Statins

[nspower]

I am a heart patient with history of MI and low ejection fraction (20-25%). I have been prescribed statin as on of the drugs, among others and I am taking it for last 7 years.
Yesterday, one of my colleagues with similar history (EF less than 20%), returned from London after one month's stay and consulted several doctors regarding future of his heart conditions. He shared several information, and one which got me very interested is that he has been advised to stop STATINS. It is not that every doctor, he talked to, advised him to stop Statin. But as a result of his several consultations he has decided to stop statins for a while and see how it impacts his cholostrol levels.
The reason he gave me was that statins adversely impact muscle strength. Since he stopped statins he no longer experiences cramps in leg muscles and otherwise feels better. Also considering that low EF has direct relation with strength of heart muscles, statins may be adversely impacting heart muscles, as well. If yes, should these be advised for low EF patients?

Any thoughts or experience in this regard?

Many thanks in advance.

[nspower]

Have come across some interesting literature on statins, then followed it on net. This is what I understood about statins:

1.  Statins are mycotoxin antibiotics like penicillin. Highly toxic.
2. The process by which statins block formation of cholesterol, aslo block some vital biological substances, including coenzyme Q10, which are essential for providing energy to cellls, their efficient functioning and communication and multiplication. Net result is weakening and damage of cells.
3. This muscle damage is not always picked up in blood tests and can go unnoticed and misunderstood as ageing process.

As for usefullness of statins, the scientific articles say that blockages are caused due to "oxidation of LDL', not necessarily because of LDL quantity.   Even very low levels of LDL can cause blockages if the blood chemistry promotes LDL oxidation. This means, go for high anti-oxidants intake rather than taking statins and causing irreparable damage to body at cellular level and invite serious health issues.

I have not come across any literature saying that above findings are not correct.

Anyone with more information in this regard?

[ed34]

Every time you see a new idea for the perfect diet by a Doctor (usually not a medical Doctor by the way) one topic they always add to the literature is how you don't need statins. They claim nature does all that is needed. However, with hypercholesterolemia which I have, nature won't do anything to help. We also have to remember that diet can just about alter 20% of cholesterol levels in the blood, if lucky.

[erijon]

Some interesting points, but let's get realistic about statins and get past the misconceptions.

First off, statins may cause side effects and the most common in is muscle pain. There have been several studies lately that illustrate how rare side effects are. Ed touched on it earlier, a meta analysis was done that included 80,000 participants from 29 trials and the results showed that the people in the placebo group reported more muscle pain than the statins group.  In reality, the latest research of the studies over the past 5 - 10 years show that the real risk of side effects is less than 1% and the most serious side effect, Rhabdomyolysis has been proven only 2 times since the inception of the drugs in 1987 to be the result of statins.

In addition, the FDA is in the process of dropping it's warnings for liver damage and will no longer recommend that doctors do blood tests more often than annually.

here has also been a recent new finding that statins play a major role in stabilizing vulnerable and soft plaques making them much less likely to cause an MI.

The state of statins is changing almost daily. These drugs are proving to be more effective and safer than what was know just 5 years ago.

I would be happy to supply links, just let me know.

[ed34]

Well, it may be in good shape now, but I still don't think we have enough data showing long term effects of statins. I was on 40mg from 2007 to 2012. Then I took a year out and returned mid 2013 to 80mg. So 5 years on 40mg and so far nearly a year on 80mg which isn't long really. How do they determine statins as the cause of Liver function decline? does it improve if you stop the statins? I have also read that many patients who react to a statin seem to accept a variant brand quite happily but not sure how true this is.

[nspower]

ed34 many thanks for the feedback.
What I have experienced in my case is that abnormalities of liver function appear in blood test much after poor liver function has impacted digestive system and cholesterol chemistry.

But I agree with you, if you do not have problem with 80 mg of atorvastatin, your liver must be really good shape.

In my case, liver function abnormality (although very minor) have appeared in blood tests only couple of years back but I suspect, my blockage was a result of something going wrong with liver function  as I had problems with my digestion all along since my 40s and may be something else which went un noticed. Now I am working on it with alternate medicines.

