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Tell Me About Statins

5,964 Views | 38 Replies | Last: 2 yr ago by Cromagnum
Buford T. Justice
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AG
I went in for my annual wellness exam and completed the blood work for the first time in a long time, and my LDL was 190, so my Doctor said that I need to start taking a statin.

Over the years, I've heard some negatives about them, mostly from relatives, and this has caused me to think before I start taking them.

What are y'all's thoughts and experiences with statins?
"Gimme a diablo sandwhich and a dr. pepper...to go"
YokelRidesAgain
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AG
With an LDL in that range, statins would be recommended to reduce risk of heart attack and stroke.

Most common side effect is muscle aches; if very bothersome a different statin can be tried. Rarely there can be a much more serious inflammatory muscle condition triggered by statin use.

Personally, I have been on a statin since my mid-20s and have never perceived any adverse side effects of any kind.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
bigtruckguy3500
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Depending on what data you look at, and your goals of therapy, the answer is different.

If you don't have a history of heart disease, then there is statistically minimal benefit to mortality that can be directly attributable to statin therapy. However, one could argue that just because it doesn't prevent death, it still has other benefits. It for every 100 people that take it, it may prevent 1 heart attack. And for every 150 people that take it, it may prevent 1 stroke. However, for every 10 people that take it, roughly 1 person will develop muscle pain from it.

That being said, looking at the raw numbers is simplistic. Just because it only prevents 1/100 heart attacks, and has no mortality benefit, doesn't mean there is minimal benefit. Heart attacks can also cause morbidity and not just mortality. If you get a heart attack that doesn't kill you, but damages a bunch of heart muscle, your quality of life will decrease.

Another factor is that it reduces narrowing of blood vessels from cholesterol plaques through the body. This may help reduce the risk of erectile dysfunction, may reduce the risk of dementia (although via another mechanism may also cause cognitive issues).

Long story short, diet and exercise should be first line, along with weight loss. But if it was me, I would probably put myself on a low dose statin, or another cholesterol reducing medication in the mean time.

I don't know how old you are, but you could consider a coronary calcium score (which isn't the best marker for coronary health, but is one of the easiest to get).

Hopefully our resident cardiologist chimes in.
MaxPower
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Any thoughts on bempedoic acid? Seems some people think it accomplishes what statins do but without being as impactful as other parts of the body that use cholesterol to function.
Buford T. Justice
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AG
Everything else with my lab work looked good, and my HDL was 71, so the high LDL was my only issue. I'm 50, exercise regularly, but can definitely add a couple of more workouts in each week. There is no family history of cardiac events.

What I would like to do now is make a couple of diet changes for the next three months and see if there will be a change in my LDL. If not. then I will gladly take the statin.
"Gimme a diablo sandwhich and a dr. pepper...to go"
BQ2001
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I got on 5mg of rosuvastatin and LDL went from 126->85 (6 months)->66 (6 more months). No muscle pain at all.

My Small LDL is still high though at this last checkup (way down from 6 months ago) so I'm exploring some cleaner diet options, like cutting out pasta/bread

I do have a history of heart issues on my dads side so doing anything I can is a priority before it gets bad.
YokelRidesAgain
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MaxPower said:

Any thoughts on bempedoic acid? Seems some people think it accomplishes what statins do but without being as impactful as other parts of the body that use cholesterol to function.
The efficacy of statins does not appear to be primarily linked to lowering cholesterol numbers. There are a number of therapies (niacin, Zetia, etc.) that unquestionably lower lipid numbers but do not seem to have much if any benefit on adverse events.

The leading theory is that statin treatment is linked to "plaque stabilization".

Bottom line, until someone shows a primary outcome that is clinically meaningful (e.g., less heart attacks or strokes, or less likely, mortality) for an alternative therapy, you are better served by taking the stuff that has been proven to work.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
YokelRidesAgain
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Buford T. Justice said:

What I would like to do now is make a couple of diet changes for the next three months and see if there will be a change in my LDL. If not. then I will gladly take the statin.
You can eat nothing but Bud Light and Twinkies for the next three months, and as long as you consume less of the former than the calories you burn, your lipid numbers will look better.

