This blog is opinion-based and does not constitute medical advice. Please share your experiences!
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Statins may increase risk of postoperative delirium in elderly patients according to a recent article published by the Canadian Medical Association Journal. Delirium is a sudden and severe change in cognitive function causing confusion, inability to concentrate, and sometimes hallucinations. It is commonly experienced after surgery in people over 70, and it can cause delayed recovery, increased hospital costs, and anxiety for the patient. Sometimes the patient never fully recovers and stays at a permanent level of dysfunction.
The study looked back at the medical records of over 280,000 patients in Ontario who were 65 or older and went in for elective surgery. About 7 percent of patients were using statins and just over 1 percent, or 3195 patients, experienced postoperative delirium. 1 in 90 patients using statins before their surgery experienced post-delirium, showing the risk to be 30 percent higher than those not using statins. The correlation seemed to be greater for patients using higher doses of statins and undergoing a longer surgery time. The risk between statins and delirium was not seen in any other cholesterol lowering drugs.
One theory is that statins may cause altered blood flow within the brain which would cause a temporary lack of oxygen to neurons and predispose patients to delirium. This shift in blood is produced by a change in endothelial nitric oxide synthase within small blood vessels. This is an effect caused by statins, which is not even related to lowering cholesterol or preventing heart disease.
Even though the percentage of people experiencing this is on the low end, it would affect many people due to the large number of elderly patients taking statins and undergoing surgery. One recommendation or compromise is to stop taking statins a few days before surgery and restart after.
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Statins may be effective in lowering cholesterol – but at what cost? With the high price of statin drugs and potentially undesirable side effects, many people have begun looking into supplements as an alternative to lowering cholesterol.
Omega-3s are essential fatty acids, meaning they can’t be manufactured by the human body yet they are essential for good health. Omega-3s lower triglycerides, increase HDL “good” cholesterol, and lower high blood pressure. The American Heart Association recommends eating fish twice a week to get your omega-3s, or you can take it as a supplement. One new study by Professor Luigi Tavazzi and Professor Gianni Tognoni , GISSI-HF Coordinating Centre, ANMCO Research Centre, Florence, Italy compared the effectiveness of taking a one-a-day capsule of omega-3 polyunsaturated fatty acids to taking statins. The results concluded that taking omega-3 can effectively reduce hospital admission and mortality rate for cardiovascular issues in heart failure patients. Statins, on the other hand, proved to not have any affect in the mortality outcome of patients.
An herbal supplement called red yeast rice has been used in traditional Chinese medicine for centuries. Red yeast rice contains lovastatin, the same active ingredient as the prescription statin drugs. Made from a rice extract fermented with red yeast, it is shown to significantly lower LDL levels. In a study from the July Mayo Clinic Proceedings, one test group was given prescription statin drugs with written diet and exercise guidelines. A second group was given red yeast rice, omega-3 supplements and in-depth diet, exercise and relaxation counseling. The findings were almost exactly the same, with a drop in LDL levels of 40 percent for each group. Despite these results, red yeast rice may also cause similar side effects as statins due to the same active ingredient lovastatin. Additionally, it is difficult to know the exact quality of red yeast rice because it is not closely regulated by the FDA.
While a lot of attention has been put on lowering LDL levels, research is showing that raising HDL cholesterol is just as important. It is thought that HDL cholesterol picks up excess bad cholesterol in your blood and takes it back to your liver for disposal. Niacin, or vitamin B-3, has long been used to increase HDL levels. Studies show that niacin reduces LDL levels up to 20% and boosts HDL cholesterol by about 35%. Niacin also seems to lower lipoprotein A, which is another risk factor for atherosclerosis. Despite these benefits, niacin may cause flushing and raised blood sugar. It should be taken under the supervision of a health care professional.
Additional supplements that may have cholesterol lowering effects include blond psyllium seed husks, artichoke leaf, soluble fiber, plant sterols, garlic, flaxseed, Metamucil and policosanol to name a few.
Have you been diagnosed with high cholesterol? Have you decreased your cholesterol levels? If so, by what means? Have you found that “natural” supplements have helped you establish lower cholesterol levels without side effects? Share your experiences!
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Although it is typically thought that lifestyle change alone can’t lower LDL cholesterol levels as well as statins, there is mounting evidence that it may. Joseph Keenan, a cardiologist and professor at the University of Minnesota, prescribes Lipitor to his patients and was using it himself until he began to experience muscle spasm side-effects and blood tests which indicated muscle damage. For people like Keenan who can’t tolerate statins, a balanced diet, exercise and supplements may be the answer. Keenan managed to lower his LDL cholesterol by 60% without prescription drugs. After his personal success, Keenan believes that 70% of people who would be prescribed cholesterol drugs could get their cholesterol levels to a healthy balance solely through these lifestyle changes.
