*Not* taking statins

[BoodaGazelle]

I have (familial) high cholesterol. After reading extensively online (research papers etc) as well as "The Great Cholesterol Myth" and "Bad Pharma", I decided to stop taking Crestor. I had been on it a couple of years, at a pretty low dose, and (full disclosure) it *did* make my numbers much better. Originally, I did experience some muscle weakness, but it was endurable.


Still, since I had *none* of the indicated reasons for taking it other than the numbers (i.e. no previous heart disease, no familial heart disease, good weight, exercise, never smoked), I decided to "bleep it" and told my doctor (after giving him the TGCM book, which he read) that I wasn't going to take it anymore.


I am not interested in rehashing the details of pro vs con statins.


I was wondering if anyone else has made a similar decision.


Thanks,


Bood

 

[braumeister]

Same here. I let my doc talk me into taking a statin 20 years ago, and took them for around ten years. By then I had read enough that I don't believe in them in my case. I think they are a valid treatment for some people, but I'm not one of them.

If you search for statins here you'll find a lot of threads that discuss them.

 

[BoodaGazelle]

Thanks... I know it has been discussed here... I probably participated in them! Still, I just got back from my physical, and it came up again. It is not easy to stand up to it, and I really can't/don't want to argue about it.


I guess I was looking for confirmation that I am not the only one.


The book "Bad Pharma" was really *after* I had made this decision, but it is pretty interesting to look at how our healthcare system works.

 

[Chuckanut]

I sort of made your decision. I say 'sort of' because in my study of cardio vascular disease two things stood out -

Lowering LDL is important, more important than raising HDL, maybe not as important as lowering Trigs.
The first small dose of a statin gives the biggest bang for the dose. Each doubling of the dose only decreases LDL by another six percentage points (absolute not relative).

So, I use a lowest-dose statin. Most of the benefits, with a smaller chance of undesirable side effects. It appears that the Law of Diminishing Returns applies to this medicine. If I have misinterpreted this, somebody please correct me.

https://gpnotebook.com/simplepage.cfm?ID=x20130329085540685340

if the dose of a statin is doubled then there is an approximate 6% increase in LDL lowering efficacy by doubling the dose - the so-called 6 percent rule

• for example
  • rosuvastatin statin 5mg produces an approximate LDL reduction of 40% - if the dose of rosuvastin is doubled to 10mg then there is an approximate 46% LDL reduction expected with this dose of rosuvastatin
  • pravastatin 20mg produces an approximate LDL reduction of 24% - if the dose of pravastatin is doubled to 40mg then there is an approximate 30% LDL reduction expected with this dose of pravastatin
• the "6 percent rule" holds approximately for all statins (1,2)

 

[H2ODude]

Only indication I had was LDL of around 120. It had been dropping for 3 years and then when PCP retired new one prescribed Crestor. Never discussed it with me, just found out by pharmacy saying it was ready a week after annual exam. I had a friend who suffered massive problems w leg muscles from statins. So to answer your question, I never took a one. And every year I drop a point or two.

 

[Dash man]

I recommend you ask your doctor for a prescription for a Cardiac Calcium Score. Its basically a CT scan of your heart. It’s not covered by insurance, but is typically less than $200.
You can google what the scores mean. My results got me watching my cardiovascular system much more closely. My cardiologist highly recommended it and refers to it at every appointment. I have my regular three year nuclear stress test next week.

 

[RunningBum]

Trying to remember the exact conversation I had with my doc. Basically he would rather keep me off statins and encourages me to stay active to avoid them. If my health changes he said we'd talk about it.

 

[sengsational]

It's my belief that this recent podcast has some of the best, current information on the topic: https://peterattiamd.com/tomdayspring6/

It's Peter Attia (clinician) and Thomas Dayspring (very long-time lipidologist and not a statin "fan-boy").

The bottom line that I took away from the discussion is that apoB is a more important target than LDL-C, and that is why, on the last such discussion on this board, I said I'd fire any doctor that didn't test apoB. Also, a one-time measurement of LP(a). And if you're still on the fence, get a calcium score. These doctors have a lot to say about how they treat their patients and whether they put them on a statin. One thing Dayspring said was he wasn't on-board with slamming people with a full dose that was used in the studies. Instead, he uses the smallest dose to move apoB. You get a good response from some people, and no response from others. The kind of response will determine a next step.

Every time I hear these guys who really pay attention to this stuff talk, I feel short-changed by any typical doctor nowadays (quaking in their boots, afraid of their megapractice, medi-business, green eyeshade, DGAS about patients, experts at coding to maximize billing, blah, blah).

 

[Peter]

I recommend you ask your doctor for a prescription for a Cardiac Calcium Score.

After getting a surprisingly low calcium score, my PCP agreed that I did not need to take statins.

