Had a vid check-in with my doc today. He tried to get me on statins. Said may risk factor for a CV over 10 years would drop by less than 3%. No thanks.

Why would I?

.....so you'd rather stick with the....Stati(n)s.....quo....????

---

_____________________________________

I reject your reality and substitute my own!

Three of my close relatives had the muscle problem sometimes associated with statins. Not for me.



Edited 1 time(s). Last edit at 05/26/2020 08:28PM by Dennis S.

Quote
Dennis S
Three of my close relatives had the muscle problem sometimes associated with statins. Not for me.

Yup, my thoughts, too. Probably got a free statin pen from a rep or something.

What've you got to lose?

They literally nearly killed my husband, so, no.

---

Roswell, GA (Atlanta suburb)

Don't know your age, cholesterol level, risk factors, or likelihood for side effects.

But here's what up with statins in my family...

Three of my grandparents died of heart disease before they were 70 – two before 65.

My father thought he was going to die in his 50s when he started having his heart problems.
But, he made it to 82 with the help of advancing technology and a cocktail of drugs including a statin.
When he died, it was Alzheimers, not his heart issues.

My brother is 10 years older than I, in his early 60s, and he recently had a procedure to clear some blockage, and a stent.

So, I have a strong family history and I've had borderline-high cholesterol since my 30s.

My doctor tells me, with my family history, it will be no surprise if I need some kind of heart procedure at some point. But, the goal would be to push it out as far as possible - my 70s or 80s instead of 50s or 60s.

I took a statin for about two weeks about three years ago. I had a side effect with that one and stopped without telling my doctor.

So, when I eventually told my new doctor, he understood and gave me a different statin. I've used it for about a year now with no side effects.

....if you are at risk....I wouldn't ignore the danger of not taking them.......many have taken statins and then through diet and exercise gotten off of them.......

---

_____________________________________

I reject your reality and substitute my own!

AMA standards for cholesterol.

1. For many folks, you can get as good results by changing your diet-drop the refined carbs and bad fats.

2. If you’re going to take statins, you MUST take supplementary vitamin coQ10.

3. The last time I looked, the all-causes mortality rate was the same if you take statins or you don’t.

Hmmm. My experience is directly contradictory to anonymouse1:

1) Dietary change didn't alter my cholesterol a whole heckuva lot. The statin I'm on, on the other hand, has had a dramatic effect. This is likely because a number of people-- myself included-- may have high cholesterol at least partly because of genetics, the cholesterol being manufactured in your body in addition to whatever you ingest.

2) I haven't found any solid evidence that CoQ10 makes much, if any difference for statin-related symptoms. Also relevant: not all statins are alike... I'm tolerating a relatively low dose of the one I'm on now, and was on a different one for years that seemed to be OK but gave some GI symptoms, but the one before that was terrible and made me feel like cr@p. Of course, YMMV, and what is right for one person may not be right for another.

3) My GP would really disagree with this statement, since cardiovascular disease is the #1 killer of men in my age group, and the data looks pretty good that bringing down the cholesterol reduces risk of MI's and strokes.

---

Freya says, 'Hello from NOLA, baby!' (Laissez bon temps rouler!)



Edited 1 time(s). Last edit at 05/26/2020 11:08PM by PeterB.

My TOTAL cholesterol number is good BUT, my HDLs are always lower than my MD would like. He put me on a 10mg statin years ago with the thought that by lowering the LDLs further, the HDL / LDL ratio would improve. He also told me to take Co-Q10 with the statin.

At my last heart check, I had some minor blockage and my doc put me on a statin. I took them for a year or two but started hearing anecdotal bad things so I stopped taking them for a few months. At my next annual exam, he suggested that he would be so sad attending my funeral knowing that it could have been put off if I had just taken my meds. I resumed taking them and am not aware of any side effects. Certainly no myopathy.

We'll resume the conversation once annual physicals are resumed.

Knights on White Statins?

had to be said.

---

********************************************
The police have no duty to respond. See Castle Rock v. Gonzales, 545 U.S. 748 (2005) or Warren v. District of Columbia[1] (444 A.2d. 1, D.C. Ct. of Ap. 1981)

Quote
Racer X
Knights on White Statins?

had to be said.

stealing Newton's thunder gravity!

merely a moment of weakness.....

---

********************************************
The police have no duty to respond. See Castle Rock v. Gonzales, 545 U.S. 748 (2005) or Warren v. District of Columbia[1] (444 A.2d. 1, D.C. Ct. of Ap. 1981)

I started on a 10mg dose last year, and noticed a change in my short-term memory that I didn’t want to live with. Doc changed to a 5mg dose and that has been OK. I haven’t had blood work since then but will find out this fall whether it has helped.

