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Statins and Exercise

Old 02-04-13, 01:52 PM
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Statins and Exercise

I don't know if anyone has posted a link to this article, if so, I apologize:

http://www.medscape.com/viewarticle/...?src=emailthis

You may need to register to read it.

The gist of it: statins may have a far greater effect than generally known - at least by those in the medical community - on people who perform a fair amount of exercise, compared to people who don't exercise.

Effects on people who exercise a lot are just annoying muscle pains, the usual complaint, but debilitating pain and even rhabdomyolysis (breakdown of muscle tissue, with potentially fatal results).

In fact, after an extremely long ride a few years ago, I experienced rhabdo. My then cardiologist dismissed my contention that my rhabdo could be associated with my ride and my use of a statin. I feel vindicated, although of course I'll never know if there really was an association, because I'm never going to repeat that ride.

I still ride a lot, including a few centuries a year, and so I wonder if my skeletal muscles are being effected adversely in the short or long term, or both, by using a statin, irregardless of whether or not the drug is keeping me from having another heart attack.
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Old 02-04-13, 02:04 PM
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Originally Posted by icyclist View Post
I don't know if anyone has posted a link to this article, if so, I apologize:

http://www.medscape.com/viewarticle/...?src=emailthis

You may need to register to read it.

The gist of it: statins may have a far greater effect than generally known - at least by those in the medical community - on people who perform a fair amount of exercise, compared to people who don't exercise.

Effects on people who exercise a lot are just annoying muscle pains, the usual complaint, but debilitating pain and even rhabdomyolysis (breakdown of muscle tissue, with potentially fatal results).

In fact, after an extremely long ride a few years ago, I experienced rhabdo. My then cardiologist dismissed my contention that my rhabdo could be associated with my ride and my use of a statin. I feel vindicated, although of course I'll never know if there really was an association, because I'm never going to repeat that ride.

I still ride a lot, including a few centuries a year, and so I wonder if my skeletal muscles are being effected adversely in the short or long term, or both, by using a statin, irregardless of whether or not the drug is keeping me from having another heart attack.
If I had already had two heart attacks or was other wise in an extreme risk category, I MIGHT consider taking a statin, apart from that NO WAY!! We have several family friends who have been prescribed statins for nothing more than LDL numbers. We have several family friends who have suffered or are suffering serious side effects from statins.

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Last edited by Don in Austin; 02-04-13 at 02:07 PM. Reason: TYPO
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Old 02-04-13, 02:24 PM
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When the first statin was approved, another biochemist in the lab I was working in asked for some pure product. We had lens cells growing in culture and were curious as to what we might see in light of a clinical trial finding of increased cataracts among the participants taking the statin.

The company went absolutely ballistic. They threatened us with lawsuits if we dared to purify our own product and look into it. The threat was empty, but there's only so much time in the day and we had more important things to do. Suffice to say that their concern over what we might find was and still is a big red flag.
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Old 02-04-13, 03:19 PM
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Been on statins for 14 years now- since the bypass and I have never noticed any muscular pain. Cholesterol build up was my problem and I was lucky in that I survived the problem. Mate of mine wasn't as lucky and like me- Heart problems are in the family. His daughters were checked for Cholesterol levels and they are now on statins that keep the level down to acceptable.