A balanced diet of vegetables, fruits, whole grains, fish, and legumes has shown to work well in lowering LDL cholesterol. Whole food diets work best compared to prepared foods that are low in cholesterol, says Christopher Gardner, a Stanford nutrition specialist. This is because the components of whole foods, such as plant sterols, interact differently with your body and are able to lower LDL cholesterol. Plant sterols work by displacing some of the cholesterol from intestinal micelles resulting in less cholesterol being absorbed into the bloodstream. Thus, plant sterols have shown to lower LDL levels by 10%. Plant sterols are present in small quantities in many fruits, vegetables, vegetable oils, nuts, seeds, cereals and legumes.
In addition to diet, exercise has a big effect on cholesterol levels; specifically aerobic exercise and HDL levels. A new research study from the Archives of Internal Medicine says that at least two hours per week of aerobic exercise like walking, biking, or swimming will provide an increase in HDL or “good” cholesterol levels. Workouts need to last at least 30 minutes to gain HDL benefit, and it is recommended to exercise at least five days per week. The study found that the “gains in HDL cholesterol levels translate to a 5% drop in men’s heart disease risk and more than a 7% drop in women’s heart disease risk.”
Already, 16 million patients take some form of the drug statin. As this patient base grows to include millions more people worldwide, another side of high cholesterol research is showing that simply diet, exercise, and supplements can be as effective as statins in lowering LDL cholesterol and potentially more effective in preventing cardiac events.
Have you been diagnosed with high cholesterol? Have you decreased your cholesterol levels? If so, by what means? Have you found that “natural” means like diet and exercise make you feel better overall, due to fewer side effects? Share your experiences!
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www.RateADrug.com has a page where you can rate your experience taking Lipitor as well as other statins. Here you can voice your opinions about side effects, benefits, and get an effectiveness score of the drug you are taking. Very interesting results…
Take the Lipitor Survey, click HERE
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An important new study has found that people who take statin drugs were about half as likely to develop dementia or clinically significant cognitive impairment as those who did not use statins (Neurology July 29, 2008; 71:344-355). This study was conducted by Mary Haan, epidemiology professor at the University of Michigan School of Public Health. Haan said “The bottom line is that if a person takes statins over a course of about 5-7 years, it reduces the risk of dementia by half, and that’s a really big change.”
The Alzheimer’s Society commented on the news, stating “The jury is still out on how effective they are, but this study adds to growing evidence that they may have some benefits.” Currently Nymox Pharmaceutical Corporation (NASDAQ:NYMX) holds U.S. and global patent rights for the use of statin drugs for prevention and treatment of Alzheimer’s disease (AD).
Haan said, “It’s likely that many people taking statins have already benefited unknowingly from the dementia fighting properties.” She continues, “We aren’t suggesting that people should take statins for purposes other than what they are indicated for, but hopefully this study and others will open the door to statin testing for dementia and other types of cognitive impairment.” The next step, Haan said, is to determine exactly how the statins work on the biochemical pathways involved in dementia.
Contrary reports on the effects of statins say the opposite - that statin use results in impaired brain functioning, coined ” Transient Global Amnesia, or TGA” including the story of Duane Graveline, MD, MPH, a retired family doctor and former NASA scientist/astronaut. He had been taking Lipitor for six weeks before he was found “wandering, confused, and reluctant to enter his own home because he didn’t recognize it or remember his wife’s name.” He was diagnosed as having transient global amnesia (TGA), but neither he nor his physician suspected that it was due to taking Lipitor. Six weeks later, after resuming the same dosage of Lipitor, the TGA returned. Dr. Graveline began to suspect the statin, and he contacted some physicians. After printing a letter in their column about the potential connection between Lipitor and TGA, they received hundreds of responses saying that they, too, had experienced severe memory loss while on Lipitor.
Still, memory loss is not a listed FDA side effect of statin drugs. One explanation, offered by Joel M. Kauffman, PhD, research professor of chemistry and biochemistry at the University of the Sciences in Philadelphia, is that “in drug trials, the pharmaceutical companies often divide similar adverse effects into six or seven different categories to keep the scarier side effects under 1%.” Kauffman illustrated this point with the example that amnesia could be divided into confusion, memory loss, senility, and cognitive impairment.
So some say that memory loss is a side effect of statin drugs, and others that say statins are a preventative for dementia. What do you think? Are these reports contradictory? Please leave your comments below.
