*Not* taking statins

[Buckeye]

I had a heart attack while playing basketball 14 years ago. Always an active healthy guy, basketball and running, but a high stress job. Regular checkups. No HBP, no cholesterol meds to that point. Got a stent in the LAD (yes, the widowmaker).

Since then I have stayed active (eased out of hoops for other reasons), taken station religiously, and followed cardiologist orders. Took a nuclear stress test February 2018-flying colors. Late June of same year experienced shortness of breath while doing yard work. They just about decided I was fine but finally sent me to catch lab, and I received a 2nd stent in LAD adjacent to the first. Retired a little less than a year later (not for medical reasons per se.)

I asked more than one of my cardiologists how I can do everything right and still had what they call a "heart event".

They have no answers. I'm on the same meds/etc as before. Well, actually I'm on Crestor now but that was my idea, not the doctors.

Seems like statins were made for someone like you, i.e. to prevent another heart attack. Have you ever done a calcium score scan? Given your history, seems like it would be really interesting to know your score. Although, I wonder if the presence of stents rules you out of being able to do it.

 

[anethum]

I don't need no stinkin' statins.

https://www.health.harvard.edu/hear...ho eat chili peppers,of just over eight years.

"Researchers analyzed the diets and health records of more than 22,000 people living in southern Italy and followed them for a median of just over eight years. People who ate chili peppers more than four times a week were about one-third less likely to die of heart disease than those who rarely or never ate the spicy-hot peppers."

 

[harley]

I don't need no stinkin' statins.

https://www.health.harvard.edu/hear...ho eat chili peppers,of just over eight years.

"Researchers analyzed the diets and health records of more than 22,000 people living in southern Italy and followed them for a median of just over eight years. People who ate chili peppers more than four times a week were about one-third less likely to die of heart disease than those who rarely or never ate the spicy-hot peppers."

I'm going to live forever!

 

[Chuckanut]

I don't need no stinkin' statins.

https://www.health.harvard.edu/hear...ho eat chili peppers,of just over eight years.

"Researchers analyzed the diets and health records of more than 22,000 people living in southern Italy and followed them for a median of just over eight years. People who ate chili peppers more than four times a week were about one-third less likely to die of heart disease than those who rarely or never ate the spicy-hot peppers."

And here it was me thinking the magic plant was rosemary....

https://undergroundhealthreporter.com/the-secret-longevity-herb-of-southern-italy/

In fact, in a small village called Acciaroli in Southern Italy, 1 in 10 inhabitants is a centenarian enjoying high-quality health well into the second century of their lives. Researchers from the University of California at San Diego and Sapienza University attribute these remarkable life spans in large part to the population’s high consumption of rosemary.

Maybe the best plan is to eat the chili peppers with a cup of rosemary tea.

 

[NavAir]

Interesting article on statin side effects and the "nocebo" effect:

https://www.bbc.com/news/health-54951648

 

[Koolau]

Thanks so much for all the info and opinions on statins. I guess I can quit going to my cardiologist now. He has me on the highest dose. YMMV

 

[Canoesmith]

I did the same thing. Had high numbers but took a Nuke stress test which came back perfect and I asked about the Lipitor. Doc said take em’ or dont take em’. He didn't care much either way. i stopped that day. That was about 4 years ago. I am 60 now.

 

[valsdad]

Been on statins for years. No side effects, have low cholesterol levels, feel great. No reason to quit.

 

[cooch96]

But just as in any field, there are good and less good doctors, and there are those that are open minded and study new information, and those that stopped learning after internship. If you have a good doctor that you have faith in, good for you. It's not that way for everyone. And it can take many tries to find one that you respect.

Sometimes the doctor just won't hear you.

+1. I'd like to reinforce the notion that medical literature is focused on medicine that will do the most good for most people, and a good GP will focus on the best medicine for all his patients. Whereas one who self-educates only has to focus on herself and her dependents; a situation where the self-educator gets the most immediate feedback.

DW has gone through maybe 5 doctors in 12 years and is about ready to give up and settle (one was actually great, but she moved). I often wonder what the ratio is of good doctors is to average and bad doctors who are just mailing it in or going through the motions. Maybe 20:80 or 30:70? A 50:50 ratio sounds naive to me. If folks who scoff at self-education can direct the unlucky to a good doctor who is taking new patients in their location, please, by-god, through us a line.

