Statins, Now what.

Are you surprised? I got muscle pain when they tried to put me on statins, so I said shove it. ...Jim Thompson

Someone I know ended up facing a somewhat similar issue after chemotherapy for breast cancer about ten years ago. The standard protocol for her variety of cancer involves taking an estrogen suppression drug (tamixofen or an aromatase inhibitor) for five years. The side effects were really nasty. These drugs were/are promoted as providing a big benefit in reducing the recurrence of cancer... but it's always quoted as a *relative* reduction in recurrence rates (i.e. what percentage of the cancers which would otherwise recur, do not do so).

When she asked her oncologist what the *absolute* benefit to her would be of continuing the therapy, he said "About 2%"... that is, stopping taking them early would expose her to about one chance in 50 of having the cancer recur.

That's in the same ballpark as the absolute benefit of statins, in the studies cited in this paper.

Comparing that number, with the 100% certainty of dealing with crippling pain if she stayed on her medication, her choice was clear. She stopped taking the aromatase inhibitor, the side effects gradually faded away, and she's never regretted stopping.

Relative reduction in risk is never the whole picture. You have to weight what it's relative to ("half off" of a risk isn't much, if the starting risk is small) and what the costs and new risks are.

I'm always amused that "medically significant" would never meet the standard of engineering/statistically significant. ...Jim Thompson

And that only becomes significant once you address all the 'issues' with the research, which too often are major to fatal in terms of their effects on the conclusions drawn.

NT

Jim Thompson used his keyboard to write :

I have a friend who is a Doctor of Chem or somesuch and works in forensic Med. Has all sorts of excuses for the inaccuracy of even Blood Pressure diagnosis and such when as you say the measurements would never meet engineering standards.

Engineering standards are based on measuring nominally identical objects.

In medicine, every patient is different - even when they are identical twins.

The statistical data that the medical profession has to process is a lot noisier than the data most engineers get to work with.

Statins do work for some people. I've got a family history of coronary heart disease, and at the same time that I was being worked up for a new aortic valve, my younger brother was having an urgent quadruple bypass, whil my coronary arteries turned out to have only one minor (30%) blockage. I'd been on Lipitor for about a decade at that time, and it could well have helped me do better than my brother, father and maternal uncle had done.

When DNA sequencing gets to be even cheaper, we may be able to work out what drugs work for which people.

Of course. Fortunately I have a doc who listens, banters with me, and we zero in on what I need. he's finally come around to the conclusion that _my_ particular level of wine consumption _is_ beneficial to me ;-) ...Jim Thompson

Same with me. I took Lovastatin for 9 years after triple bypass heart surgery and had chronic back pains from day one. My cardiologist attributed the pains to the after effects of the surgery. At 9 years, pains became intolerable, so he switched me to Simvastatin, which immediately moved the pains from the back the upper arms. I gave up. It took about 3 months, after taking Simvastatin for only 7 days, for the arm pains to go away, and about 1.5 years for the back pains to mostly go away. It's now about 6 years since I gave up on statins and only as of about 6 months ago, the back pains seem to have gone completely away. Translation, the muscle damage is cumulative and nearly permanent. Statins suck, at least for me.

Please use carets < > to prevent line wrap. Most news readers honor this method.

Also, learn to edit and trim the URL. Most URL's include quite a bit of tracking garbage tacked onto the end of the real URL. It usually starts after the first question mark in the URL. This works the same:

A better example is a Google image search. The original URL is absurdly long, and full of garbage useless garbage. All that's need are two tags: tbm=isch (image search tag) q=statin+side+effects which produces:

Same with a Google patent search, which requires: tbm=pts (patent search tag) q=silicon+nitride which produces:

Or, a Google web search, which only requires the key words: q=statin+side+effects which produces:

Try this line. It begins with a leading space. That seems to work with the Agent newsreader and Supernews. I think. Maybe.

Key phrase - "for me". I was put on Atorvastatin (Lipitor) after mine, recently. No issues so far. I'm not happy at all about a few of the other drugs they have me on, though.

As far as reactions go, several years ago Lisinopril just about destroyed my shoulders. Fosinopril didn't cause me any problems (my doctor couldn't figure that one out). OTOH, it didn't do much good, either.

Y'er one of the few. I did an unofficial survey of my friends and associates about statins. I didn't keep accurate score, but I think about 20 friends, 15 had taken statins for varying periods and given up, typically at about 5 years. 4 more were taking statins and experiencing pains. Only one had been taking statins for more than 10 years and not had any side effects. I submitted my tabulation to my cardiologist, who ignored them.

Same here. Mostly, I don't like the prices. Before I take anything new, I do a drug interaction check, and plenty of reading. I suspect that I may have saved my life at least once with these precautions.

Suggestion: Don't take any pill that you can't pronounce.

"One pill makes you larger, and one pill makes you small. And the ones that mother gives you, don't do anything at all". (White Rabbit by Grace Slick).

