This blog is opinion-based and does not constitute medical advice. Please share your experiences!
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New Year’s resolution to lose weight flagging already? Well, here’s a good reason to stick with it, or maybe tack off in a different direction. Eat the right foods and you might be able to ditch the Lipitor, Crestor, and all those other little side-effect riddled statins and blood sugar pills along with your stuff-of-nightmares visceral fat.
Visceral fat, for those of us who try to avoid discussion of fat of any kind, is the nasty pirate stuff that can surround your internal organs even if you look quite horrifyingly slim and fit. It can cause heart attacks, high blood pressure, diabetes, and insulin resistance, and it’s a symptom of metabolic syndrome.
Prevention Magazine, originators of the Flat Belly diet (you know, that obnoxiously…yellow book that’s proliferating in shopping carts across the country) commissioned researchers at the Prevention Research Center at Yale University School of Medicine to take a look at their claim that the diet targets visceral fat.
Flat-Bellyers believe that if you add a serving of good fat—olive oil, nuts, seeds, avocados, dark chocolate etc.—to every meal, it’ll target the bad fat.
And it seems they’re right. The researchers used cross-sectional MRI scans to track the progress of nine chubby women as they followed the Flat Belly Diet for 28 days, scarfing down four daily 400-calorie meals that each included a MUFA (monounsaturated fatty acid) food. The women lost an average of 8.4 pounds and almost two inches from around their waist. Fair enough. But the real surprise was the reduction in visceral fat—about 33%. Levels of fasting insulin plummeted, and total cholesterol dropped by 21 points.
“It shows that the plan not only significantly reduces visceral fat but also lowers cholesterol, high blood pressure, inflammation, and insulin resistance,” said Dr. David L. Katz, the Center’s director in the February issue of Prevention Magazine. “If the plan were sustained (ay, there’s the rub) these women would be at reduced risk of heart disease, diabetes, cancer, you name it.”
All of us sofa-loafers probably already knew that we needed to ditch the donuts and up (or down) the vegetables. But this study shows that a Mediterranean diet really does have an exceptional impact on our innards, and although for years we’ve been told to avoid the fats, it’s obvious that low-fat foods with corn-syrup additives have had a worse effect than we knew.
Muffin-top beware; I’m going MUFA. Pass the avocados.
How about you? Do you think that a Mediterranean diet could trump your pills?
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Preliminary research at the Utah School of Medicine has turned up a potentially interesting use for statin drugs.
Researchers found that statins could “turn off” the enzyme they believe may be responsible for a blood vessel disorder called cerebral cavernous malformation (CCM).
CCMs are groups of capillaries that have abnormally thin and leak-prone walls as well as lacking essential support tissues. Because of this, the capillaries may not return to their normal size after being flooded with blood, instead forming blood-filled ‘caverns’. CCM is characterized by slow seepage rather than more immediately dangerous ruptures, although sudden ruptures could occur. It is also possible for a CCM to never bleed at all, or for the blood to be reabsorbed and thus put an end to any symptoms. CCMs can occur anywhere in the body but are only problematic in the brain or spinal cord.
The Utah researchers think that the enzyme Rho causes the endothelium, the capillary’s thin inner lining of cells, to break down. When fed to mice that had been bred to have a defective endothelium, statin drugs successfully blocked the enzyme’s pathway and dramatically reversed blood leakage.
About one in 200 people in the US are estimated to have some form of CCM at some point in their lives. It can be a hereditary condition, particularly in people of Hispanic descent, or it can be caused by years of radiation therapy or repeated blows to the head.
Only about 30 percent of people with CCM will experience associated problems such as headache, seizures, paralysis, uncontrollable hiccups, hearing or vision problems, or, rarely, bleeding in the brain.
Use of statins to fix cerebral cavernous malformation has not yet been studied in humans, but if further research bears out the team’s findings this is exciting news indeed. Observation is currently the first course of action, followed by stereotactic radiosurgery or neurosurgery for severe CCM. Although statins can and do have side-effects, some serious, their use might well be warranted for some cases of CCM.