But unless you feel that you can maintain a lifestyle change forever, transient changes in diet have never been shown to have any impact on cardiovascular risk.

If you're willing to eat nothing but plants until you die, no one can answer the question of how effective that will be in terms of preventing cardiovascular events. The data doesn't exist, because few if any people maintain those kind of drastic lifestyle modifications over multiple years.

In any event, most of us find swallowing a pill easier.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
anaggieshusband
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Not sure ldl matters.
The people selling oil say it matters.
But, does it really? Has it been proven,with real science, that ldl causes heart disease? Or, was ldl just hanging around at the scene of the crime??
Leggo My Elko
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AG
anaggieshusband said:

Not sure ldl matters.
The people selling oil say it matters.
But, does it really? Has it been proven, with real science, that ldl causes heart disease? Or, was ldl just hanging around at the scene of the crime??

I believe it has been proven. Not everyone who smokes will develop lung cancer, but it ups the odds. Not everyone walking around w/ high LDL will develop vascular disease, but it will up the odds.
KidDoc
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AG
Get on a statin and OTC Coq10.

If you have muscle aches call your doctor and say you have muscle aches and try something different.

Nothing to be scared of really, especially relative to strokes and heart attacks!
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
anaggieshusband
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https://www.nursingtimes.net/news/research-and-innovation/study-says-theres-no-link-between-cholesterol-and-heart-disease-20-06-2016/#:~:text=Conclusion,all%2Dcause%20or%20cardiovascular%20mortality.
anaggieshusband
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https://academic.oup.com/eurheartj/article/39/40/3641/5077833?login=false
Tailgate88
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AG
KidDoc said:

Get on a statin and OTC Coq10.

If you have muscle aches call your doctor and say you have muscle aches and try something different.

Nothing to be scared of really, especially relative to strokes and heart attacks!
I have muscle aches and have wondered if it is the statin. If I were to go off the statin as a test, how long do you think it would be before the muscle aches went away? I have my annual exam with my Doc coming up in two months but I wouldn't mind testing this theory first.
milkman00
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AG
So what is the consensus on whether statins cause dementia and other issues.

Is the person below on Twitter (X) correct?

(11) Marion Holman on X: "1/5 Statins are Mycotoxins: Statins do their damage in two ways. By their Mevalonate Blockade and their Toxic content. The lactone ring of Mycotoxins such as Ochratoxin A mimic the HMG-CoA Reductase molecule in order to inhibit it, which in turn enables Statins to block the /2" / X (twitter.com)
88Warrior
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KidDoc said:

Get on a statin and OTC Coq10.

If you have muscle aches call your doctor and say you have muscle aches and try something different.

Nothing to be scared of really, especially relative to strokes and heart attacks!


I went on a statin and immediately had muscle aches…Started on CoQ10 and aches vanished…stopped taking the CoQ10 a few days before a medical procedure and muscle aches came back…completed the medical procedure and got back on CoQ10 and guess what…the aches went away…plenty of proof for me it works…be aware all CoQ10 are not equal..I've had the best results with Qunol brand…tried the Costco and Sam's Club brands but they ended up passing right through me without dissolving the capsule…
KidDoc
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AG
Tailgate88 said:

KidDoc said:

Get on a statin and OTC Coq10.

If you have muscle aches call your doctor and say you have muscle aches and try something different.

Nothing to be scared of really, especially relative to strokes and heart attacks!
I have muscle aches and have wondered if it is the statin. If I were to go off the statin as a test, how long do you think it would be before the muscle aches went away? I have my annual exam with my Doc coming up in two months but I wouldn't mind testing this theory first.
Likely 2-3 days based on the half life of common statins.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
RightWingConspirator
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My doctor has tried to put me on a statin for years. I have super low triglycerides and high HDL. My LDL is high, but I have found many doctors with varying opinions on the danger of cholesterol. I choose to follow those that believe it to be innocuous. Good luck with whatever you decide.

