Statins and memory loss.

Aches and pains have been a normal part of aging for me. I usually ignore them and carry on. When I first went on Vytorin at age 58, the warnings about possible serious side effects and the necessity of reporting muscle pain scared me a lot. At first, I worried about every pain that I felt. I have been on it a year by now, though, and seem to be doing all right. Was your pain very marked and obviously not normal? Just curious because I am not sure if I would know what pains to report.
I noticed both of my upper arms becoming sore about the same time for no apparent reason...no heavy lifting or reaching involved in the day or two before I noticed the change.

I found it hard to bend my arms behind my back far enough to tuck my shirt into my pants and if I strained in the least I could throw the muscles into a mild spasm pretty quickly.

It's been several months and the pain has lessened considerably but is still there. The muscles no longer go into a spasm that way, either.

I'm 59 years old, so I know what you mean about aches and pains. I've learned to lived with them but that, in itself, kind of scares me when I think that I may be ignoring something that I shouldn't ignore. It's the old Catch 22, I guess.
 
I noticed both of my upper arms becoming sore about the same time for no apparent reason...no heavy lifting or reaching involved in the day or two before I noticed the change.

I found it hard to bend my arms behind my back far enough to tuck my shirt into my pants and if I strained in the least I could throw the muscles into a mild spasm pretty quickly.

It's been several months and the pain has lessened considerably but is still there. The muscles no longer go into a spasm that way, either.

I'm 59 years old, so I know what you mean about aches and pains. I've learned to lived with them but that, in itself, kind of scares me when I think that I may be ignoring something that I shouldn't ignore. It's the old Catch 22, I guess.

Thanks for the info. That does sound like it was a bit more than my usual aches and pains, at least at first.
 
I'm concerned that these cholesterol-lowering drugs seem to put a heavy load on the liver. Isn't there a new one out now that works another way? I'd like to be able to make an alternative suggestion to my doctor when we get the results from my blood test. I am going to take the test Thurs morning and I'll probably have her writing me a prescription for something on Friday.

Of course there are always people getting ready to sue someone, but I have read where there are so many people getting sicker and sicker from the use of these drugs that a class action suit is being considered. No I don't have a link or article or stats. I just remember reading a lot about it lately and I was interested because I know my doc is going to try to put me on one of these drugs soon.

I have always had muscle pain and spasms. That is just a way of life for me. If it was any worse than what I normally have, I wouldn't be able to stand it.
 
[rambling observations]
There is always a dilemma for doctors - even the compassionate and understanding ones - in reacting to patients' strong-held belief in one or another alternative medicine or in the fact that some medication is causing a symptom which is not generally reported as a side effect.

Many such patients shun prescription medications with thousands of patient-years of reseach and surveillance in favor of "natural" remedies which are generally weakly tested by acceptable standards (testimonials and vague plausible but unproven theories are not research). I never contest personal anecdote, but a series of one is, well, anecdote. Sometimes I see patients report personal anecdotes directly opposite from those of a person I saw earlier that day. "I don't care what they say, this stuff makes me feel stronger and I swear it has increased my IQ" versus "I don't care what they say, this stuff has me feeling weak and I can't concentrate" both on a drug in which neither side effect occurs more often than with placebo if you "blindly" look at 10,000 patients.

Some such patients deprive themselves of potentially life-prolonging treatments. Others are victims of tryptophan-like (i.e. fatal, for you youngsters) reactions from "safe" alternatives. But it does sometimes appear ironic how quickly some accept a web site's hype while rejecting things that are about as proven as you can get in health care. I have my theories as to why this is so, but I digress.

When I see such a patient where the prescribed drug is clearly of important benefit (outweighing the risks) I usually start with the basics. What are their fears? Are lifestyle issues optimized? In the end my goal is not to convince them to take or reject my recommendations, but rather to have them fully understand the issues I am seeing. I never discuss benefits without discussing risks. I always document their refusals and my advice.