The team is looking for 50-100 people nationwide to participate in a pilot trial. If you are interested and have been diagnosed with CCM and are on statins, contact Kevin Whitehead at Kevin.whitehead@hsc.utah.edu or Connie Lee at clee@AngiomaAlliance.org.
If you have CCM, is it causing you any problems? Are you contemplating neurosurgery, and if so, will you talk to your doctor about this very preliminary but interesting news?
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0.9 percent. That’s how much daily doses of Crestor cut the risk of stroke or heart attack in a very limited segment of the population during the JUPITER trial sponsored by AstraZenica, makers of Crestor.
But you could be forgiven for thinking that your risk would be slashed by 50 percent if you read the flurry of articles that appeared yesterday after Yale researchers published their opinion that, if JUPITER’s findings were to become an important element in medical practice, statin use would become much broader (Jan. 13 issue of the journal Circulation: Cardiovascular Quality and Outcomes). Headlines focused on the potential for millions more people to be treated—a drug stock owner’s dream—and on the 50 percent reduction, which is a misleading number.
The trial selected 17,802 participants from a herd of 90,000 applicants with normal levels of cholesterol and elevated levels of inflammation markers. Roughly 80 percent of potential participants, including those with inflammatory conditions such as arthritis, were screened out.
Of the roughly 20 percent of applicants that were left in the study, those in the non-placebo group saw their risk of cardiovascular events cut from 1.8 percent to 0.9 percent.
They also saw their risk of diabetes raised by 0.6 percent—something not mentioned by most of the articles. The focus, instead, was on the potential for millions more people to be treated with statins.
Some did raise the question of cost. 31 patients would need to be treated for four years to save one from a cardiovascular event. The cost multiplies still further when one counts up the many costs of treating side effects, including the potential for diabetes.
Statin drugs undeniably save lives for some people and are a valuable tool. However, ignoring side effects while pushing the drugs for a huge segment of the population seems premature. It’s a pity that the trial was cut very short (it ran less than half of an intended four years) so that long term effects, including the already elevated risk of diabetes, could not be studied.
JUPITER stands for Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin, and justification in this case, of course, is meant in the sense of demonstrating or proving to be just, right, or valid; but one could easily make a more ironic interpretation.
What do you think? Do you think that prescriptions of statins like Crestor and Lipitor should be handed out to vast swathes of the population? If you take a statin, are you experiencing any side effects?
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A reader recently wrote to People’s Pharmacy writers Joe and Teresa Graedon complaining that Lipitor had made his blood sugar shoot “through the roof” and questioning his doctor’s recommendation that he switch to Crestor.
The Graedons commented that another reader had complained about Crestor causing his blood sugar to go through the roof, as well as causing intense tingling—the implication being that the switch probably wouldn’t help.
They went on to say that elevated blood sugar is indeed a potential side effect of statins, and referred to the JUPITER study. JUPITER, funded by AstraZenica, examined the effects of Crestor on people with reasonable cholesterol levels but elevated levels of C-Reactive Protein (CRP). It included 17,802 people.
When the JUPITER trial, of course, was ended suddenly—less than halfway through—it was found that 0.6 percent more people (3 percent of statin-users as compared to 2.4 percent of placebo users) had developed diabetes.
As the Graedons pointed out, this could be merely a coincidence or it could be a real side-effect of statin drugs. At this point, no-one really knows.
People with diabetes are routinely given statins as a precaution because of their increased risk of heart attack and stroke. It would be ironic if the drug were further raising their blood sugar.
A friend of mine has Type 2 diabetes, which she works hard to control through a vegan diet. Even though her cholesterol levels are low she used to take a statin drug that her doctor had insisted on. Because she was suffering from apparently statin-induced brain fog, she and her doctor agreed that she’d drop the statin and just monitor her cholesterol.
Lo and behold, her brain fog cleared—and her blood sugar also improved.
That’s why a site like RateADrug is important. It goes beyond the information offered by doctors and drug companies to statistically aggregate both the negative and the positive side-effects of the drugs that hundreds of thousands of people are taking every day; side effects that may have previously gone unnoticed or under-reported. Hopefully, people like the Graedon’s readers will add their real-life experiences to the growing database to provide a true picture of the pros and cons of our medications.
