{Health} Is your statin safe?

The FDA is adding new warnings to this popular drug. Here’s what you need to know now.

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If you’re over fifty in America, there’s a good chance you’re taking a statin. Nearly 22 percent of adults 45 or older take one of these cholesterol-lowering drugs, making them the most commonly prescribed medications in the world.

Last week, the FDA added new safety alerts to statin labels, including reported side effects of memory loss, confusion, and a higher risk for Type 2 diabetes. Not surprisingly, many people panicked. Medical message boards were flooded with questions like, “Will Zocor give me dementia?” and “Is Lipitor making me sick?” A cursory google search brings up dozens of sites claiming statins are dangerous, unnecessary, over-prescribed—even a corporate conspiracy. Still, the FDA insists that this new information should not “scare people off statins. The value of statins in preventing heart disease has been clearly established. Their benefit is indisputable.”

So what’s the real story? For answers, we turned to a source we truly trust, Dr. Steve Nissen, Cleveland Clinic Chairman of Cardiovascular Medicine. Named one of Time magazine’s 100 most influential people, Dr. Nissen is not only a leading cardiologist and researcher, he’s also a leading patient advocate. He has has led inquiries as to the scientific integrity of many big-name medications currently on the market. In other words, he’s not afraid to question the status quo. Here, he answers all our questions.

FOF: If you are currently taking a statin medication, should you consider stopping as a result of this report?
Dr. Nissen: No patient should stop a medication because she hears a news report. These decisions should always be made through a discussion with your doctor. Most authorities do not believe that these new warnings represent a major change in thinking about statin drugs. We’ve known for several years, for example, that statins do very slightly push up blood sugar. That means, if you’re just under the threshold for diabetes, you’ll cross over and be labeled as having diabetes. But, in those patients for whom the blood sugar did go up a little bit, the benefits of the drug remained the same. The diseases that statins prevent–like heart attack stroke–are still reduced equally well.

Still, it’s alarming how many people are on statins. Do you think these pills are over prescribed?
I do. Doctors need to stick with the guidelines, which are very carefully worded so that patients at high cardiovascular risk are recommended for receiving statins, and patients who are at low risk are not. There are a certain number of people–I’ll call them the ‘worried well’–who are treated with statins by their doctors but who don’t really meet the current criteria. Those people are better off using diet, exercise and other means to control their cholesterol elevation. But, there are equally large numbers of patients who meet all the criteria for receiving a statin and who aren’t on them.  The key is to make sure the right patients get these drugs.

How do you know if you should be taking a statin or if you’re one of the “worried well”?
There is a risk calculator available online called the Framinghan Risk Score. If you put in your numbers (age, cholesterol, blood pressure, etc) it will give you your 10-year risk of having a heart attack. If you come out well under 10% risk for 10 years, your risk is low, and you likely don’t need to be on a statin. If you’ve had a heart attack, you should be on a statin–period. If your LDL cholesterol reaches a certain level–above 160-190–we will treat you with a statin even if they have minimal other risk factors.

If your doctor says you need to be on a statin, but you are still concerned, what do you need to say to your doctor to make sure you’re getting the right treatment?
Ask exactly what calculations he or she using to determine your treatment. Did he or she use the Framingham or another similar tool? If you still have doubts, it is never a bad idea to get a second opinion.

What if you’re on a statin and you’re experiencing some of these side effects. Should you be worried?
Every drug has a degree of tolerability that differs from patient to patient. Good medicine is about customization. The goal is to find the drug in the dosage that works for you with the least side effects possible.

There are many sites on the web with experts who claim that these drugs are way over prescribed, and that there are “natural” alternatives to lower your bad cholesterol without jumping on a statin.
I have a very simple answer for those sites: nonsense. There are no “natural” alternatives to statins. The dietary supplement industry is unregulated, so they make these claims but there’s no science to back them up. Don’t be fooled by these promotions of dietary supplements—they simply don’t lower cholesterol.

So maybe there isn’t a supplement. But what about changing your diet and exercise? Can behavioral changes be a good alternative to statins?
A statin should always be coupled with behavioral changes. Good and prudent doctors always couple lifestyle changes with drug therapy. Using these behavioral changes as an alternative to a statin depends on your level of risk–every patient is a little bit different.