Finally, if they choose to strike out on their own (through refusal or taking something unorthodox), I let them know that I am not rejecting them as people or patients, I just excuse myself from the consequences of their deviating from my best advice, but they are encouraged to come back to see me just as they have over the years. Global rejection of patients who demonstrate one iota of "alternative" leanings is not rare, but is very harmful and unethical in my view.

Compliance often increases in keeping with the seriousness of the condition. Just wish it had done so earlier when the condition might have been controlled or prevented.
[/rambling observations]

Then again I kind of like this part of my job. It really digs into human nature and decision-making. We are a marvelously chaotic species, thank goodness.
 
ERD50,
It is my understanding that Vitamin C acts as a natural statin, strengthening your artery walls. I cannot refer you to specific sites as I did this research awhile ago. You need to dig through the many sites regarding this topic, if you are interested. I can state that after taking 12 grams of C / 6 grams of L-lysine a day my LDL dropped over 25%, with no diet change. I showed these results to my doctor and he was not the least bit interested. Then he started on the statin pitch.

Billy
RetireEarlyLifestyle.com


Thanks very much, Billy. How long did you take these before your cholesterol dropped? I'm not surprised your doctor wasn't interested. As I understand the medical profession, they are not interested in any anecdotes unless backed up by double-blind clinical studies.

Nords: I meant to say that nicotine (not caffeine) raises dopamine. Weird that my slip up is also true. That explains everything about my coffee addiction!
 
Rich,

I appreciate the dilemma for a doctor, and I am sure it harder and harder to convince some people that you know more than they do. After all, they have done 30 minutes of research on the internet so they know everything. :D I am sure it frustrates you. It would me. And I am probably one of those 30-min researchers. :rolleyes:

I am not taking any prescription drugs at age 60 (or alternative treatment either), and I would love to make it another 10 years without having to start. My mother's twin sister took about 20 drugs per day, my mother takes about 10. I hate the thought of ending up like that.

My cholesterol 3 mos ago was 237, LDL 163, HDL 52 for overall Chol/HDL ratio of 4.54 with triglycerides 110. Have never smoked, have BP about 126/75. I really don't want to take a cholesterol lowering drug unless it appears I absolutely need to. I hate all of the "potential" side effects of prescription medications; they just scare me. Some people run to the doctor for a pill to fix everything. Not me. But if I absolutely have to, i.e. I'm going to stroke out or have a heart attack if I don't take statins, then I guess I have to go for it.

And no, I have not done everything I can to change my lifestyle to avoid drugs. I have cleaned up my act significantly in the last 3 months, but I'm still afraid that the results will not be good enough.

We shall see what Thursday's blood test indicates.

Thanks!
TG
 
I started in February with 4-6 grams per day. In April after further research, including all of the detriments of statins, I increased it to 12 grams and added 6 grams of L-lysine. It would be much less expensive and less of a hassle for me to take the statin. I would not have believed the results either except that I was the one tested. And there are no side effects. I purposely did not alter my diet so that I would know if I had results.

I do own some big phrama, and have no ownership in any vitamin co. that I know of.

Speaking about alternative medicines, the Chinese have been at this stuff for 5000 years. Do they know something we don’t? I prefer to have a open mind and am willing to look at all information.

I guess website hype is different from TV hype where every other commercial states “call your doctor” .

Billy
RetireEarlyLifestyle.com

 
As I understand the medical profession, they are not interested in any anecdotes unless backed up by double-blind clinical studies.

Oldbabe, what other standard would you propose we hold to for drug-related decisions, realistically?

Imperfect and incomplete as high quality research evidence may be, it is the best we have if not contaminated by pharmaceutical company interests. When no such evidence exists, we fall back on biologic plausibility. If the issues appear to be more spiritual than physical we need to be open to that too.

Knowing the evidence is the sine qua non of being a good doctor, though there is so much more. Anecdotes should always be carefully listened to and valued, but not necessarily used as the basis of practice, at least for me.