If you’re taking Lipitor or another statin, do you monitor your blood sugar level? Has it increased since you began taking the drug?
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If you heard anything about the much-trumpeted JUPITER (which, ironically, stands for ‘Justification for the Use of Statins in Primary Prevention; an Intervention Trial Evaluating Rosuvastatin’) trial of the statin drug Crestor, sponsored by its maker AstraZenica , you no doubt positively skipped off to your doctor’s office to beg for a statin drug. Heck, if the buzz says that statin use can cut heart attack risk by about 50 percent and journalists begin suggesting that we put statins in the water supply, why wouldn’t you?
Well, you might not skip quite so fast if you look beyond the headlines.
The trial first screened 90,000 men over 50 and women over 60 for inclusion, eventually excluding most of them because of other conditions such as arthritis or use of other medications. So first you’d have to ask yourself whether you, like some 80 percent of us, would also have been excluded from the trial. The combination of normal levels of cholesterol but elevated levels of inflammation marker C-Reactive Protein (CRP) found in the remaining 17,802 patients isn’t all that common.
Taking Crestor did apparently cut the risk of cardiovascular problems in that group by roughly 50 percent. However, while cutting a risk from 1.8 percent to 0.9 percent is certainly significant, even the higher risk wouldn’t exactly have kept you awake at night.
Furthermore, what the headlines didn’t focus on was the apparent increased risk of diabetes.
0.6 percent more people (3 percent of statin-users as compared to 2.4 percent of placebo users) reportedly developed diabetes, which is also statistically significant. Diabetes can in itself eventually lead to an increased risk of heart attack.
And because the study, designed to last for four years, was halted after less than two years, medical researchers will not be able to determine whether the early benefits will hold up over the long term. Nor will they determine whether longer-tem use is safe, nor whether other risks might show up. According to the drug company it ended the trial on independent advice so that placebo-takers could enjoy the same outstanding benefits of taking a statin drug. One can only hope that worry that an increased risk of diabetes could become more marked over the long haul wasn’t a factor in the decision.
What did you think about the JUPITER trial? Did, or would, the results influence you to take a statin drug?
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Pill-takers, beware. A new study from UCSF found that doctors frequently rely on “skewed” information when they’re learning about new drugs or drug trials—reports in medical journals that are biased both of terms of what they don’t choose to publish (unfavorable results) and what they do publish (some rather selective data that may differ from what was reported to the FDA).
In theory, doctors have access to the same complex information that the FDA gets about drug trials. In practice, they usually get information about new drugs and drug trials from medical journals.
Many such reports are quietly sponsored by drug companies and may be “skewed” to show their drugs in a favorable light. They might be written by a company medical writer or physician that has been involved in developing the drug, or by a ghostwriter attributing the article to a physician.
UCSF’s team of medical investigators, led by Lisa A. Bero, examined 164 drug trials that took place over two years. They then looked at write-ups of the trials in medical journals and found that trials with favorable outcomes were about five times more likely to be published than those with unfavorable outcomes. Worse, there were sometimes discrepancies between the results the FDA received and the facts submitted to the medical journals. Approximately one-fourth of the results of trials testing the effectiveness of new drugs still had not been published five years after approval by the FDA.
What that boils down to is that your doctor may very well not be getting complete, unbiased and accurate information before he prescribes all those little pills in your medicine cabinet.
And at a time when doctors are increasingly prescribing drugs Lipitor and other statins for ever-larger groups of people, cheered on by trials like the JUPITER trial that are sponsored by drug companies, it could be very important for them—and you—to understand that.
Read about the full results of the UCSF study in the online medical journal of the Public Library of Science, PloS Medicine.
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A recent study by the Oregon Health & Science University shows that the cholesterol lowering statin drugs may cause a muscular eye disorder.
