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.