BlazingPedals

I never took more than 10mg per day, and by the time I quit them and fired my doc, I was cutting the pills in half (5mg) and taking it every third day.

sch

There is a concept in medicine called Number Needed to Treat (or NNT), which denotes an estimate of the number of patients taking the medication
versus the desired outcome. For statins this works out to how many AMI or CVA per 100 people taking the med for a given length of time. There is
a website (natch) for this: theNNT

Here are the figures for those without preexisting disease: Statins for Heart Disease Prevention (Without Prior Heart Disease) | theNNT
Here are the figures for those with known CV disease: Statins for Heart Disease Prevention (With Known Heart Disease) | theNNT

It gets a little shaky for no pre-existing disease and no risk factors (ie HTN, DM, family history, peripheral arterial dz).

Another opinion from one of the better review sites in medicine: https://www.sciencebasedmedicine.org...chrane-review/

Generally speaking, the benefit of statins is probably not related to what they do for cholesterol levels, but something else.

beechnutC23

No way. Because of this:

I've been the same. Just 3 months on statins and *only* 10 mg and I still haven't fully recovered from that episode. Where in the past my wife and I would give each other a run for our money on rides, on exactly the same rides, compared to last year, I can no longer keep up with her. In the past, she'd be tough to follow for the 1st 3d of the ride; then we'd play cat-and-mouse on the 2nd 3d, then on the last 3d, I'd pull her home. Now the only way I can keep up is to draft her.

There is NO WAY I will ever go back on that toxin. Even 3 months after quitting them my CK was still over 300. I am not prepared to take the risk of trying another one only to have it cause even more muscle damage. When I was on statins, an easy 30 km ride that I do multiple times a season (my regular training route in fact) resulted in excruciating leg cramps at 20 km; I had to limp back to my car, and 2 days later when I went in for blood work my CK was over 300.
That evening, I could barely go up the stairs in my home without terrible pain.

That was enough for me.

skye

Statins are the worst BS foisted on an unsuspecting public in the checkered history of mainstream medicine.

OldsCOOL

I echo the same.

chinarider

Some of you may remember me, from about 4-6 years ago when I posted pretty frequently. I was also in good shape back then-- routinely riding 30-60 miles, sometimes more. Fast forward a few years of decreasing riding until barely doing any for a couple of years and eating lousy and putting on weight. Well, about a year ago I wound up with a quad bypass. After initial recovery, I've been exercising a lot and following a pretty strict diet. Dropped about 20-25 lbs in last year.

Also got put on metoprolol (beta blocker for blood pressure) and crestor (40 mg daily). I had trepidation about taking these as I read about the possible side effects, but given where I had gotten myself, I really wasn't in a position to argue. I can't really say I've suffered any effects. Out door cycling has about a 5 month season here, so I'm early in the process, but definitely rounding into better riding shape. I get some aches and pains after a hard effort, but nothing abnormal. Did 30 miles today and it felt good. Slower than I used to be, but also 5 years older (64). Hopeful this will come around with more miles. And my lipid numbers have been very good. Whether this is due to lifestyle changes, the meds or a combination of both is hard to know. Having dodged the bullet once, I'm not going to take chances, at least not without noticeable side effects. YMMV.

OldsCOOL

Good to see you posting again. I recall your location and avatar/pic. I hope your recovery is a speedy one. Keep at it!

nmichell

Statins save lives, and there is a mountain of evidence to support that claim. That said, if we could get everyone to follow a good diet and exercise regularly, then statins would only be needed for folks that had the bad luck to roll snake-eyes in the genetic lottery.

One point on dosage -- the dose/response is not linear ie doubling the dose does not double the effectiveness, not even close. So the first suggestion to your doc if you have muscle pain is "Let's cut the dose in half", and if that doesn't work, cut it in half again.

canklecat

There are also some disagreements among researchers about the validity of the evidence from those earlier studies.

And some skepticism of the skepticism.

My mom takes them because her doctor will have a hissy fit if her levels rise even a single point above the designated maximum. I won't persuade my mom to stop taking statins because her older half-brother suffered multiple heart problems and strokes associated with plaque. So I'll acknowledge the consequences of not taking statins may be greater than the risks associated with statins, particularly with cognitive functions. But my mom has already struggled with vascular dementia and there's no way of knowing for certain what causes it, beyond the multiple TIAs, although her specialists don't know what's causing the TIAs.