If you’re on the borderline of taking a statin, should these side effects be a motivation to make changes to your lifestyle so you don’t have to go one one?
It’s not that easy, and here’s why. Lifestyle changes typically don’t reduce cholesterol by more the 10-15 percent. Statins reduce cholesterol levels by 30-60 percent.If your numbers are high enough that you need a statin, the odds are good that you’re not going to get them down with diet alone, unless you’re willing to take on an extreme diet…and most people can’t sustain that.

Why would you be in a situation where your cholesterol levels are so high that there’s nothing you can do but take a statin?
It’s really about genes. Only 20 percent of cholesterol level comes from your environment…80% comes from your genes. That’s one reasons that diet can only lower cholesterol so much.

What about people who say that these drugs are being over-prescribed because of all the marketing being done by big pharmaceutical companies?
There’s a marketing element here absolutely. Having said that, we have probably saved more lives by lowering choesterol levels with statins than with any other drugs in the history of the medical profession. The only thing that comes close probably is penicillin.

If there is one single change you could be making to lower your bad cholestorol–apart from a statin–what would it be?
Reduce your intake of saturated fat in your diet–butter and meat.

  • Norma

    WOW! I agree with these two ladies – whole heartedly!

    • Fernanda

      ELAINE OUBRE / OK, I’m not going to lie, that post was too FUNNY, yet very informative. Great job, Jay. I see you have your mom’s sense of humor. The beabis are cute as little bugs in their haloween PJs. Elaine

  • sonsethues

    I have to agree with Gregoryanne. I have had high cholesterol for years and refuse to take a statin for a couple of good reasons. 1. There has been an alarming increase in diabetes among statin users and cancer. They’ve known this for years.

    2. My mother was put on a statin last year and while she was driving she lost all use of her motor skills and bodily functions. she tried to pull over to the side of the road and managed to get there by the grace of God and managed to sit there until she could get some help. Her doctor told her it was all in her head. We went on line and found all the side effects listed under the statin she was given so she went off the statin with her doctor actually yelling at her. She hasn’t had another episode and had her blood work was redone and found everything normal. She’s almost eighty and never had any problems with cholesterol before.

    The scale for the Cholesterol has been lowered. That means more people are put on statins everyday even children. People need to do their own research and find out if they believe they need the drug. I don’t think many doctors are really looking out for the best interest of the patient any more. There are a few that do but over the last few years I have seen more mistakes because they are in a hurry. By the way the statin that mother was given was recalled but the doctor didn’t seem to notice. These drugs are dangerous and look at all the recalls they have all the time. It makes common sense to work on your diet. I should tell you that I’ve never eaten meat and very little butter and my levels of Cholesterol were high. So go go figure. My son in law eats so much saturated fat and has very low levels.

    • FOF Editor

      hi there – thanks for your comment! this is definitely a controversial issue. While researching this story we did come across many personal stories from people who felt they had been very affected by statins. We’ll make sure that Dr. Nissen has a look at your comment as well. All best, Lina, FOF Editor

  • pattib

    Appreciate the information.

    • Carolina

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  • Margaret

    It amazes me that a colleague at the Clevelend Clinic would not even reference the incredible work done by Dr. Caldwell Esselstyn in reversing heart disease –not just preventing it — by switching to a plant based diet and omitting all oils and other fats. Dr. Esselstyn’s research clearly shows that we are not prisoners of our genes, but of our diets, and that we can affect the likelihood of Cardiovascular incident by radically changing diet. Even the regular use of statins only slows progression of disease, it does not prevent cardiovascular events from occurring.

  • Ann

    So, Dr. Oz is lying when he says Red Rice Yeast and Artichoke Extract work like statins?

  • Jeanie

    Ironically I have a doctor’s appointment tomorrow as I need to refill all my meds. I am on Crestor and has helped my levels greatly. Lipitor gave me muscle weekeness and I believe the Crestor is doing the same. When I was 25 lbs. lighter and working out regularly (2 years ago)I still had high enough levels that the doctor finally convinced me to get back on statins. Now I have gained all my weight back, have week muscles so I am not even interested in doing what I used to. Not to mention that my confusion and memory issues have been increasing. I am sick of hearing about menapause and too much on your plate. I just want to feel good again. I also went to the ER a few weeks ago as I had symptoms that were heart related. I passed all tests and surprisingly was released. So tomorrow I will review this info with my female physician. Thanks for the information.