Dr. F.W. Fraunfelder led the study, looking at reports of double vision (diplopia), drooping of the upper eyelid (ptosis), and loss of full range of motion of the eyes (ophthalmoplegia) in the databases of the National Registry of Drug-Induced Ocular Side Effects, the World Health Organization, and the Food and Drug Administration.
Statins are known to cause muscle problems in some patients, but this is the first report linking statins to muscle problems of the eye. Statins work by preventing cholesterol from forming. This may be good for preventing heart disease, but can cause problems in muscle by preventing the tissue from repairing and regenerating normally. Other muscle problems experienced by statin users include muscle aching, pain, inflammation, weakness, and deterioration of the tissue.
The eye disorder was rare, occurring in 0.1 percent of patients, but those who were taking gemfibrozil (another cholesterol lowering drug) at the same time as statins were at a higher risk with 0.5 to 2.5 percent occurrence.
Of the 256 patients reported on, 23 lost eye range of motion, 8 had drooping upper eyelids, and 18 people experienced both double vision and drooping eyelids. All patients’ symptoms went away after they stopped taking statins. The study was unable to determine which eye muscles were involved based from the patient database information or how long it took for them to fully recover.
Please share your thoughts and experiences! Have you or someone you know experienced side effects from taking Lipitor?
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Millions of patients in the U.S. use cholesterol lowering drugs like Lipitor (made by Pfizer) or Zocor (made by Merck) in an effort to lower heart disease risk. Last year, the patent protection for Zocor expired and the generic form of it called simvastatin was put on the market. Since generic simvastatin became available, health insurers have been pressuring doctors and patients to switch from brand name cholesterol lowering drugs like Lipitor to this similar and much cheaper generic form of Zocor.
Price is the main reason people are switching to the generic simvastatin. Currently it costs about $2 per day for Lipitor, but with the generic brand it is closer to 35 cents or less. Switching over could save billions of dollars in health care costs.
Both Lipitor and Zocor are from a drug class called statins. Statins work by inhibiting the enzyme that produces cholesterol. Other cholesterol-lowering drugs from this class include Crestor (rosuvastatin), Pravachol (pravastatin), Lescol (fluvastatin), and Mevacor (lovastatin).
Compared to Lipitor, Zocor (simvastatin) is less potent. Therefore, if you were taking 10 mg of Lipitor, you would have to take 20 mg of the generic Zocor. Currently, the highest dose you can get of Zocor is 80 mg (equal to 40 mg of Lipitor). This means that if you are presently taking more than 40 mg of Lipitor you will not be able to get a strong enough dose. For most people this shouldn’t be a problem.
By law, the generic version of Zocor is required to contain the same active ingredients as the brand name. They also have to the same dosage, potency, quality, function, and approval from the FDA.
Both Lipitor and Zocor share similar side effects because they are from the same statin drug class. Not all of the side effects are known; some patients experience headache, muscle pain and weakness, muscle tissue breakdown (rhabdomyolysis), memory loss, postoperative delirium, and others. (For more side effects check out: Five Biggest Risk Factors in Taking Lipitor or Other Statins)
What do you think? Have you experienced any differences since switching to the generic form of Zocor? Please share your experiences!
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More and more evidence is pointing towards statin drugs causing muscle pain and even debilitating muscle problems.
There are generally three types of muscle trauma that people experience from statin medications, says Dr. William Shiel, a specialist in muscle and joint conditions. The first is muscle aching, which typically goes away within a couple weeks after stopping statin treatment. The second experience is muscle pain and mild muscle inflammation with or without a feeling of weakness. A blood test may reveal elevated levels of CPK enzymes which typically mean that the skeletal muscle is injured or under stress. This can take up to a few months to heal. The third condition (rhabdomyolysis) is most serious involving severe muscle inflammation, weakness, and the breakdown of muscle. Patients experience muscle damage and pain throughout their entire body. Elevated CPK enzymes can also accumulate and damage the kidney.
Jill Slade, assistant professor of radiology and osteopathic manipulative medicine at MSU, believes that the muscle damage caused by statin drugs is underestimated. Her current study is following 50 patients on statin medications to track their muscle integrity through magnetic resonance imaging. “While statins have tremendously helped millions of Americans lower their cholesterol and improve their cardiac health, we need to be confident we are not causing other problems in the body,” Slade said. “Statins work by preventing cholesterol from forming. While this is a good thing inside structures such as liver cells, it can be problematic in places such as muscle cells.”
