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The Pros and Cons of Statins

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Comparing drug benefits to risks is a delicate balancing act. Nowhere is this more apparent than with statin-type cholesterol-lowering medications such as atorvastatin (Lipitor) or simvastatin (Zocor).

These drugs can save lives, particularly for people who have had heart attacks or needed cardiac interventions. But others find the quality of their lives compromised by drugs meant to prevent trouble.

One reader, R.R., wrote to protest an article we wrote about statin side effects:

"I had a heart attack a few weeks after my 49th birthday. I had a five-way bypass operation four days after I went into the hospital. After that, my cardiologist, my family doctor and I worked on reducing my blood cholesterol. We settled on Lipitor, which I have been taking ever since.

"My cholesterol has dropped from the low 200s to about 150. I am carefully monitored for liver and kidney function as well as cholesterol.

I am now 74 and remain very appreciative of my medical team. My cardiologist has said I don't need to see or call him unless I have symptoms. My health is good.

"The tone of your article was that Lipitor should be viewed with extreme suspicion. I disagree with that. Some of what you describe as side effects I ascribe to advancing age. Lipitor has kept me healthy all these years."

RR is the type of person for whom statins are appropriate. He had a heart attack at a young age, and taking atorvastatin reduced his risk of another one. Fortunately, any side effects he experiences do not bother him very much.

Not everyone is so lucky. Some people suffer with debilitating muscle pain or weakness as a reaction to statins. The neurological impact, while much less common, can be even more devastating. Here is one reader's account:

"A year ago, my husband Tom started taking atorvastatin (Lipitor) for high triglycerides. It lowered his triglycerides, but he has begun to forget things like names and numbers.

"He got lost at our son's house in New Jersey, and I was stunned. He traveled for years for work and simply never got lost. I used to joke that he could find dead north blindfolded.

"Even simple math had become a problem. When we found your website describing the problems people had with Lipitor, especially transient global amnesia, we were amazed. He confessed that he had thought he was getting Alzheimer's disease. I was worried about him too, as he had lost his sense of humor.

"After reading about memory problems with statins, Tom stopped the drug. A week later he is back to his old witty self again, quick to laugh and eager to participate in conversations. What a gift!

"Why didn't his doctor warn us about this problem? I think it would be better to risk living with high triglycerides than to lose your joy for life."

In this instance, atorvastatin had been prescribed for a condition (high triglycerides) that could be treated with another approach. Omega-3 fatty acids lower triglycerides effectively without the adverse reactions that statins may cause. A low-carb diet is another way to lower triglycerides.

We get especially concerned when an older woman is prescribed a statin to lower cholesterol that may not need to be lowered. This frequently happens when a women has a very high HDL (good form) cholesterol. Here is an example of just such a situation. Robert writes:

"The women in my wife's family have all lived into their 90s. By the way, she is in her late 70s and is very healthy. My wife's sister has a good HDL cholesterol level of 110. My wife's HDL cholesterol is in the 80s. I understand that is better than average. Her total cholesterol is 230, which makes her doctor nervous. He keeps suggesting a statin prescription, but I have calculated her total cholesterol to HDL ratio as 2.6. I believe that anything under 4.5 is considered very good. Does she really need to lower her cholesterol if her HDL is so high?"

We obvisouly cannot diagnose or recommend a treatment for any individual. We are not doctors. There is little data to suggest that statins will prolong the life of a woman in her 70s who is in good health, especially if she has such a high HDL level and great ratio. 

We are not anti-statin. We are for the appropriate use of any medication, but only after determining that the benefits outweigh the risks.

To learn more about when statins make sense and when the risk may exceed the benefit we suggest our book Best Choices From The People's Pharmacy. In it we offer a variety of non-drug ways to lower the risk of heart disease. Another option is our guide, Cholesterol Control and Heart Health.

Please share your own statin story below. Have statins been beneficial? Did they prevent another heart attack? Did you experience side effects? If so, how did you cope? We'd love to learn your experience.

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22 Comments

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The problem is that what you think may be aging can be a side effect.

I took Zocor (simvastatin) for awhile to lower my cholesterol. I quit taking it because it made my blood sugar go up. As someone with a family history of diabetes, but not heart disease, my physician and I decided this was an acceptable choice.