    • Simone

      Uh, now that is a good one and something I will have to think on. Given cundissioss I’ve had with other moms, that is a daunting task so that the lunch includes variety, healthy choices and easily packable for school. I’ll work on a future post about it. Thanks for the suggestion!

  • Carolyn

    I have had high cholesterol for a long time and a year ago found a statin that did not produce muscle aches after one or two doses – Pravastatin or Pravachol. This is a sodium based statin rather than calcium based like Lipitor or Crestor. I refused to take the prescribed dosage and taking 20mg then 40 mg has reduced my cholesterol from 320 to 206, my HDL is normal and only my LDL was a little above normal. I call that winning. This week my DR said the reason for taking the statin was to prevent stroke and heart attack not just to lower my cholesterol. Now I am in a quandary as he wants me to double the statin, but think that I will stick to my 40mg after reading this article. While not homeopathic in action, it it is in theory. Thanks for the info.

  • gregoryanne

    I’d like to offer another opinion, that of a doc I respect, is a practicing cardiologist who includes alternative therapies and some supplements into his treatment protocols. He is nationally known as one of the best in his field, Dr. Stephen Sinatra. I’m quoting from the Nov. 2011 issue of his newsletter, Heart, Health, and Nutrition:
    “Simply put, cholesterol is not the problem. Cholesterol is absolutely critical to the body in so many ways, including as an essential raw material for cell membranes and sex hormones. The real problem is the current cardiology obsession to slash cholesterol levels to even lower and lower levels.”
    He goes on to say, “Specifically, the best candidates for a statin are males with low HDL (below 30 mg/dL) and established coronary artery disease (CAD). The benefits these men derive from stain drugs are not from any cholesterol-lowering effect but from the ability of statins to thin the blood and defuse inflammation. Women with high cholesterol in the absence of CAD have no business taking statins. There is no substantial evidence that the drugs do anything for them.”
    Part of my mission is to get this kind of information out to the women in the world. If you are going to continue taking a statin, please add CoQ10 to your daily routine. Statins deplete this critical energy nutrient and while all the muscles suffer, the heart is the biggest consumer of energy in the body, (Because it is always pumping) and you don’t want the heart short of energy right?
    I applaud Geri for starting this conversation, it’s a very important one.
    One last point, many of the studies “proving” the importance and efficacy of statins were paid for and supported by professionals who are paid by the very drug companies that produce them.
    To your health

    • FOF Editor

      Hi Gregory Anne – Thanks for this comment. To be honest, this was a tough topic, because different doctors have wildly different opinons. It’s very interesting to hear what your doctor said, and actually not entirely in opposition to Dr. Nissen, who also agreed that these drugs are over-prescribed. We did ask him about CoQ10 and he said that there are yet to be studies that prove its effectiveness when it comes to statins, but he admitted that it may be helpful to some people. Again, thanks for the great info….hopefully this is a conversation that will continue! Best, Lina, FOF Editor

      • Kapungwe

        in my post…I am very excited to be the htsseos for this week’s Mil Spouse Weekly Roundup! Thank you for creating such a fun blog hop! I am so glad that I was able to get the linky up…my hubby and I left to drive up (11 hours later…) to see our kids and we left at O’dark hundred! So was hoping the linky worked, but couldn’t check it until we got to our daughter to check on her computer. Have a wonderful Mother’s day too :o)Blessings & Aloha! I will be sure to visit everyone, but it may be after we get back to Georgia.Hope you come back again :o)

  • Rita

    I have had “high” cholestrol numbers since my 30s. My total is about 220 but it is because my “good” cholestrol is so high. My ratio of good to bad is good, but the doctors have put me on various statins. I am a small person, and low body weight. 5’5″ @ 113 lbs. All of the statins have caused very severe muscle cramps, spasms and pain. I have had to stop taking the statins. The doctors aren’t happy because my “numbers” aren’t down, but I just don’t feel like I need to be on a statin drug. The side effects have been so severe, I just don’t feel like this can be good for my body. I have hypothryroidism and I have read that sometimes that can “throw” your numbers off. Sometimes, I think doctors don’t look at the entire picture before prescribing a one size fits all diagnosis.