[ed34]

Well when I take statins, my total cholesterol is around 162. When I don't take my statins it rises very sharply in a few days to 330-340. I can drop my cholesterol more if I take ezetimibe. This stops absorption of fat in the small intestine but for some unknown reason, they don't want me having this drug any more. I'm pretty sure my last attack was due to clotting rather than plaque because after a lot of anticoagulant the problem went away. The angiogram couldn't find a real reason for it either. So yes, the attack could have been due to lack of anticoagulant rather than no statins, but the clot may have formed due to artery inflammation, caused by no statins. I don't think I will ever know.I have never had liver, eye or muscle issues with statins and I still have a resting EF of 70%. I take atorvastatin which is a particularly strong statin and I take the strongest allowed dosage 80mg. I did have a few abnormalities in my last blood test, which is to be repeated in 2 weeks time. My white cell count is always elevated, has been for years, and I have to wonder if this is the cells continually being involved with artery disease, causing the inflammation.

[nspower]

Many thanks for sharing your thoughts.
ed34 I was wondering if you noticed your cholesterol go up when you stopped statins? You also mentioned that you stopped all medications for 10 months. Could your heart attack be combined effect of all medicines and not just statin?

As for studies on statins, in my opinion, in short term proving ill effects of statins may be difficult although they may be there. And long term effects are often not adequately presented in such studies. The reason is, most of these studies are financed/done by parties who have interest in promoting such drugs.

In my case I have realized problems of using statins only after 7 years, since I started statins and I am only on 10 mg per day, although the adverse impact may have started on day one .

Based on my own experience, I have no doubts that statins have adversely impacted my muscle mass, nerves, eyes and liver function. I am trying to figure out if this has happened to my heart muscles also, considering that my EF has deteriorated from 30-35% to 20-25% in last 7 years.

From my own experience I have also found that improving liver function can reduce reliance on statins and will have many more benefits. I did that by trying Indian Ayurveda medicines for liver function and results are amazing from cholesterol point of view.

Now I want to reduce my statins to half and see whether I can maintain my LDL/HDL levels while continuing with these liver function medicines.
Shall keep you posted.

[ed34]

I'm sorry to hear you have had problems with statins. This kind of shows my point though. Two years ago I stopped my medications for about 10 months and then suffered another attack. I started my meds again and for over a year I have had no further incidence. I am on the highest dose of Lipitor (quite a powerful beast) and have no side effects from it. My Liver, kidneys are fine, my muscles are fine and my EF is 70%. The last trial I looked at which involved nearly 7000 people on statins and nearly 7000 who were not, showed that the difference between the two groups with muscle issues was around 1-3%. I know that in the UK, the policy of statins is to run a batch of blood tests very soon after the medication is started, which should alarm the Doctor of any problems. I know that the heart is a muscle along with the skeletal muscles, but as you know it's smooth muscle, a different type. Is it certain that statins can harm this type of muscle also? I have not seen any concrete evidence so I'm hoping you have a link or something of some trial.

[Occupant]

Strictly my own experience (to avoid being called a "scaremonger": I had a CT- Scan showing an Agatston Score of 130 in the LAD in 2001 and again in 2011 with a score of 783 i.e. the calcification is now 6x times as bad as it was ten years earlier and I was on Statin drugs all the time. These are drugs being advertised to  prevent this from happening. Severe Rhabdomyolysis which affected my left shoulder and arm then my right arm and shoulder and - at the end, when I stopped taking them - my kidneys to the point where I wound up in the E.R. No, I don't have direct evidence, but the heart is a muscle just like the kidneys and the muscles in your arm and shoulders, it makes sense that my RBBB and PVC's now are also a result of the effect of Statins.

[ed34]

I don't think that the conclusion should be based on symptoms alone, they should be backed up with proof. There are a number of tell tale signs that can be seen with simple blood tests if Statins are affecting someone. Obviously if muscle swelling occurs then they should be stopped until blood tests are completed but from the data, muscle issues are actually rare. In the vast majority of patients the benefits far outweigh the risks. I think we have to be careful to filter through scaremongery with drugs, and there is a lot of it on the internet for statins. If a person is lucky enough to be able to keep their cholesterol profile low through diet alone then maybe statins can be stopped. The problem is, statins have other benefits it seems, such as preventing inflammation of the artery walls which starts the disease or progresses it. I think such decisions require a lot of investigations.