Three months later my blood sugar was back down to normal where it had always been. But what was really surpising is I no longer had memory lapses. I'm a teacher and I had started having problems finding what to say while I was lecturing and talking to students. I just chalked it up to getting older, but now that I no longer take Zocor, I'm no longer having this problem.

On April4, 2013 I had a slight stroke which affected my left side. While in the hospital I was put on Lipitor. Within a month my hip and leg hurt so bad I could hardly walk across the floor. I stopped taking it and am now much better. I do not plan on trying any other statins. I plan to eat better and exercise. I think it would be better to have high cholesterol than to suffer from severe pain.

My doctor took me off of statin drugs since I was having some serious problems with muscles. I was them put on LIPOFEN which is not a statin. I've not heard too much about Lipofen, but it does seem to be controlling my cholesterol quite well. Would be interested in hearing about Lipofen and better understanding the benefit and also the risk of taking Lipofen versus statins.

Peoples Pharmacy response: Lipofen is a fenofibrate drug. It will lower cholesterol, but we have not seen studies showing that it will prevent heart attacks or prolong life.
http://www.ncbi.nlm.nih.gov/pubmed/22529231

Good Morning! Several months ago I promised to share w/you my latest lab results related to cholesterol and triglycerides. I have, for decades, battled very high numbers. I have tried and tried for years to get these numbers down. I was finally put on statins. This started a whole series of terrible body aches and pains. After trying every statin medication available, I decided to try more natural methods, to see if that helped the situation. My doctor supported me in this decision. I should add that I am a 64-year-old female, in otherwise good health.

After a high total cholesterol of 294, I started taking the following: Nordic Naturals brand of Omega-3 Fish Oil, added flaxmeal to my bread recipe and walked on the treadmill 3x per week.

After 6 months, lab results showed a 51 point reduction in total cholesterol. After the next 6 months, lab results taken May, 2013 showed another 31 point reduction, for a total reduction of 82 points!

I was astounded!! I was told by my physician to 'keep doing what you are doing'! I should add that very high triglycerides have been the norm for me for decades. I am now at a normal reading w/those also. My husband, who has terrible muscle aches from his statin, is already trying my more natural methods.

Best of luck to everyone out there! Every person's system is so unique, so it may take a bit for you to find your 'golden ticket'. Again, best of luck. MJ

I am on Lipitor (generic, of course) and have memory loss, muscle aches and join pain, tiredness....but my cholesterol is astronomically high --I cannot remember exactly what it is (!!Lipitor??) but the one number is 260 (has been as high as 400), but my "good one" is about 45....that is really bad, isn't it? I don't really trust my dr. (I am on Medicaid). He rarely checks my bloodwork (although I am also on Allopurinol, a calcium channel blocker, Prilosec, Ambien---yes, I hate that drug; L-thyroxine, baby aspirin, 600 mg Ibuprofen, and I worry about my liver handling all that.

My blood sugar is also very high at times (never was before) I am now on Nitrofurantoin for a bladder infection and I just can hardly get out of bed...any suggestions, anyone? THANKS

All these Knee-jerk prescribes who push statins regardless of the negative consequences tell us how wonderful these drugs are by citing aggregate statistics about the decline in cloggged arteries and the consequent drop in the plumbing needed to fix such problems. This is foolishness - like comparing apples and oranges. Has anyone ever done any proper clinical trials comparing the good and evil effects of statins? I've never heard of any and I am impressed by the fact that the studies that led to FDA approval were short term and used the early weaker statins, like Pravacol, only, neglecting the more potent versions like Zocor and Crestor.

I work in health care and share the concern these drugs are often prescribed to treat a cholesterol number, not based on the full picture of risks and benefits.

I have a 65 year old patient who is physically active, no cardiac history, watches her diet, weight, etc, whose cardiologist insisted she take a statin for a total cholesterol just above 200 (normal HDL, LDL). He was furious that she questioned whether she needed it, and proceeded to berate her in the office.

I also see many patients in long term care with moderate to severe dementia, in their late 70s, 80s and 90s, with life expectancies less than 3 to 5 years, almost all of whom are on statins, whether or not there is a cardiac history. This is unnecessary exposure to side effects, a waste of health care dollars, and offers no improvement in quality of life or functioning.