Personally I won't take them. My cholesterol has been normal. I eat and drink what I want and what I like moderately, exercise and keep my weight down. I'm within 5 lbs of my peak condition weight when I was in my 20s. Even if my cholesterol was high I probably wouldn't take statins. I'm not interested in prolonging life with cognitive impairments. And it seems preposterous to hear doctors insist on patients taking statins on the one hand, and then insisting patients supplement their diets with fish oil and omega-3 to offset the damage caused by the statins. The entire issue needs new research to ensure its free of bias and to pressure doctors to fully inform patients of the potential risks.

billd76

I've been talking them for over six years, 20mg dose of pravastatin. Zieta and Zocor drove the CK levels up, I had not experienced any side effects. I only take one every three days, supposed to take one a day. My wife doesn't like me taking them at all. I'm "on the fence" with it all. heredity is why I'm taking them. I found out I had high Cholesterol when I was 43, at that time I was running 40 -50 miles a week!! My total Cholesterol then as about 450. Now taking statin every third day hovering around 200. I know there have been studies that suggest the 300 should be the normal and that the body needs cholesterol to function properly. for the moment, I think I'll keep taking it every day. I told my doc about my training for an ultra and ask is I should worry about the effects of the statin. She said that a 20 mg dose should not affect me in any way. It's hard to say what's right or wrong. Will it help me live to be over 100, heck who knows. I think we Americans are too infatuated with trying to live forever, truth is we just won't.

OldsCOOL

There....it.....is.

My doc is freaked because my total hit 204. That is my norm and has been for 30 years. I refuse to take them.

gettingold

I have not had any problems with statins. Two MI's and two stents, it clearly wasn't working without them. I eat well, exercise regularly, have low b/p and am not overweight. As my doc said, some people just can't process cholesteral. My father was the same way; he was dead by 56.

wnl256

I have found this thread intensely interesting and very relevant for me. My doc put me on lipitor last year after my heart attack. I was in no position to disagree. Even though my cholesterol was never measured above 200 and I exercised regularly, I still had a 100% blockage that led to cardiac arrest. Frightening! So now I take this horse pill every day, and I still ride regularly. The medicine and a huge change in my diet cut the cholesterol down to 109. Of course I don't know how much of that can be attributed to the medicine. Fortunately I have not experienced any of the unpleasant side effects that others here have mentioned. Not yet anyway. I've always cramped easily, so I try to stay well hydrated and take lots of electrolytes on longer rides. A week ago I did a metric and had no cramping problems during the entire ride, even though it was a pretty hot day.

It's always good to hear about people who take command of their own health: who push back on the doctors when the recommendations seem out of proportion with the symptoms. But I have more than my doctor to deal with: my wife would completely freak if I told her "I'm not taking the statins anymore".

Thanks for the interesting stuff!

metalheart44

I had my first heart attack in 2005. My total chlosterol at the time was 180, but a less than desirable ldl/hdl ratio. Subsequent blood tests showed I have a particularly sticky kind of chlosterol. I was prescribed a statin and a cocktail of other meds. I had a second heart attack in 2010 and my total chlosterol at the time was in the neighborhood of 110 with a more desirable ldl/hdl ratio. Four stents later statins were not something I rejected.

I started cycling in 2010. Prior to that I was a regular at the gym, using the treadmill, swimming, and weights. While beta blockers have had some consequences for my cycling --- I have worked with my doc on dose and timing to minimize those consequences --- I have never had any adverse effects from statins and I take the maximum dose of lipitor and my total chlosterol ranges from 90-110. On the other hand, I cycle with friends with chlosterol in the range of 250-300 who do not take their prescribed meds because of muscle aches.

My family practice doc and cardiologist are well aware of the potential side effects of statins and have asked me over the years about my dose and its effects. However, with a strong family history of heart disease (my dad died at 52 from a MI) I never considered not taking the meds.

My wife has chlosterol in the 250-300 range. We both eat a reasonable Mediterranean style diet. She has no family history of heart disease and no other risk factors for heart disease other than her chlosterol numbers. Her family practice doc suggested taking a statin after multiple efforts to refine diet and exercise did little to lower her numbers. She was, for a variety of reasons, reluctant to take a statin so her doc suggested a calcium scan (~$400 out of pocket) and then a follow-up discussion. Fortunately, her calcium scan score was zero and her doc agreed that without other risk factors and a calcium scan score of zero, statins were not indicated.

Some folks have adverse reactions to one type statin but can tolerate another. And, then there are those of us who take higher doses and have no effects on exercise. I current ride 150-200 miles a week, do a reasonable amount of climbing, and can easily do 50-60 mile regular rides.

ltxi

I've been on statins for 30 years, since the first...Mevacor...was new. I was at 295. My problem is genetic, have a family history of heart attacks, and rigorous diet and exercise was of no help. Successfully been on 40mg of Lipitor now for at least 15 years with no discernible side effects and I consider it a probable lifesaver. Tried 80mg once at my doctor's suggestion (Lipitor dosage ascends 10-20-40-80) and that did wipe me out, so I do have a limit. I also know some folk who unfortunately can't tolerate any statin in any meaningful dosage.

And an aside....this got me into the habit of regular, now every three months, doctor visits which has led to early diagnoses of other incipient, mostly age related issues and their before it becomes a problem control. As a consequence, at 73 I'm healthy and fit and my remaining life expectancy is longer than I prolly want it to be.

Gresp15C

The CK test, is it routinely given to people who take statins, or do you have to specifically ask for it?

