. Each is a lesson that should be given exposure to doctors and patients.
My goal:
I’m not looking for any vindictive or alarmist agenda or personal gain. Victory for me would be having medical school lectures held and public warnings written that speak about statins AEs. Statins may have a place for certain people. OK. But, consider my points above. Each is a lesson that should be given exposure to doctors and patients.