My GP wants me to start taking statins even though my cholesterol is 4.3mmol/l (167mg/dl)...

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Permalink Reply by elaine peterson on February 19, 2009 at 7:20am

I have read references lately to test results showing statins to lower inflammation so there is thinking that they are potentially helpful in warding off other health issues as well.

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Permalink Reply by Dave   _ on February 19, 2009 at 10:00am

I hope everyone doesn't think I am somehow "anti-statin" and am ignorant of the positive benefits of that class of drugs. What I've been saying, in BASIC TERMS, is be INFORMED, and GET PERIODIC BLOOD TESTS to check for possible liver-related issues. I'm WELL AWARE of statins benefits. However, like most things in life, there are trade-offs. Being well informed never hurt.

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Permalink Reply by Sam Innocent on February 20, 2009 at 2:23am

Hi Dave,
Of course we don't think you're totally "anti-statin" - it's just you've had a bad experience with them and want to inform people that they're not all a bed of roses. That's understandable and thanks for the information. I've read the Wikipedia entry about the statin that I've been prescribed and although I've decided that I AM going to take it, I'll take your advice and ensure that I have the reccommended liver function blood tests while I'm on them. The last thing I want is to have problems with my liver due to statins, trust me!!
Thanks again for all your advice :-)

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Permalink Reply by Dave   _ on February 20, 2009 at 9:14am

Coo! The chances of having issues are low, but IF it happens, the statistics don't really matter to the affected person. Blood tests will keep you safe.

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Permalink Reply by Anthony Holko on February 20, 2009 at 7:34pm

Dave you are right one can live with high cholesterol and diabetes but you can't live without a liver.

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Permalink Reply by Dave   _ on February 21, 2009 at 1:28pm

Right on! I've survived over 31 years with diabetes, and in just a few months my liver was compromised from meds. I hardly see the point in blithely taking any and everything I'm prescribed if it's harming me. I'm by nature, anti-pill anyway. I take only the meds that are essential for me to function. I've been a bit under the weather this week and my mom (she's 78 and lives 5 miles away) wanted to bring me antibiotics! I said, "no thanks!". LOL! My usual response is the same to my wife if I'm in pain and she wants me to take a pain reliever. I finally relented twice, this past week, due to inability to sleep from pain from a busted toe. My druthers is to avoid meds. Having said that, I AM on Simvastatin for the time being, pending every 4-months-apart lab test looking for a repeat of liver involvement.

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Permalink Reply by Mick on February 21, 2009 at 4:16pm

An important point, in response to liver damage due to statins, is that no one, I repeat, no one has ever died from statin-induced hepatotoxicity. As Dave indicated, stopping the med always returns the liver enzyme levels to baseline. This is in contrast to drugs like Tylenol or Rezulin (the 1st drug of the TZD class that are now represented by Actos and Avandia) which can cause irreversible liver failure and death. The most dangerous side effect of statins is not liver related, but rhabdomyolysis (muscle breakdown), which can cause kidney failure and death. This is why cerivastatin (Baycol) was pulled from the market, as it caused a disproportionate amount of this side effect. That said, rhabdomyolysis is EXCEEDINGLY rare and 100% preventable, if the symptoms are appropriately recognized.

Certainly, no one wants to have a drug side effect, but statins have clearly been shown to lower the risk of the most common cause of death in type 1 and type 2 diabetes, vascular disease. To put it bluntly, the worst side effect of a statin is that you might live longer! :)

For Sam, the question of whether someone with type 1 diabetes and a normal cholesterol level should be on a statin is controversial. Clearly, as a population, people with type 1 diabetes have increased CV risk, but that may not apply to the individual person. It's very hard, in the absence of kidney disease, to identify people with type 1 who are at high risk. This is because all of the prediction methods (ie the Framingham risk calculator or UKPDS Risk Engine) don't work for type 1. Also, most people with type 1 have very high HDL cholesterol (good cholesterol), however this HDL may not be as protective as HDL in people without diabetes (insulin raises HDL so taking insulin REALLY RAISES HDL).

Most GPs simply see diabetes =statin. I don't know if that's correct, but I err on the side of taking it because the benefit far outweighs the risk, in the vast majority of people. That said, it is a decision that is not urgent and waiting to discuss it with your endo won't do any harm. He may be able to better quantify your risk for you, than the GP who says "everyone with diabetes needs a statin."

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Permalink Reply by Dave   _ on February 21, 2009 at 5:46pm

"No one ever died from statin induced hepatoxicity".

????? Excuse me, but that's really not a true statement.

The number of deaths from statins is NOT zero, and would be far higher if not for the wide usage of routine blood tests to watch for elevated liver enzymes

I always am leery when someone claims "never" (or conversely, "always"). I'll continue to have my liver monitored.

oh, I went to another doctor who had me get a 3 shots for Hepatitis A and B to further reduce risk to my liver from those diseases. The worst part of getting them was I had to pay for the shots despite having insurance. Overly cautious action, I'm sure, but I figured "why not".

I've got but one liver for this old body of mine, and I'm taking as good a care of it as I can--same as I do with the rest of me.

There are very few drugs with absolutely NO downside to them. Statins ARE a problematic family of drugs.

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Permalink Reply by Mick on February 21, 2009 at 6:06pm

Agree to disagree.

Permalink Reply by Lois La Rose on February 21, 2009 at 3:50pm

Sam:

Wow. You sure know an awful lot about statins and diabetes which brings me to my only question -- not meant to be combative -- But, if you knew all of this, why did you bother asking? It sure seems to me that you were out to pick a fight about it just to air your disagreement with three doctors.

Lois La Rose
Milwaukee, WI

P.S. I'm still on statins after bring my cholesterol number down because my "good" cholesterol number needs to go up.

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Permalink Reply by Rick Phillips on February 21, 2009 at 7:38pm

Lois:

I found a pretty good way to bring up that good cholesterol, (oh yeah i use statins but could not elevate my good cholesterol) I use almonds, jsut a few a day lifted my good stuff about 5 points. It does work.

Rick

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Permalink Reply by Lois La Rose on February 22, 2009 at 11:01am

Rick:

Since this message was so hard to find would you contact me at my site and give me some more details about bringing up the good cholesterol?

Lois La Rose

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