Last lipid panel was Cholesterol 225; triglycerides 40; HDL 75. Type 1 Diabetic as well. I'm about 6'1 185 lbs with lots of muscle and very little fat. Lift 5x/week and eat high protein/fat, low carb.
milkman00
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AG
I envy your triglyceride to HDL ratio. They say it should be under 3. I'm working on cutting the carbs as well as high protein to see if I can make it change.
KidDoc
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Omega 3 fatty acids/fish oil is fairly well proven to help with Triglycerides. Easy and safe treatment.

New AHA Guidance on Omega-3 Fatty Acids for High Triglycerides | tctmd.com
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Tailgate88
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KidDoc said:

Omega 3 fatty acids/fish oil is fairly well proven to help with Triglycerides. Easy and safe treatment.

New AHA Guidance on Omega-3 Fatty Acids for High Triglycerides | tctmd.com
Any thoughts on Krill oil vs. "regular" Omega-3's?
jtraggie99
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anaggieshusband said:

https://www.nursingtimes.net/news/research-and-innovation/study-says-theres-no-link-between-cholesterol-and-heart-disease-20-06-2016/#:~:text=Conclusion,all%2Dcause%20or%20cardiovascular%20mortality.
From your article:


Conclusion
This research suggests that contrary to common belief LDL cholesterol is not as "bad" as may be thought, and higher levels are not linked to all-cause or cardiovascular mortality.
However, before accepting this as fact, there are many important limitations to consider both to the review and the included studies many of which the review authors themselves acknowledge:
  • There is the potential that many studies relevant to this question may have been missed out. The review searched only a single literature database, excluded studies only available in non-English language, and excluded studies where the title and abstract did not appear to contain information on the link between LDL and mortality in older adults.
  • The study only looked at the link in older adults aged over 60. LDL-cholesterol levels may show different links with long-term mortality in younger adults. Though this was intended to represent the general older-age population, some studies had excluded people with specific conditions such as dementia, diabetes or terminal illness.
  • The studies varied widely in adjustment for confounding factors that could be having an influence on the link between LDL and mortality. Age, gender and body mass index (BMI) were common factors that studies took into account, but others variably accounted for lifestyle factors (e.g. smoking, alcohol), socioeconomic factors, presence of conditions, and use of medications.
  • Only LDL cholesterol was examined. Levels of total cholesterol, trigylcerides, and the ratio of LDL to HDL "good" cholesterol could be having an effect and mediating the link between LDL and mortality.
  • Most of the evidence for this review is for the link with all-cause mortality not cardiovascular mortality. High LDL-cholesterol is believed to be linked with the development of atherosclerosis and cardiovascular disease. This review does not provide enough firm evidence to refute this link. The review cannot with certainty explain the reasons for the apparent link between LDL levels and death from any cause with roughly half of studies finding a link and half not.
  • Importantly, the study does not provide evidence that statins are "a waste of time". These are not trials examining mortality between people prescribed statins or not. The researchers openly acknowledge that the use of statins which they haven't directly examined may be confounding the links in these studies. For example, the people found to have the highest LDL cholesterol levels at the study's start may have then been started on statins, and this could have dramatically cut their reduced mortality risk.
The findings of this review and possible explanations will need to be explored further, but for now this review doesn't provide solid evidence that high LDL cholesterol is good for you, or that statins are of no help. People given statins should continue to take them as prescribed.
"Fat is actually good for you" may be a great headline for a newspaper, and there are always researchers who are willing to make such a case, as we saw with the recent National Obesity Forum report.
These types of stories are often based on a selective view of evidence, rather than a comprehensive systematic review. There is currently no comprehensive body of evidence that contradicts current official advice on saturated fat consumption which recommends no more than 30g of saturated fat a day for men and 20g for women.
BCOBQ98
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My cardiologist put me on a statin. I took it for a year or more but I just doyt feel the same on it. Can't place my finger on it exactly. I feel it also negatively impacted my testosterone. I went down to 3x week vs prescribed 7x week and was recently tested and I'm a little high. LDL 137 but rest of stats ok. Dr yelled at me but I've now gone off them completely. I'm getting tested again in a week and expect the results to be about the same. Will see if I get in fight with doctor.