Reading between the lines a little, I wonder if your doctor just isn't listening to you very well, period. It may be less about anecdotes v. evidence than about providing a kind and patient relationship where you truly feel like you are being heard.
 
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Interesting - I had the 'cholesterol scare - if you don't lower this, you're going on statins' speech a few months ago - the MD gave me 6 months and then wanted a retest before the statin routine would start. Little did he know I work with cardiologists everyday and started asking lots of questions of them as well as doing my own research. My family history is of higher cholesterol on my father's side and high blood pressure on my mother's side---I don't have high blood pressure and only recently had the cholesterol spiked a bit - I had hovered around 200 or so and then it had gone up 20 or so points in the last few years. I work out close to daily and eat a healthy diet as well.

I tried regular niacin and had one he!! of a hot flash - was one of the weirdest things I've experienced - and that was at only 50 mg (need to go up to 1500 mg for therapeutic benefits). I then read about inositol hexaniacinate - or no flush niacin, which is prescribed in Europe for circulatory benefits as well as cholesterol lowering benefits - I did this on my own for a month before the cholesterol test - and I only took one 500 mg pill daily - results, a 30 point drop in my cholesterol, the MD congratulating me and me not telling him I was going to find another doc if he persisted in the scare tactics.

I am very fortunate that I have access to professionals and this information - your mileage may vary, but it is worth doing your own research for other ideas.
 
Transient Global Amnesia: Another Statin Side-Effect?
Former NASA astronaut and USAF flight surgeon Duane Graveline, MD, believes that the statin drug Lipitor caused his own case of transient global amnesia (TGA) —a statin drug-associated memory dysfunction experienced while flying (see Statins and the Flyer .
Dr Graveline believes that these drugs are the cause of a recent epidemic of TGA to hit emergency rooms and, fearing the dire possibilities with airline pilots who take statins, he has begun a crusade to educate the medical profession and public about the potential danger of cholesterol-lowering drugs. He has written a book, Statin Drugs: Side Effects and the Misguided War on Cholesterol (see the Spacedoc.net website).

Billy
RetierEarlyLifestyle.com
 
Oldbabe, what other standard would you propose we hold to for drug-related decisions, realistically?

Imperfect and incomplete as high quality research evidence may be, it is the best we have if not contaminated by pharmaceutical company interests. When no such evidence exists, we fall back on biologic plausibility. If the issues appear to be more spiritual than physical we need to be open to that too.

Knowing the evidence is the sine qua non of being a good doctor, though there is so much more. Anecdotes should always be carefully listened to and valued, but not necessarily used as the basis of practice, at least for me.


Apparently, in the context of my post, my statement came across as critical. Not at all. I was stating what I understood to be true , as you have also explained in the above. Hope you were not offended. I really value your contributions on this board. :)
 
I was stating what I understood to be true , as you have also explained in the above. Hope you were not offended. I really value your contributions on this board. :)

Of course, no offense taken whatsoever.

Just curious about your statement, "As I understand the medical profession, they are not interested in any anecdotes unless backed up by double-blind clinical studies."

This seemed to imply in context that such an approach was troubling to you so I was hoping you might expand on that. In my opinion, patient anecdotes are highly valuable, interesting, and important, but they are not "evidence" in the sense the word is used for drug research, etc.

I'm interested in your opinion.
 
...But it does sometimes appear ironic how quickly some accept a web site's hype while rejecting things that are about as proven as you can get in health care. I have my theories as to why this is so, but I digress.

It really digs into human nature and decision-making. We are a marvelously chaotic species, thank goodness.

I'm fascinated by this also Rich. I have my own theories. In a nut shell, people want to believe what they want to believe ('no, my son/daughter would never do drugs/steal/cheat etc', even when confronted with the evidence).

In this thread alone, we have seen some pretty low thresholds for acceptance of 'alternative' treatments along with very high thresholds for conventional treatments. Alternatives seem to get positive responses from a casual, 'I took it and it worked for me', but conventional treatments are rejected because 'someone read somewhere that someone had trouble', despite the results of large studies that do not indicate that problem. I don't mean to 'pick' on anyone in this thread, it is just an observation.

