Statins impair exercise
 

This recent study shows that those who take a statin have a reduced capacity for exercise. It can be found at http://psychiatryneurology.net/foren...g-adaptations/.

Abstract
OBJECTIVES:
This study sought to determine if simvastatin impairs exercise training adaptations.

BACKGROUND:
Statins are commonly prescribed in combination with therapeutic lifestyle changes, including exercise, to reduce cardiovascular disease risk in patients with metabolic syndrome. Statin use has been linked to skeletal muscle myopathy and impaired mitochondrial function, but it is unclear whether statin use alters adaptations to exercise training.

METHODS:
This study examined the effects of simvastatin on changes in cardiorespiratory fitness and skeletal muscle mitochondrial content in response to aerobic exercise training. Sedentary overweight or obese adults with at least 2 metabolic syndrome risk factors (defined according to National Cholesterol Education Panel Adult Treatment Panel III criteria) were randomized to 12 weeks of aerobic exercise training or to exercise in combination with simvastatin (40 mg/day). The primary outcomes were cardiorespiratory fitness and skeletal muscle (vastus lateralis) mitochondrial content (citrate synthase enzyme activity).

For myself, I had cycled over 4,000 in a year (100 miles a week) but still felt weak and tired and could not lose weight.

As soon as I started taking COQ10 (which counteracts statin's adverse affect on ATP) I felt like a turbocharger had kicked off in my legs. My strength and energy levels improved drastically. My average heart rate jumped nearly 10% as did my average speed -- but despite the increased intensity I no longer felt fatigued for the rest of the day after a ride. And, I started losing weight!

But the cardiologists tell you the "myopathy" from statins is rare: That's probably because of the way they measure it. If you set the threshold high enough, (or measure muscle pain instead of weakness) it will be rare...

Personally, I've read more bad than good about statins. I don't ever plan to take them.

There are multiple different types of statins. They do not all have the same effects.

Hmmm
I take a low dose 10mg lipitor every other day.
Yes it makes me "feel funny" and my quads seem sore.
Trying the Q10- 100MG/D don't really notice any difference.
Now I have seen the claims that a form of Q-10 that has only been around for 1.5 years is "absorbed better"
but the claims for Q-10 predate this new version by 20 years
So the new version Q-10 sellers are either lying-or all the old Q-10 info is essentially fake
Best guess is the claims for the new version-exaggerated
I'm continuing on the Q-10 but no improvement

I took them for 12 years, and by the time I quit them, I was cramping up so badly I couldn't sleep at night. If you have artherosclerosis, then statins make sense, but I think they're way, way overprescribed, and the drug companies don't like to talk about how many people have serious problems with them.

+1, Let food be thy medicine.

I take 100mg/day CoQ10, no statins. Seems good for old folks like me, too. I understand that statin folks take 200mg/day. I'd like to hear more from people who have experimented with CoQ10 dosages. I doubt that 10mg/day would do much.

When I asked my cardiologist he said: "Go ahead, try them. Some people say they help. But if you take them, take at least 200mg a day."

So, I tried 200mg and they made a very BIG difference for me. The effect was dramatic. But I found the effects wearing off -- so now I am taking 200mg capsule twice a day and that seems to be about right and I try to take it with food. I could probably tweak it some more -- but right now its working ...

Well, you could say the same for most any medication. Every single one them has side affects. You take the medication when the benefits out weigh the side affects...

When I was working in mental health I cared for a lot of patients with severe cases of schizophrenia. But, as bad as that disease is, the side affects of the meds to treat it were almost as bad. So, we had a lot of patients who would not take their meds because they preferred the disease to meds...

For statins: They can help keep your arteries from clogging up which can help prevent things like heart attacks and stroke and other nasty diseases. It is a personal decision whether the good of possibly preventing a heart attack outweigh the bad...