My old cardiologist wasn't concerned and didn't have me on statin. This new one freaked out and had me go get my heart calcium score checked which came back at ZERO.

I'm not sure I will go back on it.
bigtruckguy3500
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BCOBQ98 said:



My old cardiologist wasn't concerned and didn't have me on statin. This new one freaked out and had me go get my heart calcium score checked which came back at ZERO.

Just remember, coronary calcium is not necessarily indicative of lesions and narrowing of the coronary arteries. It only shows calcified plaques, not ones that are yet to be calcified.
anaggieshusband
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https://pubmed.ncbi.nlm.nih.gov/35938780/
anaggieshusband
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https://pubmed.ncbi.nlm.nih.gov/35938780/
Unfortunately, the doctor doesn't know if people actually eat what they say they are eating
Buford T. Justice
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AG
That is a large reason why I presented the question.
He didn't ask me any questions about diet, exercise, alcohol consumption, stress, etc., it was just straight to the statins, and for life. (And I want to say, I like my doc, just don't understand what felt like the statin was being pushed on me. Even though I have elevated ldl.)
"Gimme a diablo sandwhich and a dr. pepper...to go"
bigtruckguy3500
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anaggieshusband said:

https://pubmed.ncbi.nlm.nih.gov/35938780/
Unfortunately, the doctor doesn't know if people actually eat what they say they are eating
This isn't an actual study, nor is it a systematic review of studies that prove the hypothesis they state. It appears to be an indirect conclusion based off risk factors for CVD, such as insulin resistance (this is from an endocrinology journal).
MaxPower
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I never really answered your original question. I'm on the lowest dose and noticed absolutely no adverse side effects. It lowered my cholesterol (total and LDL) by 30+%.
KidDoc
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AG
On atorvastatin 10mg my ldl went from 180 to 60s. HDL is 90s. No side effects and $0 copay. Hard to argue about that.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
anaggieshusband
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https://pubmed.ncbi.nlm.nih.gov/38276308/
25Lighters
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AG
I've been on Rosuvastatin for about 3-4 years now and I'm early 40's. No issues at all. My family has a history of heart issues so my cardiologist recommended it due to the initial test results below.

Before the statin my cholesterol total was 257, triglycerides 131, LDL 180, HDL 41.

Now it is cholesterol total 143, triglycerides 69, LDL 85, HDL 48.

I do take fish oil and other supplements that "might" help but there was a direct correlation between 6 months after I got on the statin that my levels got drastically better across the board. I really want to increase my HDL levels.
True Anomaly
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AG
anaggieshusband said:

https://pubmed.ncbi.nlm.nih.gov/38276308/
Counterpoint:

PuryearFratDaddy
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AG
I'm going to try Qunol CoQ10 for muscle aches. What do you take? Seems Mega may be better than Ultra per marketing (but sounds better than Sam's, others).

Anyone have statin suggestions? Rosuvastatin? Sounds like a switch in statin could also benefit me after current stock is out.

However, tried stopping statin and fenofibrate for a couple of weeks, didn't notice difference, so pain may be unrelated.

Rest of story - Cholesterol runs in Moms family, heart disease in Dads, I'm in 50s. Waiting on this years physical results. Been taking simvistatin and fenofibrate or acid for 20yrs, had muscle aches in upper shoulder/back area for about 10. These can be chronic esp in morning, seems less in last 6months (can't think of reason why), but have learned to live with it.
Tailgate88
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AG
I have been on Simvistatin for years. The past year or so I have developed muscle aches. In the morning I looked like an old man walking across the room and while they got better as the day went on, they did not completely go away. I was starting to think I was developing some chronic illness and was dreading asking my PCP about it at my annual in a few months.

After reading this thread, I stopped taking them. Next morning was better, second morning way better, by the third morning they were gone!

I am going to wait a few weeks and then set an appointment with doc to do blood work and see if I need to go back on a different one.
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