---

My life goes smoothly and in regular intervals

Glad doctors are starting to not suggest them. I think statins will eventually be put on the List of Withdrawn Drugs or at least relegated to the rarely used category. Too many great dietary alternatives to help lower cholesterol are known, and the safe range of mmol/liter is being questioned.

That said, I'm very libertarian when it comes to person choice of drugs. People should be able to take whatever they want into their own systems.

---

Mac mini (M1 2020, 16G 2T) • Big Sur 11.x • Dual 25" Acer 1440p LCDs • 11" i5 MacBook Air •

My late dad (an MD) refused to take them because of the muscle thing. I think he would have had fewer heart attacks had he taken them. I've taken simvastatin for 15 years with no ill effects.

And given my food choices, I would have almost certainly had heart issues before now.

I'm with PeterB. Familial hypercholesterolemia is a real thing, and for some of us no amount of dietary change or exercise regimen will lower our risks to typical levels. Statins are not for everyone, and they still have real risks for folks with FH. Healthcare choices are about calculated risks, which is where tuqqer's libertarian leanings come in handy. Let's keep the informed in informed consent.

---

rj
AKA
Vreemac, Moth of the Future




Edited 1 time(s). Last edit at 05/27/2020 08:44AM by rjmacs.

Quote
rjmacs
Healthcare choices are about calculated risks.

Spot on.

---

Mac mini (M1 2020, 16G 2T) • Big Sur 11.x • Dual 25" Acer 1440p LCDs • 11" i5 MacBook Air •

Quote
rjmacs
I'm with PeterB. Familial hypercholesterolemia is a real thing, and for some of us no amount of dietary change or exercise regimen will lower our risks to typical levels. Statins are not for everyone, and they still have real risks for folks with FH. Healthcare choices are about calculated risks, which is where tuqqer's libertarian leanings come in handy. Let's keep the informed in informed consent.

My ex-wife's family had hereditary high blood pressure and high cholesterol. Great diet and daily exercise barely made a dent.

---

********************************************
The police have no duty to respond. See Castle Rock v. Gonzales, 545 U.S. 748 (2005) or Warren v. District of Columbia[1] (444 A.2d. 1, D.C. Ct. of Ap. 1981)

While the statins have been overused in the past, they have been definitely proven to reduce the risk of death in certain patient populations, to various degrees depending on patient characteristics. It is extremely naive to think that dietary changes alone will reduce risk factors in the majority of those patients. Not to mention that no one really knows how to do that properly (e.g., high-fat low-carb diet may be beneficial for improving the lipid profile in some more than low-fat diet).

But yes, there are definitely potential side effects, in some cases severe. Some of them can be mitigated by switching to another statin, some maybe not. My mother in law went through 4 of them until she found one she could tolerate. On a side note, she is thin, extremely active for her age, eating healthy food religiously, and having a really bad lipid profile. Her mother was similar, took no medication, and died early from heart attack. I, on the other hand, used to be morbidly obese, ate high fat food while being a couch potato and always had a perfect lipid profile. Genetics matters a lot.

I would suggest letting the physician determine what is your individual risk-benefit. Keep in mind that most of statins are off patent nowadays and thus not promoted by sales people, so I think that the fear of a pharma rep influencing your doctor is unfounded.



Edited 1 time(s). Last edit at 05/27/2020 10:47AM by dk62.

My doc (since retired, still looking for a good replacement) was all about the final outcome. Did you live or die? Is your quality of life improved? I went off Niacin because question 1 leaned towards "die" as good data came out. He also leaned away from prescribing drugs if there was a better option like changes in diet and exercise for Diabetes, Hypertension,etc.

However he said that statins were the drugs with actual net positive outcomes and do prevent heart attacks and death for at-risk groups.

Cholesterol levels are homeostatically regulated, and except for soluble fiber, diet has no affect on this.

This is where statins come in for those who have high levels, although I believe that the jury is still out as to whether lower cholesterol levels achieved this way truly result in different medical outcomes.

There are however, people with insanely high - quite literally grams per deciliter of blood - cholesterol levels, and perhaps intervention is justified here.

.....like all medicine.....it is neither good nor bad.....the key is to find a good doctor which can be difficult to find......and use your own judgement.......

---

_____________________________________

I reject your reality and substitute my own!