I did a small amount of research. Wiki is pretty good for these things, IMO, because people weigh in on both sides of an issue. For anyone that is interested, check these out:

Vitamin C megadosage - Wikipedia, the free encyclopedia

Statin - Wikipedia, the free encyclopedia

Nut shell time again: There doesn't seem to be anything to back up multi-gram Vitamin C improving heart-health, and the 'liver problems' alluded to with statins seem to occur about the same rate as in a placebo. Rhabdomyolysis affects about one in 20,000 people. Who knows what problems would occur if we had records on 20,000 people taking 6 grams of Vitamin C?

To tie this back to investing, it seems more like listening to a hot stock tip from somebody's cousin's mailman, versus buying an index fund.

Speaking about alternative medicines, the Chinese have been at this stuff for 5000 years. Do they know something we don’t? I prefer to have a open mind and am willing to look at all information.

Billy, I have an open mind to alternative treatments. Subject those treatments to a large controlled study to evaluate their effectiveness and risks, and then we have some info we can use to decide if we want to take them. W/o that info, I'm not certain what to be 'open minded' about.

Interesting info here:

Traditional Chinese medicine - Wikipedia, the free encyclopedia
many Traditional Chinese medicine treatments are based on their apparent basis in magical thinking — for example, that plants with heart-shaped leaves will help the heart, or that ground bones of the tiger can function as a stimulant because tigers are energetic animals.
Just because someone has believed it for 5000 years, does not make it so. I think it was believed far longer that the Sun circled the Earth. Or that spontaneous generation explained how maggots appear in meat.

Again, just observations.

-ERD50
 
http://www.cure-guide.com/Natural_Health_Newsletter/Statin_Drugs/statin_drugs.html

http://whale.to/a/fonorow.html#•_High_Blood_Pressure/Hypertension

http://www.brownmccarroll.com/articles_detail.asp?ArticleID=245

ERD50,
If you want to take Statins I say go for it. All I am saying is that with a little effort you can find a load of information conflicting what Western doctors are promoting. The case study of myself is only one, but for me, it’s the most important one. We all must take responsibility for our own decisions and health. Again, I would not have believed my results except that I am seeing them. If they did not produce positive results I would have been the first to dump the vitamins. I am in Thailand right now and the vitamins are imported and not cheap as they are in the US. The statins on the other hand costs little, and I can purchase them over the counter. (Btw, you need to take more than 6 grams of C per day.) Whether it would work for you is anyone’s guess, but if one’s not willing to think out of the box then they would never know, right? I didn’t retire at 38 following what everyone else was doing. In fact when everyone goes one way it scares the heck out of me, and I tend to look for alternatives. We all are going to end up the same way. I can see the markers now. “They died with great cholesterol numbers.”

"In your nutshell", we are complex human beings and one pill doesn’t fit all. There are many ways to lower cholesterol if that is your goal. A cardiologist I know swears by the niacin route, and tells me he would never take a statin. He’s retired and sailing around the world. So, what do we make of this?

Again it’s a personal decision to take control of your health and live or die by the outcome.

Good health to you,
Billy
RetireEarlyLifestyle.com
 
All I am saying is that with a little effort you can find a load of information conflicting what Western doctors are promoting. The case study of myself is only one, but for me, it’s the most important one.

I disagree. A case study of ONE does NOT conflict with trad med. A case study of thousands is required for that.

And I did look at the links you provided. Thanks, but they don't make much of a case that I can see. They are filled with flawed logic.

A) Just because a DEFICIENCY of Vit C results in heart disease, it does not follow that above 'normal' doses will provide more protection than 'normal' doses. 'More' is not always 'better' than 'enough'. Try adding 5 extra quarts of oil to your car's crankcase.