For myself: I have high cholesterol, High Blood pressure, I have a strong family history of heart disease, I'm a guy and I'm over 60 -- and every one of those things increases my odds of having a heart attack, stroke, dementia, etc...
... I choose to take the statin and try to manage the side affects as best I can.

Let me encourage you to do some homework on statins. They will drop your cholesterol, but they do not have _any_ effect on morbidity/mortality rates until after you've already had a heart attack, and even then it's not a big effect. If you have high cholesterol numbers, then find out why they're high. I'll bet it has nothing to do with the amount of fat in your diet and everything to do with the amount of refined carbs, specifically wheat/grains. Are your triglycerides high? That's a carbohydrate problem. How about your LDL? Get them to actually do the particle size test. If you're loaded up on small particles, then that is refined carbs causing that as well. How about blood sugar? Do you have any diabetes issues? Controlling blood sugar/insulin is a _big_ deal.

The big fat no-no is hydrogenated oils and trans fats. The second is vegetable/corn oil. If you stay away from both of those, then you may have some fixes that aren't as difficult as you might think.

You would be hard pressed to find a cardiologist in America who would agree with you that statins have little or no affect on mortality and morbidity -- unless you limit the population to those who have no risk factors.

Numerous studies (and I have not kept track of them) have shown that as LDL increases, the chances of a heart attack increase as well. They also show a benefit from lowering elevated LDL for those with risk factors - but not a guarantee. The main risk factors are:
-- DM2
-- Obesity and/or waist circumference over 40" (in men)
-- High blood pressure
-- Unfavorable lipid profile
-- Family History of premature heart disease
-- Smoking
-- Age 55 in men or 65 in women

The controversy comes into the medical picture when it is pointed out that half of all people who have heart attacks have "normal" cholesterol levels. There are a couple theories running to explain that:
-- The Esselstyn's claim the 'normal' value (200 total) is too high. That people with a total cholesterol below 150 do not have heart attacks.
-- Others claim that an unfavorable cholesterol profile is only part of the story -- that there are other things that also contribute to heart disease. The leading contender for the runner up right now is inflammation as measured by HS-CRP. And some even claim that the main benefit of statins is not lowering LDL but lowering inflammation. (Another recent addition to the list is TMAO.)

But, the medical consensus is clear: a poor cholesterol profile (elevated LDL and/or low HDL) contributes to heart disease and statins decrease the LDL.

That doesn't mean that statins are the only way to do that. In fact, every recommendation starts with life style changes and, if they are insufficient, then taking a statin will decrease your elevated chances of having a vascular related event.

For myself: I have seen the results of clogged arteries and I will do whatever can to limit that happening in my arteries. LDL cholesterol is one of the main ingredients in the recipe that clogs the arteries -- and statins are one way of reducing LDL.

That is true.. and why I try to take as little medication as possible. I've been on meds for various issues in the past and decide that the side effects are worse than the issue itself in many cases.

I haven't read a single thing that convinces me that artificially lowering cholesterol has any impact on incidence of heart disease. I do believe that high cholesterol is a potential indicator for heart disease, because it's the body's way of trying to heal itself. Statins don't do anything to fix the underlying problem that contributed to the high cholesterol to begin with.. so it's kind of like stopping the bleeding from a gun shot wound but leaving the bullet in (which is admittedly probably a flawed analogy in some way).

Now naturally lowering cholesterol with diet and exercise is a completely different story, one which I believe can be highly effective.

I wish you the best of health. I trust that you're making the decisions that are best for you. Although you may want to research statins and memory loss if you're concerned about dementia.. and keep a look out for the signs.

Death also impairs exercise.

Actually, I agree with all that you say except: "I haven't read a single thing that convinces me that artificially lowering cholesterol has any impact on incidence of heart disease." I suspect you are not reading medical literature and the studies that back it up. I have found them to be quite convincing.

But, I especially agree that statins do nothing to treat the causes of that disease. Only diet and exercise can do that.