I am now the longest living male on my paternity side-All of them having died before reaching 60 of heart attacks except my Father who had Cancer at 56. No longer have checkups at the cardiac unit and rely on the Doctor to keep me in good condition. Think she has gone over the top now as Besides the usual PSA and cholesterol checks- Wednesday I will be having blood tests for a multitude of things. Sugar levels- Diabetes- and the list of tests went into the 2nd page. Each one will require its own sample and for the British out there- I will feel like Tony Hancock. The blood they take will be nearly an arm full.
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Old 02-04-13, 04:19 PM
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I took statins for 12 years, and finally gave them up 2 years ago after the cramping became so severe I couldn't sleep at night.
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Old 02-05-13, 08:54 AM
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Originally Posted by stapfam View Post
Been on statins for 14 years now- since the bypass and I have never noticed any muscular pain. Cholesterol build up was my problem and I was lucky in that I survived the problem. Mate of mine wasn't as lucky and like me- Heart problems are in the family. His daughters were checked for Cholesterol levels and they are now on statins that keep the level down to acceptable.
You are the perfect candidate for statins Sapfam. Studies show no decrease in mortality except for people who already have evidence of CHD, among whom there is a significant decrease in mortality. The rest of us need to balance the slim potential benefits against the potential negatives. For you the benefits are enough to warrant taking them and seeing whether you experience side effects.
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Old 02-05-13, 09:55 AM
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Originally Posted by stapfam View Post
Been on statins for 14 years now- since the bypass and I have never noticed any muscular pain. Cholesterol build up was my problem and I was lucky in that I survived the problem. Mate of mine wasn't as lucky and like me- Heart problems are in the family. His daughters were checked for Cholesterol levels and they are now on statins that keep the level down to acceptable.

I am now the longest living male on my paternity side-All of them having died before reaching 60 of heart attacks except my Father who had Cancer at 56. No longer have checkups at the cardiac unit and rely on the Doctor to keep me in good condition. Think she has gone over the top now as Besides the usual PSA and cholesterol checks- Wednesday I will be having blood tests for a multitude of things. Sugar levels- Diabetes- and the list of tests went into the 2nd page. Each one will require its own sample and for the British out there- I will feel like Tony Hancock. The blood they take will be nearly an arm full.
Two MI here, first in '08 with two stents, second last August resulting in one re-stenting. Was on no drugs prior, now on a cocktail that includes Simvistatin. I don't have muscle fatigue or cramping. Bruising and hematomas from The plavix are a bigger annoyance, as is the reduction of max HR from the beta blockers.

I would like to reduce the meds through exercise and diet, but my doc's are ruled by a paradigm that assumes bad lifestyle, and treat all accordingly. My cholesterol problems came from a combination of heredity and lifestyle. I would like to try lifestyle changes to get off the drugs, but that is really hard given the easy food choices, and the difficulty I have getting the whole family interested in following better food choices.
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Old 02-05-13, 09:59 AM
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Originally Posted by icyclist View Post
Effects on people who exercise a lot are just annoying muscle pains, the usual complaint, but debilitating pain and even rhabdomyolysis (breakdown of muscle tissue, with potentially fatal results).

In fact, after an extremely long ride a few years ago, I experienced rhabdo. My then cardiologist dismissed my contention that my rhabdo could be associated with my ride and my use of a statin. I feel vindicated, although of course I'll never know if there really was an association, because I'm never going to repeat that ride.
Consider yourself vindicated, sir.

Muscle breaks down under exercise and renews itself - which is why everyone should always have a recovery day after a hard session. This damage is identified by the level of Creatine Kinase enzyme (CK) given out by the damaged muscle fibres and is found in a blood test. Normal levels are between 20 and 150 units per litre - I have a high-ish one of 133 but was told not to bother about it.

When I was first put on a statin, I had to try a few until one would work without side effects. It just so happened that I had started on a new one a week or so before the first ride after the winter break - I knew what to expect after a lay-off but this was vicious, and I certainly could tell that it was out of the ordinary. The Doc was told I wasn't continuing with that one.

A later one seemed to work with no side-effects at the lowest dose, so it got stepped up to see if it would lower my naturally high levels even further. Another blood test to see how I was progressing was scheduled. I'd recently taken up kettle-bells and the test was taken the morning after an evening's hard 1hr KB session. My CK reading of over four times usual, and well on the way to self destruction, invoked a call to my mobile as soon as the results were available to ask me to come in straight away. I explained about the KB session and the panic was over.