Many years ago, my stepmother was having medical issues. Her son and I went through her extensive perscription list and checked for interaction and possible side effect issues. There were a few. Then, we noticed that all the drugs with problems were prescribed by different doctors. Apparently, she had multiple physicians, who didn't seem to have an accurate list of what medications she was taking. We arranged for an appointment with what we guessed was the most cooperative doctor. When he saw the list, he went white, got on the phone to the other doctors, and together they drastically reduced the drug list. Some drugs had to be reduced slowly, but the positive effects were almost immediate and she greatly improved.

That worked as you described. One long line with no wrap. Thanks. However, that won't work if there's a space anywhere in the URL. Most browsers convert spaces to %20 but sometimes miss.

Notice the difference here. The first and last lines have spaces betweent the words:

It's been said before: "We" would much rather a pill to treat the result, than a life-style tweak to treat the cause.

Speaking of which I should strap on the snow shoes and take the dogs on a walk. It's going to be above 20F here today..

George H.

It's only been three months, so I (hope I) have several years for it to play out.

Cost is no problem. Most are $4/month, without insurance (and $4 with ;-). One is $10, I think. SWMBO has been dealing with that. The problem, with one anyway, is that the list of possible side effects is just *huge*, with big warnings to the effect of "for use treating life threatening conditions only". I'm not on the list of conditions the stuff is approved for and I don't have any symptoms of that (though it's possible it's because I'm taking the drug).

These are old drugs, from before the industry ran out of pronounceable names. ;-)

Peanut butter and jelly sandwich (long story).

I just looked at my list (on the hospital's site) and the doctors who prescribed them. I was surprised how many doctors, some I don't even remember seeing, were prescribing these things. All of the drugs I'm taking are in the record, though. I intend to go over it when I next see my cardiologist (in a month).

I take 500mg Niacin per day. However, there's a potential problem. Niacin interacts with statins if you're taking over 1gm Niacin per day: Allegedly, it's rare, but I know of two people that had a problem.

My numbers are in the general area of normal. These are from Jan 2014 and are probably worse today: Component Standard Range Your Value Flag Cholesterol 98 - 212 mg/dL 153 Triglycerides 40 mg/dL 61 LDL Cholesterol (NOT liver-related) to the skin. I was lucky. I had none of those

I was having trouble with Niacin causing "flushing". Eventually, I read the fine print and found that "no-flush" Niacin magically morphs into "ultimate-maximum-flush" if taken with warm or hot water. I was sipping hot tea with the pills. Oops. I also found that it can happen up to an hour after eating a hot meal.

When I was taking statins, I would run a hepatic panel (liver function test) every 6 months to see if there was a problem. No problems except for occasional insane results caused by bad handling of the lab data.

I've done more than just think about it. I spent quite a bit of time and effort reading through the literature, research and reports. Much of what I've read is garbage or cleverly packaged garbage. For example, when a pharmaceutical company pays for research, they expect the result to favor whatever drug or procedure they are selling. An honest researcher can write an unfavorable report, but will likely never see another research grant from that company (or its competitors). The compromise is that the research procedures and data are usually totally honest, but the summary and conclusions are owned by whomever paid for the study which are then tweaked to favor their agenda. The popular media will usually only quote the summary and conclusions. Anyone reading the original report and actually looking at the data and computations might reach very different conclusions. All this is usually buried except that clueless students like to publish reports summarizing current progress in such areas. They use the data from previously published test reports and ignore the summaries and conclusions. These medical survey and progress type of reports make very interesting reading and often highlight procedural and computation problems.

As if that's not enough, there are web pages and reports all over the internet offering drugs and procedures that can cure anything imaginable. Some of these medical reports looked very much like real research with copious footnotes and references. I was suspicious and dug deep into one such published report and found that while the references were usually on topic, the data and conclusions from the reference and the published report were very much unrelated. The research could say that some drug was totally ineffective, while the report said the opposite. That works because few readers bothered to check the references and if they did, few could understand the medical terminology.

I could go on forever on this topic, but I think this will suffice to show that there may be a problem.

Getting the doctor intoxicated in order to have him endorse your favored dietary choice seems a bit devious. However, I was thinking I might try the same thing. Did you bring a single bottle of wine to the appointment or a case? Red or white?

My triglycerides are great and HDL is very high for male. My LDL was high, also, but the thought was that the HDL more than compensated for the LDL so they didn't have me on statins. It didn't work.

My mother had the flushing problem with even low doses of Niacin.

It's not a magic bullet, either.

My brother complained of chest pains and fatigue for two years before they finally gave him an angiogram.

He had 82% blockage in a main artery into the heart, and 64% blockage of another.

They placed a stint in the 83% location, and decided they were going to fight the other with drug regimens. He had to undergo a full quad bypass less than a year later. Less than two years after that, he had a heart attack and died on the operating table undergoing a cancerous tumor removal in his bladder on my 50th birthday.

He was the athlete in the family. But being a serviceman type worker meant daily lunches at McDonalds and other heavy long chain triglyceride foodstuff intakes are what caused his pipes to plaque up.

I no longer have any happy birthdays.