A recent study at the University of Alabama supports this. It shows that statins may prevent skeletal muscle from repairing and regenerating normally due to the anti-proliferative effects of the drug. The researchers also agree that the current 7 percent of patients reporting skeletal muscle problems may not be accurate. Dr. Anna Thalacker-Mercer said, “It is possible that older adults may not be able to distinguish between muscle pain related to a statin effect or an effect of aging and therefore adverse effects of statins in older adults may be under-reported.”
Dr. Shiel stated that it is important for patients and doctors to be extra aware of this potential side effect because it is easier to treat the sooner it is found. “When discovered late, it can lead to serious injury—not only to the muscles but also potentially to the kidneys and heart.” In 2001 the FDA pulled one statin drug, Baycol, off the market because it was shown to be the cause of 31 deaths from muscle tissue breakdown (rhabdomyolysis). From Dr. Shiel’s experience, “Of all causes [of muscle pain] statin drugs are what I see as the most common culprits.”
What do you think? Have you experienced any muscle pain after taking statin drugs like Lipitor? Please leave a comment about any side effects or experiences you have had with this drug!
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A new study reported in the New England Journal of Medicine shows that taking statin drugs like Crestor or Lipitor may prevent heart disease even if you don’t have high cholesterol levels.
The study looked to test whether statins could prevent heart disease in patients with normal cholesterol levels but high C-reactive protein (CRP) levels. C-reactive protein is a biomarker used to measure the levels of inflammation, which is thought to play a role in half of all cardiac events. Inflammation has a compound effect on the amount of LDL cholesterol absorbed by artery walls and can lead to further plaque buildup (See our article on The Role of Inflammation in Heart Attacks).
The clinical trial included 17,802 men and women from different parts the world with cholesterol levels less than 130 mg/dL and CRP levels above 2.0 mg/L. Participants were given 20 mg of rosuvastatin (Crestor) or a placebo.
After 2 years, the 5 year study was ended because the endpoints had been met. The results showed that statins lowered the risk of cardiac events by 44 percent. The statins were shown to lower LDL cholesterol by 50% and CRP levels by 37%. The total number of deaths was 20% less in participants taking statins compared to the placebo group.
The new findings could rework who is eligible for statins, potentially adding 10 million more Americans to the existing 36 million already taking a statin drug. Currently, only people with high LDL cholesterol levels are prescribed statins. This study may help validate CRP levels as an additional test to determine people at a higher risk for heart disease.
Do you think statins should be prescribed to people who don’t have high cholesterol levels? Please share your opinions and experiences with statin drugs!
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15. June 2009 at 9:14 am :
After a mild stroke (TIA), my doctor decided that I should take lipitor. After 1-2 years I starting having headaches every 7-10 days. The headaches would last 8-12 hours during which the pain would rise to unbearable limits and my blood pressure would rise to about 180/115. The highest being 207/127. My doctor then started me on ziac and lotrel to lower my blood pressure. Next, I started having muscle pain in my legs. At times it was difficult to walk. Also, I started to have dizzy spells. The doctors performed numerous tests: MRI’s, X-rays, Cartoid scans, etc in order to determine the cause(s) of the headaches, muscle pains and dizziness. Never was a cause determined. Last year, I quit working because of the frequent pain. Finally, I decided to quit taking lipitor and during the next 3 months I only experienced one headache. What a relief after 8-10 years of headaches. The muscle pain has reduced but it has not gone away. I finally told my doctor that I stopped taking lipitor and I also wanted to stop taking ziac and lotrel because I did not have high blood pressure.
I feel that after spending thousands of dollars on medical tests, having headaches and muscle pain and eventually being forced to quit working, the drug company should have some liability. I do not know how to go about securing compensation. Also, I have heard similar stories from numerous other people and even some pharmacists that do not not recommend lipitor or other statins to their customers.