 

[skipro33]

Yes I stopped and here's why;
I've been badgered by my doctor for years that I have high cholesterol and that I should be taking a statin. She kept saying it would reduce my risk of heart attack by 50%.
Well, who doesn't want to reduce their risk of heart attack by 50%, especially since it's the leading killer of folks my age and older? Finally, I asked her some questions;
1. What is my risk of heart attack if I don't take a statin. She said 92% of people in this group will not have a heart attack, 8% will.
2. What would be my risk of heart attack if I had good C level and did not need the statin. She said 95% of people in that group would not have a heart attack, 5% will.
3. A difference of 3% between the two standards; those with high C and those without regarding heart attack. So the statin reduces my risk by 50%. 50% of 3 percent is 1.5%. A lifetime of taking a statin will reduce my risk of a heart attack by 1.5% compared to my current risk without taking it. She smiled and said yes.

So do the math and see if reducing your risk of heart attack by taking a statin really reduces your risk by much, if any, at all. 50% of the difference between a low C person and a high C person is just 1.5%. The whole difference is just 3%.

 

[razztazz]

I was on Lipitor for 3 1/2 years from 1998 to 2001. Side effects. Some permanent. All clearly listed. All denied by the doctor. (Must be elves. No way drug caused them. And even if they did you must keep taking them.) I've been over this here probably more than once over the years so it might sound familiar. I stopped taking it unilaterally.

Calcium scores were not alarming. I was one of the first people "on the street" to get a scan when they came out. I was always active. Weight textbook. Low BP/ slow heart rates.

As you might recall from last June I had a serious heart attack and 2 weeks ago had a pacemaker and defibrillator installed. I am currently on 5 mg of rosuvostatin. Partly to humor my doctor but also because I am aware that while statins are nearly useless for those without symptoms or previous heart attacks, they do have a measurable positive effect on people who have had a heart attack or a bypass. And the effect has little to do with lowering cholesterol. It's from making blood vessels more pliable.

Now Le Grand Question is: IF I had kept taking lipitor for the last 17 years would I still have had the heart attack and ensuing complications? Apparently the studies say "yes." While I was in the hospital and going over lifestyle, diet, exercise, stress levels, whether or not I own a dog or a cat with several doctors, and "passing the tests" one thing I kept hearing over and over and over again was "Well, sometimes it's just your genes."

I suspect the statins wouldn't have saved me. They'd have killed or crippled me years before I had a heart attack and even if not, you can't prove they would have prevented an eventual heart attack anyway. (In fact they did cripple me but I outlasted it.)

 

[Dash man]

After getting a surprisingly low calcium score, my PCP agreed that I did not need to take statins.

My calcium score was through the roof at over 1,100. I was put on 40 mg Atorvastatin and haven’t had any side effects. Apparently statins help if you do have heart disease already, so I’m on it.

 

[athena53]

It's my belief that this recent podcast has some of the best, current information on the topic: https://peterattiamd.com/tomdayspring6/

It's Peter Attia (clinician) and Thomas Dayspring (very long-time lipidologist and not a statin "fan-boy").

I looked into this podcast after you recommended it earlier. Thank you, thank you, thank you! I don't know where he gets all these brilliant, thoughtful, eloquent doctors but I've learned so much.

My experience: doc prescribed Prevastatin around 6 years ago. Numbers got a little better but after 6 months I had tendonitis so bad it hurt to raise a spoon to my mouth- and my knees were starting to hurt. I did some research and threw the statins away. Slowly I returned to normal. I've chosen to manage it through diet and exercise and numbers are fairly stable- I get tested every few months so I can tweak if necessary.

In January I need to get an echocardiogram to check out a slightly enlarged heart (found in a breast MRI, likely due to lots of exercise) and plan to ask the doc about the calcium scan. I'm 67 and haven't had any heart health tests other than a lipid panel so I guess it's time.

 

[sweetana3]

My doctor wanted me to take them. She went on and on and on. Then she got the bright idea to show me my statistics show I would die early. She input all my data and was surprised I had NO increased chance of death. Shut her up regarding statins.

 

[Teacher Terry]

Years ago my numbers were over 200 and the doctor suggested statins and I said no. She hasn’t mentioned it again.

 

[Dtail]

My calcium score was through the roof at over 1,100. I was put on 40 mg Atorvastatin and haven’t had any side effects. Apparently statins help if you do have heart disease already, so I’m on it.

I was on 20mg of Atorvastatin, but suffered a lot of muscle cramps, which I already have some due to Pickleball.
I am weaning off it and will discuss alternatives with my doctor at my upcoming physical.

 

[OldShooter]

This amazes me. My system is to find a doc I trust and then to take his/her advice. We talk a lot, and I ask questions. That's one of the ways I develop my trust level.

I don't have the education and experience to do a quality survey of the medical literature and draw valid conclusions from it. I also do not have the skills and judgment that come from years of clinical experience. Going even further, trying to personally evaluate and act on youtube and podcast medicine boggles my mind.

YMMV, obviously.