My current doctor is at least average, a decent communicator and not condescending. But I'm open to upgrades. If anyone can suggest a good GP in the S. Puget Sound who is taking new patients, I'm all ears.

 

[OldShooter]

... If anyone can suggest a good GP in the S. Puget Sound who is taking new patients, I'm all ears.

Well, there's the rub. Finding and keeping a doc you can trust. You might want to look for concierge medicine practices in your area. We are in a concierge practice embedded in a large clinic. Three specially selected docs, access to full resources of the clinic. Super service, very personalized.

That said, there is no "standard" concierge practice so you have to work at finding and evaluating. Fees are all over the map in our area too.

 

[Joggernot]

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

Bood

Yep, decided a few months ago to stop taking statins because of the muscle aches and pains. The statins did lower my cholesterol. After stopping I had my cholesterol checked twice and it went up both times. I'll check again after Christmas and see if it has levelled off.

 

[troutnut1]

Total Ch under 200 with good weight, bp, and active lifestyle at 67 so I was surprised when two PA’s prescribed 10mg atorvastatin for a “15% elevated rrisk based on family history”. Hated giving up my grapefruit. Youtube’s on statins scared me. I normally make it my practice to avoid drugs that say “side effects, including death, have been reported.” Finally gave in three months ago. No obvious side effects but I noticed my normal BP of 120/80 went consistently to higher than 150/80. Legs felt more tired after daily treadmills, but not terribly so. Stopped then last Thursday and in two days my bp returned to 120/80. I thought I would have to make another appt for another drug to lower my bp. All I had to do was stop my statin. Dreading the next appointment where they try to hard sell me drugs again. Might be a good time to change doctors. I realize my experience was not common. But I’d rather be on no drugs and normal, that two drugs just to get back to normal.

As a retired appraiser I worked with a lot of statistics. One of my favorite sayings was “most people use statistics like a drunk uses a lamppost, for support rather than illumination”. If a study shows 1% of a group using statins had heart attacks, and 2% using a placebo had heart attacks, they tell us there was a 50% reduction in heart attacks. While it might be true, that stat is clearly not a search for the truth, but rather is an attempt to support their idea that we should all take that drug. There is lots wrong with this and I don’t like it.

 

[Estuaryman]

I was told by my previous doctor that if you can get your total cholesterol under 150 and keep it there you will eventually die from something other than cardiac disease. I have a family history of heart disease (mother and younger brother - quad bypass) so I happily take my 10 mg of atorvastatin and have for many years. I don't drink or smoke but am overweight (why don't they have a pill for that?). YMMV

 

[RAE]

Statins are overprescribed, without a doubt. They may lower cholesterol to some extent, but cholesterol is a very poor indicator of heart disease risk. If you want to know what your real risk for heart disease, look at your triglyceride/HDL ratio. If you are below 1.0, your risk of heart disease/heart attack in the next decade is very low. If you are between 1.0 and 2.0, you are not high risk, but should probably alter your diet somewhat to get closer to (or better yet, below) 1.0. If you are over 2.0, you need to make some fairly major dietary changes to lower your ratio (eliminate most processed foods, for one thing). Here is a link to an article with more info: https://www.thebloodcode.com/know-your-tghdl-ratio-triglyceride-hdl-cholesterol/

As someone else has mentioned, it is also good to have a calcium artery scan done at some point, to see what your current score is. That will provide some useful additional information.

Finally, it's a good idea to have your ferritin (iron) level checked, when you get your annual blood tests. High ferritin can cause all sorts of problems, including heart disease. You don't hear a lot of doctors talking about ferritin, but believe me, it is important to monitor it (especially for guys over age 50 or so). If your ferritin is too high, it's easy to lower it by donating blood a few times each year.

A lot of doctors still want to focus on cholesterol, and trying to lower it, but cholesterol is a pretty worthless indicator of heart health. Actually, beyond a certain age (like 70, I think), people with relatively "high" cholesterol actually live longer.

 

[ER Eddie]

I have "high cholesterol," secondary to my keto-carnivore diet, which I've been on for about 3 years. I have a new doc. When he saw my numbers, I could feel his anxiety and agitation about them. He talked up statins pretty hard. He was on them himself, he said, and it was a way of helping to make sure I lived a long time.

I knew this was coming, so I'd done my homework. I declined the statin. I presented my case as succinctly as I could, knowing doctors have about 10 minutes then it's on to the next patient.