By all means use these drugs for people with established heart disease where the benefit is clear. Just stop giving them to everyone to treat a lab test.

The doctor prescribed zocor after I complained about itching because of niaspan. Within a couples weeks I started having pains in my legs, hands, ankles, etc. I quit the zocor and am not taking any cholesterol lowering drugs. I feel good and my cholesterol is just over 200 and other things are normal. The doctor said I should not worry about it as I am not dangerously high in any of the things that people worry about. I am 86.5 years old and good for my age.

Betty A., I am beginning to think so (I had family members who died in their 60s of heart, so I do get scared) but the pain is worse every day.... Anybody know anything about Lipofen? How do you feel, Rick? Thanks to everyone....

I just looked up Lipofen...it is a drug I was on once..."fenofibrate" is the generic....it didn't seem to have side effects, but it didn't lower my cholesterol much....thanks, though

Also (sorry lol) has anyone heard of lipitor causing floaters, blurred vision, or flashing lights, like retinal detachment? I had that about 6 weeks after starting it, and Dr. said "no relation", but I never had that before and it is not going away....I read a few posts about it online...maybe I will ask to switch to Lipofen...

I have two suggestions for you. #1 Start taking some Fish Oil or Krill Oil every day as that has lowered my Cholesterol quite a bit. #2 Find a new Doctor ASAP!!

Supplemental information on why my doctor changed me from LIPITOR to LIPOFEN and how I am doing with it.

I was on Lipitor for approximately 15 years. About 5 to 6 years ago I tore a rotator cuff and went through misery for about a year until I was able to get the full range of motion back. Then a year later I detached a left arm muscle at the shoulder. When the left arm muscle detached I was standing on my front porch and not doing anything physical nor had I been. I just turned around and felt it snap off at the shoulder.

I immediately recognized what happened and it scared me. Went to orthopedics and internal medicine and was taken off of Lipitor immediately, but was told there was not much I could do with the detached muscle. Was it the Lipitor? Great question, but a hard one to determine if that was the root cause of my muscle problem.

I was on 10 mg per day of Lipitor since my cholesterol numbers were always very high. My internal medicine doctor felt it was best to get off off the statins completely. He recommended I go on LIPOFEN, however I decided I would go cold turkey and see what happened to my cholesterol levels. Once I stopped the Lipitor my cholesterol numbers climbed back into the higher range which concerned me - in about 2 to 3 months.

I decided to start taking the LIPOFEN and my numbers are now back to acceptable levels. I am skeptical about all drugs and they concern me but the LIPOFEN seems to be working. I also now eat grapefruit without a problem. I keep questioning what would have happened if I stayed on Lipitor. Was it the Lipitor that was causing my problems or was it my age and maybe other factors?

I am presently 69 and seem to be in rather good health. I don't know the answer and there does not seem to be an answer that can help me put a finger on it. The doctors do not give me an answer that I can accept in my brain. Presently, I see no ill affects from the LIPOFEN, but I'm concerned and watch for any signs that the LIPOFEN might be having on me. So far there is nothing I can say negative about the LIPOFEN. I question why I never was put on this medication before.

I feel great and have not noticed any side effects from LIPOFEN. I would rather not be taking anything. IF I find out anything I will post it.

Rick

With the knowledge of my elderly geriatrist, I abandoned my pravachol last year because statins can increase insulin resistance in certain people and especially at my age of 74. The risk of statins on diabetes may be small but real. I already have several risk factors for Type 2 diabetes beyond my control, like gestational diabetes and the Cytomegalovirus (CMV) virus (causing herpes simplex and shingles), so I do whatever I can to reduce any further risks within my control.

My blood tests last week indicated a rise in my total cholesterol from 183 to 233; I am sure the pravachol held down the numbers, but my HDL/cholesterol and triglycerides/HDL ratios were excellent, including my 66.9 Vitamin D level. High insulin levels are associated with many forms of cancer, and I have a strong family history of cancer. Additionally, diabetes is a strong risk factor for heart disease—much stronger than elevated cholesterol.

My doctor then prescribed Lipitor to bring down the cholesterol, but I refused and said I would work harder to reduce inflammation and also eliminate trans fats and sugars from my diet which are perhaps the real causes of heart disease. Food can replace medicine!