That statin got stopped too, strangely enough.
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Old 02-05-13, 02:14 PM
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Originally Posted by CommuteCommando View Post
Two MI here, first in '08 with two stents, second last August resulting in one re-stenting. Was on no drugs prior, now on a cocktail that includes Simvistatin. I don't have muscle fatigue or cramping. Bruising and hematomas from The plavix are a bigger annoyance, as is the reduction of max HR from the beta blockers.

I would like to reduce the meds through exercise and diet, but my doc's are ruled by a paradigm that assumes bad lifestyle, and treat all accordingly. My cholesterol problems came from a combination of heredity and lifestyle. I would like to try lifestyle changes to get off the drugs, but that is really hard given the easy food choices, and the difficulty I have getting the whole family interested in following better food choices.
I had to get off the beta Blockers and quick. They were ruining my riding and had a chat to the doc. First suggestion was to take the BB the night before a ride-Ride with a monitor and keep the HR below my previous Max. Then immediately after the ride to take another BB. 3 Months after the bypass I did a ride following these rules-or nearly. Someone pi**ed me off at the start of a hill and I had to show him who's boss. Saw my max up that hill but i knew the ambulance was at the top so I would have help if necessary. Only result was that it took a long time for the HR to come down. That ride was only a 40 miler- but had a couple of 25%ers in it that made me work.

Then chatting to the doc and he suggested cutting the daily dosage of the BB's by 50% each week- but with a weekly visit to him. 1 month later and I was off the darn things.

I do not suggest you take this action off your own back- consult the doctor first and make him agree that it is possible before he sanctions it.
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Old 02-06-13, 07:57 AM
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Originally Posted by donheff View Post
You are the perfect candidate for statins Sapfam. Studies show no decrease in mortality except for people who already have evidence of CHD, among whom there is a significant decrease in mortality. The rest of us need to balance the slim potential benefits against the potential negatives. For you the benefits are enough to warrant taking them and seeing whether you experience side effects.
I'm not sure what studies you are looking at: I am not aware of any that proved statins do not help somebody who has not already developed heart disease.

Actually, quite the opposite: statins help to prevent the plaque buildups that are the root cause of most heart diseases. But once you have the blockages, statins are less effective at removing them than they would have been in preventing them in the first place.

As for the "slim benefits": anybody who has had a heart attack will be able to attest that the benefits of preventing one are not slim.
and:
for the potential negatives: Yes, like ALL medications there are potential side effects. For statins those are manageable. The primary side effect is muscle weakness and occurs in less than 5% of the users. It can be measured and identified with a simple lab test.

For myself: I have not had a heart attack. But I do have 3 risk factors: Family History, age, and gender... I also have high blood pressure and high cholesterol levels.

I will do what I can to offset those risk factors with diet, exercise and the appropriate medications.

But it's not just to prevent a heart attack: when the circulatory system is working right, other organs (like the brain) tend to work better as well. When those organs work better, other things (like quality of life) also seem to work better s well.
... All the pieces of the system contribute to the whole system working well. But without good circulation everything is compromised.
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Old 02-06-13, 09:22 AM
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+1 @ GeorgeBMac response. I not only have a family history, age, and gender for heart disease risks, but I have to add diabetes to the list.
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Old 02-11-13, 08:29 AM
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I too am entering my 14th year on Lipitor. I have my liver panel done twice a year, and it shows no problems at all. Also I have no muscle problems at all. I retired 5 years ago and exercise more now than when I was working. I feel that I am stronger now than back when I retired, with no pain at all.

It is apparent that statins do not affect me at all, yet my wife cant tolerate them. On statins her liver readings go nuts.
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Old 06-18-16, 07:49 PM
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Sorry to revive an old thread. My story with statins: I was put on low-dose simvastatin back in January. My doctor prescribed it because I'm a well-controlled Type II diabetic (oral meds only), and my LDL was "borderline" (he said he wouldn't bother with a statin if I wasn't diabetic). He had been pressuring me for a couple of years to try a statin but I resisted but finally caved last winter. He requested blood tests at three months to check progress and for any potential signs of problems. Two days before the blood tests, I did my first ride of the season, a short 30 km ride which is my typical training circuit and first ride of the season, with one climb. At the 20 km mark I developed intolerable muscle cramps. I managed to slowly limp back to my car. At home that evening, I was crippled with muscle pain. My wife, who is herself a family doctor, was concerned. The blood tests two days later showed mildly elevated CK, but the pain was excruciating. I couldn't even navigate the stairs at home.