B) They draw conclusions from small samples - 'USAF flight surgeon Duane Graveline, MD, believes that the statin drug Lipitor caused his own case of transient global amnesia'

Do I think there is a conflict of interest between Doctors and the Pharma industry? Yes (although I certainly will not accuse all doctors of abusing this). There are conflicts of interest everywhere we turn (I think I said this on another thread), we need to try to deal with them., but not throw the baby out with the bath water.

And I don't buy the conspiracy theories of suppression of data on Vit C. You talked about how expensive 12 G of Vit C is. Seems to me there is plenty of economic incentive for the Vit C group to go out and fund a study and take all that money away from the mainstream Pharma industry. Good old capitalism at work.

If I were to believe this train of thought, I would also believe that Polio vaccine studies, for just one example, would have been suppressed. After all, the medical community could make so much more money treating polio than vaccinating against it. etc, etc, etc.

We all must take responsibility for our own decisions and health. Again, I would not have believed my results except that I am seeing them.


Agreed, but I am curious about something. How do you know the Vitamin C and
L-lysine are really responsible for a 25% decrease in your LDL? Those numbers vary reading-to-reading. There could be many things responsible for it, unknown to you. Have you tried eliminating the Vitamin C and L-lysine to see if your LDL goes back up?

NOTE: I just looked at my records. I have had changes of -18% and increases of 26% between sequential readings (every 6 months), with no known lifestyle changes. What to make of that? Some larger changes when I did changes lifestyle (diet, exercise).


I didn’t retire at 38 following what everyone else was doing. In fact when everyone goes one way it scares the heck out of me, and I tend to look for alternatives.

Sure, but we need to be careful how we apply that. Silly analogy to make a point: Every living person I know breathes. So is that a bad thing? IMO, you are painting with very broad brushes.

Again, I have NO problem with seeking alternatives. What I don't understand is why those alternatives are not held to the same standard of scrutiny for efficacy/risk as the mainstream approaches. If I am going to follow an alternative investment approach, I want some data to back my decision. Buying one penny stock and seeing it double does not mean buying penny stocks is a good plan.


A cardiologist I know swears by the niacin route, and tells me he would never take a statin. He’s retired and sailing around the world. So, what do we make of this?

Nothing. Again, a very small sample.

I hope it does not seem as if I'm trying to do battle with you here, Billy. Do as you see fit. I just have a tendency to question (and seek input) on claims that appear to go against my understanding of science, logic and statistics.

-ERD50
 
Excellent post ERD50,

The idea of suppressing Vitamin C data by a vast conspiracy made me think of asprin. Every time I turn around another study has found another benefit of asprin. Since it's OTC and really, really, cheap, would there be an incentive for this conspiracy to focus on it to pump up sales of their pescription heart medicine?
 
As somebody else mentioned, Niacin is cheap and effective. Here's a simple comparison of Niacin and statins:

talk033__s034_f.gif


Ask your doctor first of course. I assume docs don't recommend Niacin more because compliance is low due to "flushing." But that's a harmless side effect.
 
As somebody else mentioned, Niacin is cheap and effective. Ask your doctor first of course. I assume docs don't recommend Niacin more because compliance is low due to "flushing." But that's a harmless side effect.

Niacin is effective in selected cases. It is part of standard-based care. I prescribe it occasionally.

You are incorrect about flushing being a harmless side-effect, at least for many. It is very uncomfortable, can make you turn beet red, itchy, lightheaded and can be briefly disabling. Most patients who experience it will not use the drug again. The pricier long-acting versions cause this less often compared to the short acting but it still occurs.

Niacin causes liver disease much like statins. It raises blood sugar in many patients. It can precipitate gout in susceptible people. It is not a totally benign drug.

Cost aside, if I had to choose between niacin and a statin for comparable reasons and efficacy I would probably choose a statin. But for certain people (e.g. low HDL and high triglycerides with normal LDL, no contraindications, and aware of the side-effects) niacin can be a reasonable alternative.