In 1984, a cholesterol level of 240 was considered normal (especially in older women), and the guidelines have been lowered many times since then. The latest revision downward was in 2004 to 200 by a committee of nine doctors, eight of whom were receiving money from statin drug companies, a blatant conflict of interests. In addition, there was no science behind this revision.

"The National Heart, Lung and Blood Institute soon will be updating their recommendations for “healthy” cholesterol numbers by an expert panel of 15 cardiologists appointed by the institute. The guidelines will set the tone for clinical practice in the United States and beyond, and will profoundly influence pharmaceutical markets. They will also reflect the growing debate over cholesterol targets, which have never been directly tested in clinical trials.” Hopefully, there will be no conflicts of interest this time!

According to the American Geriatics Society, "Older people are under represented in clinical trials and respond differently to medications and interventions than younger people" We all need to be our best health advocate, whatever age, to seek the facts/truths we all deserve.

I am reading all the replies here and saving them..thank you. It helps to just know that I am not alone...I have been on these drugs since I was 52 (I am 56) and I fear what the future brings....I have had a broken wrist and two broken toes...I have a strong family history of heart disease and very high blood pressure (along with high cholesterol)..but I do not trust my doctor very well. He is the only one I can see on my Medicaid plan....

What happens if you don't take the statins everyday? I only take a 10 mg. 3x times a week. Do you still get some benefit and less risks?

It happened with me, about 3 year ago. The ophthalmologist denied any relation. However soon after I quit Lipitor my floaters almost disappeared. (A. Reis, Evora, Portugal)

Thank you, A. Reis...I am almost certain they are connected..I can barely see the screen, I have such a huge floater now. I never had one before, never even worse glasses----now I have thick lenses, bifocals (normal, I guess) and my vision blurs up all the time....I cannot prove it, but we all know of cases where US Big Pharma doesn't bother much with trials, and, later, they get charged with a class action suite, where the cost is much lower than the profit they made...

I am beginning to suspect this might happen with statins.....Rick, thanks, I am going to ask my doctor about generic Lopid this week, if I can get in....it sounds worth a try. I wish I could try name brand, but, being on Medicaid, it is against the law for me to purchase any medical care (did anybody know that one?---stinks) Thanks, everyone!! And I would welcome more, I have learned a lot here.

My husband and I both were prescribed statins although I had never had any heart problems. I experienced leg muscle spasms every night and quit taking the statins solving the problem. My husband had a long history of heart disease and continued the statins for many years in spite of muscle problems. He is now in stage 6 Alzheimer's and I will always believe the statins are responsible. I could find no one in his family, mother, father, uncles or aunts, who had Alzheimer's. Alzheimer's is up 68% and something is responsible.

I am a 66 yr. old woman with a history of two TIAs. One in 2001, which with 20/20 hindsight, I blame undetected hypertension and the drug Viox. I have been fine since then until last summer. I had to go off of daily aspirin for some oral surgery. On the fifth day, I had another TIA. At that time the Dr. @ hospital put me on Zocor 20 mg. By October, my shoulder became very painful, for months, tendonitis.

I have treated it myself but it still has not completely gone away. I took myself off of the Zocor. My Primary did not like that I stopped taking the Zocor and I agreed to take 5 mg. of Lipotor. For the past two months I have had pain going down my left leg, cramps to the point of tears at times which I had attributed to sciatic pain. I recently have stopped taking the Lipotor and am waiting for symptoms to ease.

I work in healthcare and am doing all the right things, massage, yoga, vitamins, turmeric, exercise, chiropractic---waiting for symptoms to subside. I am at a crossroad again knowing that when I go back to Dr. in July I will have to have my mind made up. I am open to suggestions. Cholesterol under 200 but tri-glycerides high.

I have been taking Pravastatin for 4 years. I am 58 yo female. I have suffered with muscle spasms and sharp pains in my legs I also have joint pain and swelling in my knees. MRI revealed fluid. My doctor never told me about possible side effects. I have had multiple appointments with arthritis physician and nothing has shown in blood tests or X-rays. I have stopped the medication and I will try natural approaches. Thank you so much for info.

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