Caldwell Esselstyn however makes a good argument that the diet that most physicians recommend is not sufficient to control or reverse heart disease... It may help -- but not enough -- because it is usually just a minor reduction in the things that caused the disease in the first place. So, once again, people resort to pills to treat the symptoms of their disease.

He proposes a far more stingent dietary approach than most people want to deal with or think is safe.

I shouldn't have said "any impact". The studies do support some efficacy.. just not a big enough difference in outcomes to convince me to take something that I have strong doubts about the safety.


That is true.. dietary changes need to be fairly stringent to make a significant difference. I suspect we'll disagree on what dietary changes are needed, so I won't comment on that.

GeorgeBMac: Here's where I'm coming from. I'm not trying to come from a dogma position, just one that relates to what I've researched. I'm not a doctor or anything of the sort. I'm not making any recommendations except to do your homework. I really feel that 'Big Pharma' doesn't particularly care about anything but selling drugs/surgeries. Having said that, I'm a benefactor of some of these. There are some good things and some bad. It's important to figure out which you need and which you should push away.

A couple good reads:

http://www.forbes.com/sites/matthewh...diabetes-risk/

http://www.ncbi.nlm.nih.gov/pubmed/20585067

http://www.google.com/url?sa=t&rct=j...53899372,d.cGE

As far as Caldwell Esselstyn, the Forks Over Knives guy, goes, I think he's done some really good work. Ultimately, I think his success comes from getting rid of most processed food. I'm not convinced that his rejection of all animal foods is necessary or even advantageous (obviously). However, for me, the arguments against his diet theory is similar to any other vegan. A lot of my diet runs completely hand-in-hand with what a vegan eats. It includes meat, but ultimately is plant based and includes all sorts of green/colorful veggies.

Over-simplification impairs discussion.

Ah come on... LIsten to big pharma talk about the benefits of their drugs. Superman, Spiderman, BatMan and all the other 'mans combined couldn't come even close to matching the magical powers of their drugs... :)
... But I agree with with you: their actual ability to promote health is rather modest...

And, as for an effective diet to prevent and reverse heart disease? EVERYBODY disagrees on that! The nutrition experts fight so much they even make congress look good.

Good stuff, GBM!

The diet question really is a head scratcher. You're right, no one agrees. I think it's one of those things where you need to take it into your own hands a bit. Get the needed tests done, log your diet, test again. Run your own experiments and see what works for you. It's the only way you'll ever know.

Good points. Check this out: http://www.zetia.com/ezetimibe/zetia/consumer/index.jsp Here they are pushing a drug just for the sake of cholesterol numbers, while forced to admit that it is worthless for preventing heart problems! " ZETIA has not been shown to prevent heart disease or heart attacks." There are some authorities who believe that statins have an anti-inflamatory effect that may be of some benefit in reducing heart problems -- mostly in those who have already suffered a heart attack. I don't think reducing cholesterol numbers through drugs is well-advised for most. It is claimed that serious side effects from statins are rare. I seem to know an awful lot of people who have suffered this "rare" affliction. My LDL is high according to current standards. The current LDL guidelines are a result of big pharma approaching the American Heart Association to get the limit lowered. The AHA is essentially a lobbying front for big pharma if you care to look at where its funding comes from. I really don't give a rat's ass that my LDL levels are above current guidelines. Since I have taken up cycling hard over 100 miles/week and stopped drinking Cokes and eating trans fats, etc., my HDL is super high, triglycerides very low and HbA1c is very low.

Don in Austin

Chaco and Don, Good stuff and exactly what I was alluding to.

Don
Zetia isn't a statin.
You didn't say it was-but you mention statins in the sentences following the negative Zetia info.
The study indicated that a timed release Niacin-much cheaper- worked MUCH better
It didn't EXACTLY show that Zetia didn't work at all-
To do that it would need to be paired with a placebo-but it did seem to show it "wasn't great" and maybe was worthless.
My suspicion is Zetia got a foothold because of so many folks having side effects from statins-
doc will say "well take a lower dose of the statin-and I'll add ZETIA"
You I would be willing to bet that it was originally pushed-by drug reps-as a lower side effect anti cholesterol medication.
Niacin works-and should be dirt cheap-even time released it should be dirt cheap-does have some problems of course
itching+ the liver problems-significant-but you can certainly lower the dose-should be able to find a safe dose of niacin.