Camilo

I think there is some literature that says statin doses should be based on risk factors, not blood lipid levels.

Regardless, I've been on Crestor 5 mg/day for several years and have no side effects other than I'm getting older and slower, and have a benign tachycardia issue that reduces my enjoyment of "racing" (still enjoy vigorous rides and other exercise). The tachycardia - I believe, as does my PCP - is not related to the statin. Nor is the age-related decreasing endurance/speed/strength. I'm in great shape for a man my age!

skye

I weekly see patients who are suffering from what I've come to call "statin poisoning." I've been following the research on statins for a decade, and their benefits are by no means certain, or even proven to the degree that I would be comfortable prescribing them. In fact, the more recent studies have called into question the entire cholesterol hypothesis.

Ball Bearing

Wow! It's so encouraging to see a doctor that does not toe the party line. I know of several guys that were on statins for years and still had heart attacks.

donheff

+1. I was pushed onto statins for many years but quit hem when my wife had muscle pains and I read up on them. I lost a fair amount of weight and got my HDL and triglycerides in good shape but LDL is still high enough that I would fall under the most recent guidelines for statin use at my advanced (68) age - of course everybody does eventually. My doctor echoes this doc and agrees with me that the benefits are marginal and may not even be related to the reductions in cholesterol they induce.

OldsCOOL

You are paddling up a class 4 river with an opinion suggesting the studies may be wrong. I know the feeling. Keep up the good work. The only way I can call off the med pro's is to tell them that in regards to my blood labs the numbers dont lie. Gradually, I was able to convince my doc that I am not in his study groups.

chinarider

Does your opinion extend to those who would be considered high risk patients? Any studies quantifying the extent of what you call "statin poisoning"? What studies do you refer to?

Kind of a meaningless statement. I know of several guys who have smoked for decades without apparent effect. Does that mean smoking is healthy? Anecdotal evidence such as "I see" or "I know of several" doesn't prove a thing. I realize quality of studies differ and that inconsistent results are shown, but that calls for better studies, not for ignoring them.

icyclist 

I think the best evidence shows that statins help keep people from having heart attacks if they already have heart disease. Although a lot of people need to be on a statin to help just one person from having a heart attack, that's a lot of people who could benefit from the drug - many millions in the U.S. alone - given the total number of people who have heart disease.

Isn't taking a statin like wearing a seatbelt? You might never need it, but like keeping tires inflated, the brakes adjusted, etc., taking a statin a day offers added protection, along with not smoking, eating healthy foods and exercising.

They're not for everyone, though. And everyone should be able to decide for themselves if the potential side effects are worth the potential benefit of not having a heart attack. Of course, it might be illogical not to take a statin, but humans aren't always logical.

Because I had rhabdomyolysis after a long bike ride, and experienced muscle pain in my shoulders, I eventually decided not to swallow a statin. My heart attack was more than eight and a half years ago. So far, I'm winning the bet that I don't need a statin. But that's just me.

Carbonfiberboy 

AFAIK there are no long-term studies specifically of aging endurance athletes and their statistics w/r to statins and CHD.

For sure, statins hurt performance and muscle strength. Google "statins muscle damage." I think it might be possible for an endurance athlete to have more heart problems taking a statin than not, due to the lack of ability to stress the aerobic and anaerobic systems sufficiently to cause adaptive changes in arterial walls and to improve blood markers through hard exercise.

I'm 71 and have very good blood markers, yet the current recommendation is that I should be taking a statin, just because of my age. My doctor and I agree that would be a bad idea.

Seat belts have no negative consequences. I think that's a very bad analogy.

Ball Bearing

You might find this interesting...

"
Statins stimulate atherosclerosis and heart failure:
pharmacological mechanisms
Harumi Okuyama, Peter H Langsjoen, Tomohito Hamazaki, Yoichi Ogushi,
Rokuro Hama, Tetsuyuki Kobayashi & Hajime Uchino

In contrast to the current belief that cholesterol reduction with statins decreases
atherosclerosis, we present a perspective that statins may be causative in coronary artery
calcification and can function as mitochondrial toxins that impair muscle function in the heart
and blood vessels through the depletion of coenzyme Q
10
and
‘
heme A
’
, and thereby ATP
generation. Statins inhibit the synthesis of vitamin K
2
, the cofactor for matrix Gla-protein
activation, which in turn protects arteries from calcification. Statins inhibit the biosynthesis of
selenium containing proteins, one of which is glutathione peroxidase serving to suppress
peroxidative stress. An impairment of selenoprotein biosynthesis may be a factor in congestive
heart failure, reminiscent of the dilated cardiomyopathies seen with selenium deficiency.
Thus, the epidemic of heart failure and atherosclerosis that plagues the modern world may
paradoxically be aggravated by the pervasive use of statin drugs. We propose that current
statin treatment guidelines be critically reevaluated..."


Expert Review of Clinical Pharmacology

Volume 8, Issue 2, 2015



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