So, my cholesterol levels are fine:

Cholesterol 187 mg/dL <=239 mg/dL

Triglyceride 59 mg/dL <=499 mg/dL

HDL Chol 72 mg/dL >=40 mg/dL

LDL Calc 103 mg/dL <=159 mg/dL

According to his algorithm my risk factor for CV in the next 10 years is 12.5% with no statins, drops to 9% with them.

No thanks, my 70 year old muscles are sore most of the time already.

Quote
freeradical
Cholesterol levels are homeostatically regulated, and except for soluble fiber, diet has no affect on this.

This is where statins come in for those who have high levels, although I believe that the jury is still out as to whether lower cholesterol levels achieved this way truly result in different medical outcomes.

There are however, people with insanely high - quite literally grams per deciliter of blood - cholesterol levels, and perhaps intervention is justified here.

As I read this I am waiting on my morning huge bowl of oatmeal to cool. Fresh nutmeg is the trick for me.

---

********************************************
The police have no duty to respond. See Castle Rock v. Gonzales, 545 U.S. 748 (2005) or Warren v. District of Columbia[1] (444 A.2d. 1, D.C. Ct. of Ap. 1981)

Quick updates:

Yes, the points about familial hyperlipidemia are entirely correct. I’m embarrassed that I forgot to mention that, and I’m grateful to those who did.

Second, it looks to me like the jury is out on whether statins have a positive impact on all-cause mortality. My best guess is that there are still some unknown variables out there. [www.health-heart.org]

My doc had my wife and I both start using Red Yeast Rice when our cholesterol got a bit over borderline rather than using statins. He said he'd prefer to not use them unless/until we were at substantially higher cholesterol levels. We walk a golf course 5 days a week and kayak for an hour and ride bikes for an hour on the other 2 days of the week, so we're pretty active. Both of our cholesterol levels are right at the borderline level with a pretty crummy diet, quite a bit of exercise and daily Red Yeast Rice. He's happy and so we're happy.

Quote
Wags
So, my cholesterol levels are fine:

Cholesterol 187 mg/dL <=239 mg/dL

Triglyceride 59 mg/dL <=499 mg/dL

HDL Chol 72 mg/dL >=40 mg/dL

LDL Calc 103 mg/dL <=159 mg/dL

According to his algorithm my risk factor for CV in the next 10 years is 12.5% with no statins, drops to 9% with them.

No thanks, my 70 year old muscles are sore most of the time already.

Personally, I would say with a Total/HDL ratio (way) under 3, your lipid profile should be a-ok as is. I think your doc is treating a number (the LDL) which is at worst marginal.

If anything, I would instead take a baby aspirin if your C reactive protein is above 1.0 mg/L. The baby-aspirin thing has gotten some unearned bad press lately from the statin-pusher crowd, but it should have fewer side effects and may improve other things, like colon cancer risk and possibly Alzheimer’s risk.

The NNT shows the risk v harm. And IIRC, the NNT is a 5 yearsvrisk benefit.

[www.thennt.com]

---

All I ever really needed to know, I learned from watching Star Trek.

Quote
Michael
My doc had my wife and I both start using Red Yeast Rice when our cholesterol got a bit over borderline rather than using statins. He said he'd prefer to not use them unless/until we were at substantially higher cholesterol levels. We walk a golf course 5 days a week and kayak for an hour and ride bikes for an hour on the other 2 days of the week, so we're pretty active. Both of our cholesterol levels are right at the borderline level with a pretty crummy diet, quite a bit of exercise and daily Red Yeast Rice. He's happy and so we're happy.

You're on lovastatin. Red yeast rice is just a natural source.

---

rj
AKA
Vreemac, Moth of the Future




Edited 1 time(s). Last edit at 05/28/2020 12:34PM by rjmacs.

If someone said they could reduce your risk of a heart attack over the next 10 years by 28%, would you be interested in what they have to say? A drop in absolute risk from 12.5% down to 9% is a reduction in risk of 28%.

Quote
pdq
The baby-aspirin thing has gotten some unearned bad press lately from the statin-pusher crowd, but it should have fewer side effects and may improve other things, like colon cancer risk and possibly Alzheimer’s risk.

Major bleeding events do not equate with “unearned bad press.”
Only take a baby aspirin if your doctor suggests it.



Edited 1 time(s). Last edit at 05/30/2020 02:15PM by S. Pupp.

My doctor put me on a low dose of Lipitor despite my cholesterol not being high because he wanted it to be "extra low" due to family history and type 2 diabetes. He seems to think this stuff is a miracle drug. I didn't argue with him and I am having no perceivable side effects, so I don't mind very much...

Same thing, without the family history, I'm on lovestatin and low dose aspirin.