I started on lipitor after my wife's MI-trying to figure which drug causing fatigue-she takes 10 or so-it certainly makes me feel "odd" in the morning after taking a small-10mg-dose in the evening-but the studies on it-are convincing-and I'm old 62-HBP-35 lbs overweight-certainly no free lunch-
might give immediate release niacin a try-lowish dose-
My memory is that the timed release niacin caused liver damage

Right. Do some research before taking Niacin. And especially do some if you are planning to take it with statins.

Niacin and statins can both be effective, but they work very differently:
Niacin raises HDL -- which cleans LDL from the arteries
Statins lower LDL -- which reduces LDL in the arteries

It has been long known in the medical field that niacins CAN save lives -- but their unpleasant side affects make them a difficult medicine to take.

But, a recent trial demonstrated that niacins combined with statins do not save lives any more than a statin by itself. My theory is that cleaning an already clean house doesn't make it any cleaner.

An alternative to taking niacin is to cycle more: both will elevate your HDL.

GeorgeB
Thanks
Do you have a location or name for that statin& niacin trial?
It is tough to evaluate ANY medicine from a single smallish short duration trial
especially something that modifies heart disease-a disease with a long "lag time"

Niacin+ statins "should" work-plausible that they would be synergistic-but that doesn't mean they will of course-lotta plausible meds and combination don't "work"
My reason for considering niacin with the lipitor is my wife can only tolerate a tiny-5-6mg/d dose of lipitor-
it-40 mg- made her legs very weak-and it spiked her insulin requirement- 60 units on 40 mg 37 units on 5-6mg
so obviously I think statins "work" but they are a long way from side effect free- muscle weakness and insulin tolerance
Part of the reason I took the lipitor-is I wanted to see if I noticed "anything" negative-SURE AS HECK DID- I feel "fuzzy" and legs -quads-get sore taking a very small 10mg every other day-dose.
So I'm thinking maybe a smallish-100 mg TID dose of niacin-immediate release-forget extended or sustained release- you liver needs niacin free intervals
Yes they claim you need more-but got my doubts about that-it isn't as if it is an antibiotic and you develop resistance on sub clinical doses

Yeah-the statins work(according to many many studies)-but no free lunch-
my guess is many patients taking them-are old-taking soooo many meds and have so many health problems-that when they slowly get weaker don't feel right- it just isn't "noticed" and they end up in a nursing home
Many cardiologists probably will honestly say "very few of my patients have problems with statins"
Oldster walks in-maybe a bit more slowly-but how is a MD going to detect that?? He won't!! Hell- the cardio won't EVER see the oldster walk in since the patient will be in the office waiting for MD- MD will NEVER evaluate something as subtle as a slightly slower walk??
But nothing better than statins-so..... what choice do you have if you have heart blood vessel disease?? None-or maybe Zetia?? (joke)
Nothing is BETTER than statins for decreasing MIs ....
There are some MABs in development-supposed to block cholesterol production I think-more specific than statins-but they aren't "out yet"(I think it is MABs-monoclonal antibodies but might have gotten that wrong-might be wrong on mechanism also-quick glance at something 2 months ago)
and they will be HORRENDOUSLY expensive
Heart disease-you are stuck with STATINS- simple as that
Fact that meds like the MAB are in development clearly indicates BIG PHARM fully aware of statins limitations

The trial was called "AIM-HIGH" - Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy
and the conclusion went:
'Among patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of less than 70 mg per deciliter (1.81 mmol per liter), there was no incremental clinical benefit from the addition of niacin to statin therapy during a 36-month follow-up period, despite significant improvements in HDL cholesterol and triglyceride levels. "

And by 'clinical benefit' they mean the hard outcomes they were measuring: "death from coronary heart disease, nonfatal myocardial infarction, ischemic stroke, hospitalization for an acute coronary syndrome, or symptom-driven coronary or cerebral revascularization."
... As opposed to many trials that measure 'soft' outcomes such as LDL levels and such.