I tried to make three points:

1. The cholesterol/LDL hypothesis of heart disease is full of holes. The majority of the studies (like 80%) show either no correlation or an inverse correlation between cholesterol level and heart disease. It's even clearer as you get older: for people over 60 or so, higher cholesterol has been associated in many studies with better outcomes.

2. When you control for metabolic health (insulin resistance, inflammation), the relationship between cholesterol and heart disease disappears. Every biomarker and subjective sign shows that my health is much better now than it was prior to eating this way. I reviewed each of them briefly with him, but I'll spare you the details. The only indicator heading in a "negative" direction was LDL, and even that is only a problem if you buy the cholesterol theory, which I don't.

3. LDL-C doesn't tell you anything, really. Heart disease does correlate with Pattern B (small, dense) but not with Pattern A (large, bouyant). Instead of running an expensive test to subfraction the LDL, you can just look at triglyceride, HDL, and the tri/HDL ratio. All three of those, in my case suggest that my LDL is of the Pattern A type, the type not associated with atherosclerosis.


Fortunately, he's a smart guy, and he listened. He said that what I was saying made sense, and he was okay with it. He said he wished he had time to keep up with the literature better, so he could talk better about these subjects with patients like me. He said he appreciated my being engaged.

I'm sure my CAC of zero helped, too. For those who don't know, CAC measures the actual presence of heart disease. Cholesterol and other such things are only guesses at what the risk of the disease might be. CAC is a measure of the actual disease process. Get one, if you have any concerns -- or even if you don't. A large percentage of people have elevated CACs in the absence of high cholesterol or other traditional risk markers. That's the value of the test -- it detects lots of people who have advanced heart disease and who would not have known it otherwise (because their traditional markers were fine). It then allows you to do something about it, to get that disease process under control.

I once heard that if you combine all the traditional risk markers together, they only explain about 17% of the variance. We get a false sense of security from these markers. They're presented as if the medical establishment has it all figured out. Not even close. Get a CAC. They're only $100. It's not a bunch of statistical guesswork based on correlational data. It measures the actual disease.


I didn't go into detail with him about my objection to statins, because he didn't press further, but here are my thoughts about statins.


1. Their effectiveness is greatly exaggerated. They do lower cholesterol, but who cares. Their effect on heart events is minimal, and it is thought that this effect may have to do with their anti-inflammatory properties, rather than its effect on cholesterol. Their overall effect on all-cause mortality is nothing. There have been several studies where people taking statins have had worse outcomes (amazing that these studies saw the light of day; one has to assume that many more got buried).

2. Lots of people have side effects. Some of these side effects are quite serious (e.g., diabetes, cognitive decline). Statins interfere with the production of a certain biochemical (co-Q-10? I can't recall) that is essential to cognitive function.

3. The statin business is amazingly lucrative. There are billions and billions involved in marketing and in getting "hired guns" (well-paid doctors) to push them in conferences. Doctors are sold this from cradle to grave. All the studies are done by the drug companies themselves (I'm sure there's no bias there).

4. The historical record of cholesterol-lowering drugs (many of which have come and gone) is abysmal. Tens of thousands of people have died prematurely or had their lives damaged by this parade of cholesterol-lower medications. It's extremely profitable.

5. Cholesterol is an essential ingredient of life. It is present in every cell of your body. If you removed cholesterol from your body, you would die instantly and melt into a puddle of goo on the floor, like the wicked witch of the west. Cholesterol is a molecule that is basic and fundamental to life. It is present in every single animal on Earth. We have demonized something that is at the bedrock of life.

6. If/when cholesterol is a problem, it is only a SIGN or symptom of a problem; it is only a correlate and not a cause. Dave Feldman has an image that captures it pretty well. Cholesterol (or LDL) is like a firefighter arriving at the scene of a fire, and some of the firemen get trapped in the fire. Would you blame the firemen for the fire? Would you try to reduce the number of firefighters? No, you'd focus on putting out the fire. That's simplified, but it makes the point.

Sorry, that was a longwinded post. I guess I have a lot to say about this subject, lol.

p.s. To be fair, I should add that there is some data to suggest that statins may be helpful for men who've already had a heart attack or for those with CAC scores over 400 (under 400, no benefit seen).

 

[Old Microbiologist]

Same here but only after I developed severe cataracts at age 54 caused by Lipitor. If you want to freak your doctor out all the way go on a strict high fat low carb Ketogenic diet. It is kind of shocking how it effects your lipid profile in a good way if you believe lipids have anything to do with heart disease at all, which I don't.

