Statins

[osiag]

Although I have low LDL without statin therapy, I started a statin because of significant family history.  Recent evidence seems to point to very low LDL (<70) being even better than low LDL (<100).  More recently JUPITOR showed that <50 was better than <70.  However, what is particularly interesting is that statins seem to reduce cardiovascular events through mechanisms other than LDL lowering.  Such mechanisms may be anti-thrombotic, anti-inflammatory, and anti-oxidant.  Do we understand what dose is necessary to get these non-LDL lowering benefits?  For example, I take 5mg of Lipitor daily.  The reason for the dose being so low is that my LDL was low to begin with (91) and I am very sensitive to it (i.e., just 10mg brought it down by 47% to 48).

[erijon]

Good questions, I have always been of the opinion that statin use provides a great potential for the prevention of CAD in patients with a risk of developing CAD. The risks are real, but they are usually over exaggerated. Below is the official statement from the Nation Health, Lung and Blood Institute (NHLBI), a federal agency that works withe the FDA to recommend treatments and procedures;

"Statin therapy holds great promise for reducing the incidence
of major coronary events, coronary procedures, and
stroke in high-risk patients. At present, this potential has
not been fully realized, because many patients at heightened
risk are not being treated with these drugs. There is a well
documented under-use of statins in clinical practice. Statins
have proven to be extremely safe in the vast majority of
patients receiving them. Few significant side effects were
observed in clinical trials, and post-marketing reports of
adverse events have been very limited when considered in
comparison to the very large number of persons safely
receiving these drugs. Even so, these drugs are not entirely
free of side effects, and as for all drugs, they should be used
appropriately and judiciously. This advisory encourages the
appropriate use of statins while pointing out the possibility
of side effects in certain patients. If statins are used with
appropriate caution in these selected patients, the likelihood
of developing clinically important myopathy should be
substantially reduced.

The FDA report comparing the rate of fatal rhabdomyolsis
among different statins is of considerable importance
(10). The FDA performed a detailed review of all reports of
fatal rhabdomyolysis in their Adverse Event Reporting
System and obtained the number of prescriptions dispensed
since marketing of each statin began in the U.S. Fatal
rhabdomyolysis was extremely rare (less than 1 death/
million prescriptions)."

Statins have been a big help to me as I was unable to control my LDL with diet and exercise alone, even after losing 60 pounds. They have dropped my LDL as low as 58 and my total cholesterol as low as 130 so I'm happy. The majority of side effects will present themselves within the first 12 weeks so make sure to mention any you experience to your doctor.

Good luck,

Jon

[ed34]

Actually I would just like to add something here. Last year, statin drug companies were pushing the UK (not sure if it was happening elsewhere in the world) to put statins as an over the counter item in chemist shops, so anyone could pop in and buy a box full. I'm not so sure if this has happened but isn't this a high risk to the general population? I always thought that when you start statins you have to have a blood test to check liver function? The fear felt by most doctors over here is that it would misleadingly promote obesity. People will be eating lots of fatty foods thinking that popping a statin into their mouth afterwards will stop them getting fat.

[ed34]

Have you also looked into all the new research which seems to be suggesting how statins can adversly affect your health? If I had low cholesterol, I certainly wouldn't be taking any medication if I had the choice not to. New research is showing that short term memory is affected in many statin takers, CoQ10 coenzyme used in energy production in every cell is severely reduced and many others.
To put this in perspective, you have a patient living with heart problems which have gradually built up over years. Over that time they have become less fit, but so gradual most people simply say "oh im getting old". When they have a heart incident, get stented or have bypass surgery, they are put on statins. They then feel their benefits from the surgery but have no idea if they would feel better if they didn't take statins. They simply say "I feel fine" but there is no control in the test. If they were told they could come off statins, maybe they would suddenly feel much better, not realising how statins were affecting them. I have read some comments where people have stopped statins and said how much better they feel.
I know I have to take them, unfortunately I have familial hypercholesterolemia. Even if I ate no fat at all, my Liver would be having a field day producing too much LDL from other substances.
If I was in your shoes and had low cholesterol, I wouldn't even consider taking them.