I stopped the statin immediately, and two days later did my second ride. No cramping, but just normal start of season soreness and start of season stiffness at home later (I don't ride a trainer in winter; my cross-training is snowshoeing and hiking in the mountains, about 5-6 hours a week, and walking). The problem is that after 1600 km in the season I still have "start of season" soreness. My performance on average seems only slightly less than normal, but a couple of key points: my endurance is about 20-30% less, I have muscle soreness throughout the ride (last year only in the first 5 to 10 km and near the end), and I can no longer keep up with my wife. In the past she was quicker than me out of the gate, but by mid-ride I was doing long pulls with her drafting me on windy segments, and by the end of the ride I'd have a second wind and leave her in my dust. Today we rode 75 km together and I felt nearly dead at the end of the ride, worse than after the last century I rode 2 years ago, and I couldn't keep up with her the entire ride; she had to stop or circle to wait for me. I had a treadmill ECG last month up to 10 METS that was perfectly normal.

Yesterday I had another series of blood tests, and my CK was still above normal by about the same level as in March. Two years ago on a 92.5 km ride with 1000 meters vertical my CK was normal two days after the ride. My longest ride this season has been 100 km so far, normally a piece-of-cake distance for me but muscle pain was with me the whole ride.

My wife has concluded that I should never ever take statins again. I am very concerned that I may have permanent damage now. Apparently this can happen to a small percentage of those who use statins.

I have read some reports that statins are not well tolerated by people who are athletes or exercise vigorously or at least the reported incidence of issues in this subgroup is much higher than in the general population. My doctor admitted that most of the data saying statins are safe are metadata and not broken out into subgroups such as pro/amateur athletes.

It will take a lot of convincing to ever get me on a statin again. My doctor wanted to switch me to another statin but I asked that we wait until nearer the end of the cycling season. That was before I realized I was having some lingering effects, and now I will refuse to go on another one.
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Old 06-18-16, 08:16 PM
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My doctor put me on statins about six months ago due to age, gender, family history and high cholesterol level (not real high, 206) and so far I have not noticed any side effects.

Cycling seems normal to me with the same ability to climb, same speed, same endurance and no more pain that is usual. I have been off the bike for five weeks with a broken clavicle, but I was fine before the crash (crash probably not caused by statins!) and expect to be fine once I'm trained up after this unwanted hiatus.

Will advise if I find this is not the case!

Rick / OCRR

PS: I resisted for awhile too but my doctor insisted that the reduction of risk for heart attack made taking statins the right decision.
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Old 06-18-16, 08:16 PM
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My cardiologist put me on Zetia when I was leery about statin side effects. They have me taking one red yeast rice pill with one Zetia (ezetimibe) daily. Down side is that Merck wants ten bucks per Zetia pill. Enter Canadrugs.com, who sells a generic ezetimibe for a dollar a pill. So that's what I'm taking now. Not seeing any side effects.
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Old 06-19-16, 06:26 PM
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What statins do is poison your liver so that you produce less cholesterol, thus less will be in your blood. The theory is, if you have less in your blood, less may be deposited in your arteries. It does nothing to treat the causes of the build-up.
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Old 06-19-16, 07:02 PM
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@beechnut
Its a well known fact that statins cause muscle pain and cramps. If your doc insists tell him/her to try a different brand to see if the pain/cramps go away.
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Old 06-20-16, 05:15 AM
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This is why I refuse to take statins when pressured by my doctor. The troubles that can develop are not worth the the chances of muscle damage. My numbers bump near the "borderline" and have not shown significant increase in the last 16 years. If I have a heart attack and family history of bypasses, I may have considered differently.
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Old 06-20-16, 07:36 AM
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Lots of arm-chair cardiologists and exercise physiologists on this thread.
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Old 06-21-16, 05:38 PM
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Originally Posted by TimothyH View Post
Lots of arm-chair cardiologists and exercise physiologists on this thread.
Fortunately my wife is a physician. She says a small subset of patients can't tolerate statins, and this is particularly true if vigorous exercise is involved. She has one or two patients who have suffered permanent muscle issues even after discontinuing a statin.