But it is important to realize the trial was using people whose LDL levels were already well controlled. In your wife's case that may not be true.

And while most cardiologists would agree that you are stuck with statins if you have heart disease, not everybody would. Some believe that diet and exercise can do as much or more than statins -- without the side affects....

But, I totally agree with you that no doctor will see the gradual decline that statins may produce and, since those declines are often blamed on aging, the poor person ends up in a nursing home. Actually, for myself, I didn't even see them... All I knew was that I didn't seem to have the strength I thought I should have nor the energy -- and I looked everywhere, except at the statin, for the cause. But the COQ10 supplement resolved the deficiency and both my strength as my energy returned as soon as I started taking it.

But, to be honest, taking it came from me. NOT my cardiologist, not my endocrinologist and not my wellness doctor. They all said: "Well, you can take it if you want, it won't hurt you physically, just your wallet...".

GeorgeB
Thanks.
Their comment was in respect to Q10??
Now since Q10 doesn't get the scrutiny that the statins-and other prescription meds get-they really DON'T know that it is harmless.
Perhaps the anti-inflammatory effect of the statins IS related to depleting Q10?? Yes-this is "just supposing"
but since it really isn't clear WHY statins improve cardiac outcomes "more" than they should-since the cholesterol effect isn't "all" there is to it.
Yeah-just can't know what you can't know.
Niacin-a coenzyme also like Q10- can be toxic-

On the other hand-I increased my Q10 dose- 250 mg last 24 hrs-and I "feel" better-less "foggy" felt better climbing the levee-
Now really impossible to quantify "feel a little better" but I'll stay on 200-300 mg-see what happens.
My wife takes SOOO many medications that I don't want to jack her Q10 up until I see if it "kills me" 1st.
Prednisone-for vasculitis
cellcept -vasculitis
plavix-platlet
aspirin platlet
Lipitor-statin
Renexa-angina
Carvedilol- beta blocker-BP and heart
Lisinopril-BP and heart
insulin-diabetes from prednisone-worse on statin
nystatin mouth rinse for yeast infection-from prednisone
naproxyn as needed Nitroglycerin as needed
Q10= 100 mg/d for now.

Lotta meds-at least 7 crucial-better not miss many doses
Thanks
Charlie
PS What sort of dose are people taking-Q10?? older less expensive version not the latest more expensive version.

I am aware Zetia is not a statin. The point I was taking trying to make was that the drug lowers cholesterol numbers but the pharmaceutical company is forced to concede that it does not lower heart attack risk. Lowering cholesterol numbers through drugs seems pointless. Statins have such profound multiple effects that I find the claim plausible that they to may happen to have some anti-inflammatory effect that reduces the risk of second heart attck for some. But the bad side effects of statins make it criminal, IMHO, how widely they are pushed.

The public would be much better off examining why their cholesterol #s are what they are and addressing that through lifestyle changes -- taking high LDL and low HDL not as a direct cause of heart disease, but as an indicator. CRP, triglyceride levels, VLDL, HbA1c should be looked at. The automatic flagging of total cholesterol numbers is ignorant.

Zetia is probably being sold because it ISN'T A STATIN.
I suspect that is the angle the drug reps use
"if you have a patient that can't tolerate statins-complains of muscle weakness pain etc-give them Zetia"
All those markers you mentioned-are looked at
Lifestyle changes-frequently aren't in the cards for oldsters with heart disease-but they want to live also
They sure as heck can't spend 1 hr on a bike- or change diet dramatically-
hell 20% of adults still smoke-lifestyle changes-EASY to say-tough to do.

All drugs have side effects-all drugs.