Actually, here the director of the National Cardiac Institute privately agrees with me that statins are only good for pharmaceutical companies.

 

[braumeister]

I have "high cholesterol," secondary to my keto-carnivore diet, which I've been on for about 3 years. I have a new doc. When he saw my numbers, I could feel his anxiety and agitation about them. He talked up statins pretty hard. He was on them himself, he said, and it was a way of helping to make sure I lived a long time.
...
Fortunately, he's a smart guy, and he listened. He said that what I was saying made sense, and he was okay with it. He said he wished he had time to keep up with the literature better, so he could talk better about these subjects with patients like me. He said he appreciated my being engaged.
...

I think that was a very good and informative post, and I'm on your side (I know we're not in the mainstream). I had a similar experience when I changed doctors. After listening to my polite refusal to go on statins, he said he wanted to do some tests to rule out other problems, and if these tests turned out OK, he would accept my decision and shut up about it. The tests were fine, and he kept his promise, even became very interested in the research I showed him.

 

[RAE]

Excellent summary, Eddie. I came to all of the same conclusions you did about heart disease and statins, after reviewing the medical literature.

That is great that your doc listened to your evidence about all of this, and did not disagree. Some people think that doctors always have all of the answers, but they are human, and they don't. We are all ultimately responsible for our own health (especially when it comes to chronic lifestyle-related diseases). You obviously believe in doing your own research on matters like this, as do I.

 

[ER Eddie]

That is great that your doc listened to your evidence about all of this, and did not disagree. Some people think that doctors always have all of the answers, but they are human, and they don't. We are all ultimately responsible for our own health (especially when it comes to chronic lifestyle-related diseases). You obviously believe in doing your own research on matters like this, as do I.

I think doing independent research is the only way for people to save themselves in this area. There is just so much misinformation out there. You really have to dig for the truth yourself and consult people outside the mainstream. If you just accept what the mainstream authorities tell you, you are going to be badly mislead. The truth will win out eventually, though. I'm encouraged to see so many people clued in here, for instance.

And yes, credit to my doctor for listening and not insisting he was right. My CAC of zero helped a lot with that, too. If I didn't have that, I would've had a much harder time convincing him my LDL wasn't a problem.

Also, I think it helped that I have a lot of experience disagreeing with physicians and not being intimidated by them. I spent most of my career as a psychologist dealing with doctors who had a variety of problems (alcohol, drugs, personality, anger, behavior, boundaries). Although I was initially intimidated to be working with M Dieties, I eventually got over my deference and developed an abililty to relate very openly and assertively to them. We're on an equal playing field, as far as I'm concerned. In fact, without sounding arrogant I hope, I am more the expert in this area than 90% of physicians. That's not because I'm a genius, but just because I've spent years researching it, because it directly affects my health and longevity. It's personal! lol

 

[MoPops]

I quit taking it a few years ago. I was borderline high anyway. I started working out a bit more, riding my bicycle a lot more. My numbers are now lower than when I was taking the statins.

 

[gooddog]

Worth looking in to colesevelam (trade name Welchol). Do your own research, and I am sure you will find that this medication is preferable to the statin class.

 

[sengsational]

One should know the NNT for a person like yourself before taking any drug that has a significant risk profile. For an X year old M with no history of heart disease, you'd need to treat Y people to avoid one cardiac event. You can get more specific than age, gender, and cardiac history. If you get an NNT from the doctor, ask which study, and make sure the population was like you.

 

[braumeister]

One should know the NNT for a person like yourself before taking any drug that has a significant risk profile.

A very good point. For an more detailed explanation, this is a good source:
https://www.thennt.com

 

[Chuckanut]

If a study shows 1% of a group using statins had heart attacks, and 2% using a placebo had heart attacks, they tell us there was a 50% reduction in heart attacks. While it might be true, that stat is clearly not a search for the truth, but rather is an attempt to support their idea that we should all take that drug. There is lots wrong with this and I don’t like it.

Good point.

Relative vs. actual risk reduction. It's important to know which is being quoted. Rarely are we told that, and never in drug commercials.

Me? I take Pretenda. It's the drug that treats all the illnesses I don't have. And I still don't have them, so it must work.

 

[Archman]

If you can't take statins, or need to supplement statins, consider taking NEXLETOL (bempedoic acid) or NEXLIZET (bempedoic acid and ezetimibe) manufactured by Esperion Therapeutics. https://www.esperion.com