But it is interesting that since niacin is over-the-counter, has been deemed a "vitamin" and has a long, traditional history it is touted as a "natural" alternative to statins (statins occur naturally in certain plants).

Bottom line is that all medications including "natural" remedies need to be treated with respect and need to be carefully tested for safety and efficacy. Don't get suckered into assuming an agent is either safe or effective because it is marketed as organic-natural-complementary-alternative or whatever.
 
Niacin causes liver disease much like statins.

Is there evidence that the immediate release formulation causes liver damage? I thought that only the extended release forms were implicated. The immediate release form will cause more flushing, but it is also removed from your system fairly quickly.
 
Both do it, long-acting less than short-acting. One brand claims not to cause it but that claim is questionable. Then again, short-acting versions need to be taken at least twice daily, and flushing is present in up to 80%.

No free lunch here. Statins start to sound not so bad if you need treatment.
 
Btw, you need to take more than 6 grams of C per day.) Whether it would work for you is anyone’s guess, but if one’s not willing to think out of the box then they would never know, right?
Pauling mentioned once that of his 10,000 milligrams of daily vitamin C he was flushing at least 8000 mg through his kidneys. (I remember his interview quote: "I thought to myself: No one else had studied this and I wanted to find out. After all, I'm a biochemist and I know how to measure these things!") No word on where the other 2000 mg ended up... sure hope they didn't find it during his autopsy.

I'd happily OD on the entire vitamin alphabet if not for the nagging concern that someday there'll be negative side effects from the massive filtering load on livers & kidneys. This isn't like adding fiber to a diet-- this is forcing the body to work twice as hard at filtering out what it perceives to be "waste" and "poison". I've already felt betrayed by the cumulative effects of decades of pain-free blissfully-ignorant damage to my knees and I'm less sanguine about megadoses.

This reminds me of the glucosamine/chondroiton paradox. I've watched those substances make aging polo ponies cavort like foals, and old dogs act like puppies. I have yet to see a reputable double-blind controlled study concluding the same for humans. I've tried it myself for a couple months and haven't seen a significant difference, let alone a placebo effect or a difference that could be accredited to their effect. So until the evidence piles up in favor, I'll sit on the sidelines and try other methods.
 
Both do it, long-acting less than short-acting.

I need help with parsing that sentence. Long-acting niacin has *less* negative effects on the liver than short-acting immediate release niacin? That is opposite from my understanding:

Long-acting niacin has a higher risk of liver problems than other types of niacin
 
This reminds me of the glucosamine/chondroiton paradox...I have yet to see a reputable double-blind controlled study concluding the same for humans. I've tried it myself for a couple months and haven't seen a significant difference, let alone a placebo effect or a difference that could be accredited to their effect. So until the evidence piles up in favor, I'll sit on the sidelines and try other methods.

You didn't get the memo:

Clegg DO et al. N Eng J Med. 2006:354: in patients with osteroarthritis of the knee, glucosamine, chondroitin sulfate, or both did not differ from placebo for pain relief.

Randomized, placebo controlled, high quality, 6 month trial, 1583 patients over age 40. Used a well validated pain score (WOMAC) and success was determined by a 20% improvement. 60 to 67% of patients had successful outcomes -- whether in the placebo group or the experimental group (neither knew which they were taking).

It's often these waxing and waning conditions which attract invalid drug success claims, and this is why placebo control and blinding are so important. So in this study if you took vitamin C you could also have claimed a 65% success rate. Or for string beans.

Previous studies showing mild benefit were flawed by patient size, publication bias and design flaws.
 
60 to 67% of patients had successful outcomes -- whether in the placebo group or the experimental group (neither knew which they were taking).
It's often these waxing and waning conditions which attract invalid drug success claims, and this is why placebo control and blinding are so important. So in this study if you took vitamin C you could also have claimed a 65% success rate. Or for string beans.
Previous studies showing mild benefit were flawed by patient size, publication bias and design flaws.
I think the key to improving my health and reducing my pain is to participate in medical research studies!
 
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