Every medication is a risk/reward assessment. In my case the risk is too high, unless I plan to discontinue cycling. As I'm type II diabetic, vigorous exercise is an important part of my wellness plan.

The statin also had the effect of bumping up my A1c and blood sugar levels, so it was working against me by making it harder to control my diabetes. My doc and I ran my numbers through a cardiovascular risk assessment calculator; the use of vigorous exercise, a Mediterranean diet, and a moderate-dose statin, each alone reduced CV risk by 15% in my age and risk-factor group. Since I do the exercise, and follow a Mediterranean diet for the most part with only occasional red meat, he figured that I could safely avoid the statin as those two each individually reduce CV risk by the same amount as a statin.
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Old 07-13-16, 09:47 PM
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This thread saved me. Found this about a week and half back

I started taking a Statin about 7 weeks ago. 2 weeks later I started having back problem. Suffered for a couple of weeks saw the doc and mentioned what read here. He doubted me and didn't want to do blood work.

Saw another doc a week later and explained it again. This time I was taken seriously. Blood work done and my CK levels came back at 300+ in that short time.

So I'm one of those folks who can't have'em. Off them now and hoping my levels drop.
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Old 07-14-16, 12:24 AM
  #22  
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Originally Posted by TripletakeTTT View Post
This thread saved me. Found this about a week and half back

I started taking a Statin about 7 weeks ago. 2 weeks later I started having back problem. Suffered for a couple of weeks saw the doc and mentioned what read here. He doubted me and didn't want to do blood work.

Saw another doc a week later and explained it again. This time I was taken seriously. Blood work done and my CK levels came back at 300+ in that short time.

So I'm one of those folks who can't have'em. Off them now and hoping my levels drop.
I'm glad I started this thread!
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Old 07-14-16, 05:15 AM
  #23  
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Originally Posted by TripletakeTTT View Post
This thread saved me. Found this about a week and half back

I started taking a Statin about 7 weeks ago. 2 weeks later I started having back problem. Suffered for a couple of weeks saw the doc and mentioned what read here. He doubted me and didn't want to do blood work.

Saw another doc a week later and explained it again. This time I was taken seriously. Blood work done and my CK levels came back at 300+ in that short time.

So I'm one of those folks who can't have'em. Off them now and hoping my levels drop.
It is very common for doctors to discount reports of problems from statins. The actual frequency of adverse reactions is probably higher than reported since they often develop slowly, are easily dismissed as "gettin older" and the like, and the docs have been conditioned to insist that statins are critically important because they so clearly reduce cholesterol. The fact that statins effect very modest health benefits seems to get lost.
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Old 07-14-16, 05:54 AM
  #24  
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Originally Posted by beechnutC23 View Post
She has one or two patients who have suffered permanent muscle issues even after discontinuing a statin.
I was on statins (I tried most of the ones available at the time) for about a year and a half before finally telling my doc to go to hell. After even a moderate ride, I would take a week or more to recover, and so the more I rode, the more conditioning I lost. I lost so much muscle strength and conditioning that I had to rest halfway up a single flight of stairs, and I never fully recovered that strength after I quit. What really bothered me, then and now, is that the HEART IS ALSO A MUSCLE.
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Old 07-14-16, 09:47 AM
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I'm curious.

All I've read about statins indicates that the side effects, for the most part, are a function of the drug itself (some have more side effects than others) and dosage. Those of you having bad side effects ... what were you taking, and was your dosage?
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