 

[athena53]

I'm no doctor- totally agreed- but it's my body and I bear the consequences of whatever treatments, lifestyle changes, etc. I accept. Any good doctor will tell you that there are uncertainties and there are disagreements among the experts. Most conditions don't have "cookbook" definitions, prognoses, treatments, etc. that fit every case. Few docs have time to read every scientific article even though they may want to.

So.. in the end I make my own decisions given input from credible sources (including my PCP). If I'm wrong I'll accept full responsibility.

 

[BoodaGazelle]

I did have a cardiac calcium test. I forget the score number, but it showed me as average for my age... IOW, no worrisome blockage.

 

[BoodaGazelle]

>>>>I've been badgered by my doctor for years that I have high cholesterol and that I should be taking a statin. She kept saying it would reduce my risk of heart attack by 50%.
Well, who doesn't want to reduce their risk of heart attack by 50%, especially since it's the leading killer of folks my age and older? Finally, I asked her some questions;
1. What is my risk of heart attack if I don't take a statin. She said 92% of people in this group will not have a heart attack, 8% will.
2. What would be my risk of heart attack if I had good C level and did not need the statin. She said 95% of people in that group would not have a heart attack, 5% will.
3. A difference of 3% between the two standards; those with high C and those without regarding heart attack. So the statin reduces my risk by 50%. 50% of 3 percent is 1.5%. A lifetime of taking a statin will reduce my risk of a heart attack by 1.5% compared to my current risk without taking it. She smiled and said yes.

So do the math and see if reducing your risk of heart attack by taking a statin really reduces your risk by much, if any, at all. 50% of the difference between a low C person and a high C person is just 1.5%. The whole difference is just 3%.

>>>>






This is pretty much the way I saw it after doing a lot of investigation.

 

[BoodaGazelle]

not Youtube

This amazes me. My system is to find a doc I trust and then to take his/her advice. We talk a lot, and I ask questions. That's one of the ways I develop my trust level.

I don't have the education and experience to do a quality survey of the medical literature and draw valid conclusions from it. I also do not have the skills and judgment that come from years of clinical experience. Going even further, trying to personally evaluate and act on youtube and podcast medicine boggles my mind.

YMMV, obviously.

I cannot speak for others, but there is a lot of information that is pretty well documented by referring to the scientific literature. I trust my doctor, but I have to assume he is not immune from the pressures all doctors face if they don't adhere to the accepted wisdom.


Clearly, some people do benefit from statins, but it is much more narrow than those who are told they have to take it.

 

[motley]

This amazes me. My system is to find a doc I trust and then to take his/her advice. We talk a lot, and I ask questions. That's one of the ways I develop my trust level.

I don't have the education and experience to do a quality survey of the medical literature and draw valid conclusions from it. I also do not have the skills and judgment that come from years of clinical experience. Going even further, trying to personally evaluate and act on youtube and podcast medicine boggles my mind.

YMMV, obviously.

Tactfully put.

I had high cholesterol (despite a good diet and exercise) and was put on a statin. The numbers dipped considerably. I too will take clear, hard evidence and the advice of a doctor with the expertise vs "the internet."

To each their own

 

[BoodaGazelle]

Thanks to all for replying! I fully understand that it sounds a little ridiculous to try and talk a technical paper with your doctor, but I am also pretty sure that most people who have ER'ed are smart enough to get the main points.


One of those points is how much wiggle room all of the pro-statin papers have. There is no evidence that, outside the parameters in my OP, they help people avoid bad outcomes that they might not have had anyway.


They may not hurt you, and if so, probably you should take them if your doctor tells you to. But read "Bad Pharma" anyway.

 

[cooch96]

This amazes me. My system is to find a doc I trust and then to take his/her advice. We talk a lot, and I ask questions. That's one of the ways I develop my trust level.

I don't have the education and experience to do a quality survey of the medical literature and draw valid conclusions from it. I also do not have the skills and judgment that come from years of clinical experience. Going even further, trying to personally evaluate and act on youtube and podcast medicine boggles my mind.

YMMV, obviously.

I believe most of us here aren't formally trained Financial Planners either, but there's a general consensus "Nobody cares about your money like you do, so figure out as much for yourself as you can." Wouldn't it be the same about your health?

Money and politics corrupt, and there is plenty of both in the health industry. I think it wise for people to get additional perspectives from disinterested parties.

This is anecdotal, but I went to several medical and veterinarian social functions in my 20's in both the MidWest and East Coast (I was trying to date up). Everytime I was surprisingly underwhelmed at the average intelligence in the room. I was also shocked to hear how they were trained to push opiates to patients and completely discount any risk of addiction. I believe there's definitely a cultural group-think in the community, starting in medical school. It was opiates a couple decades ago, and statins and induced labor today.

 

[BoodaGazelle]

@Motley
>>>I too will take clear, hard evidence and the advice of a doctor with the expertise vs "the internet."


Really unfair to say "the internet" without acknowledging that literally *all* scientific information is there... that is what I specifically referred to. Not to mention that many of the doubters are MDs and specialists themselves.



Anyone who feels like they cannot sort through it should stay away from it.


Thanks again to all who replied to my story...