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The following risks have been reported by the FDA and other sources as being associated with the use of Lipitor and/or other Statin drugs. Common side effects of taking Statin drugs are:
● Nausea
● Vomiting
● Constipation
● Diarrhea
● Headache
● Rash
● Weakness
● Muscle pain
● Liver failure
● Rhabdomyolysis
● Memory loss (Transient Global Amnesia)
● Neuropathy
Rhabdomyolysis is the medical term for the breakdown of muscle fibers that results in their release into the bloodstream. This is a serious side effect, often beginning as muscle pain and progressing to loss of muscle cells, kidney failure, and death. Patients suffering from this side effect sometimes feel muscle pain or tenderness and may feel weak.
More frequently this occurs when statins are used in combination with other drugs
(some of which cause rhabdomyolysis themselves) or with drugs that prevent elimination of statins, in turn raising the levels of statins in the blood. Since rhabdomyolysis can be fatal, unexplained joint/muscle pain that occurs while taking statins should be brought to the attention of a healthcare provider for immediate evaluation. Since other drugs taken in conjunction with statins can increase the risk of rhabdomyolysis, it is important that your doctor know exactly what medications you are on - these include niacin, which some people take as a supplement for high cholesterol and which, with statins, can increase the risk of rhabdomyolysis.
Besides muscle pain, the other major symptom of rhabdomyolysis is dark, red, or cola colored urine, which is the manifest of muscle breakdown. Analysis of the urine and blood will show high levels of the muscle protein myoglobin in patients with this condition.
Quitting the statin use usually stops rhabdomyolysis in its tracks and leads to full recovery.
For susceptible individuals, the use of a statin drug can interfere with proper functioning of peripheral nerves. Researchers assume that the build-up of statins in the body causes neuropathy in some individuals. If left undiagnosed, neuropathy can lead to deterioration of the muscles and paralysis. This can lead to problems swallowing, breathing, and complications of the heart – as these all involve muscle groups. In the extreme case, severe neuropathy as a side effect to statin use can lead to death.
Tell us what you think are the five biggest risks in taking Statin drugs to lower cholesterol or reduce associated heart problems. Please add your opinions in the comments section below. We will address benefits to these drugs in subsequent posts.
We are interested in hearing from patients, doctors, pharmacists, medical researchers and anyone else with an opinion on this issue.
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Survey Finds Physicians Often Dismiss Complaints About Drugs’ Side Effects
By Ishani Ganguli
Special to The Washington Post
Tuesday, August 28, 2007; Page HE04
On many online message boards and Internet chat rooms, anxious patients share details about the muscle pain and memory loss they have noticed since they started taking statins to lower their cholesterol. A new study suggests these people may be seeking validation for good reason: Some of their complaints might otherwise be going unheard.
According to a survey of 650 patients published last week in Drug Safety, a peer-reviewed journal, doctors frequently ignored or dismissed patients’ concerns about such side effects. The study suggests this pattern of reaction goes beyond statins to other drugs.
When doctors fail to recognize a patient’s symptoms as drug side effects, more than that patient’s care is put at risk. Because the doctor makes no “adverse event report” to the Food and Drug Administration, the regulatory agency may underestimate the problem, and other doctors and patients may assume the drug is safer than it is.
Researchers from the University of California at San Diego had been investigating the side effects of statins when they noticed the problem.
“Person after person spontaneously [told] us that their doctors told them that symptoms like muscle pain couldn’t have come from the drug. We were surprised at how prevalent that experience was,” said Beatrice Golomb, associate professor of medicine and the study’s lead researcher.
Tens of millions of people worldwide take statins such as Lipitor and Zocor. Many experts view them as something of a panacea for everything from stroke and cancer to arthritis, although they do pose a risk of side effects in some patients, ranging from muscle injury to liver and kidney dysfunction.
Survey respondents, recruited via Web solicitations and other advertisements, were in their early 60s on average and mostly from the United States. Some of the solicitations were placed on Web sites where patients had posted complaints, raising the possibility that respondents were more apt to have had side effects than the average patient. Most said they’d complained to their doctors about such possible side effects as problems with memory or attention, or tingling or numbness in their hands and feet.
According to experts, muscle pain and other side effects occur in up to 30 percent of statin patients, by some estimates, and often lead doctors to stop or change a prescription. But patients surveyed said their doctors rarely linked their symptoms to statins — even when the symptoms were well-documented as side effects.
“Overwhelmingly, it was the patient that initiated that conversation” making the connection between the statin and their symptoms, Golomb said.
Many doctors instead attributed the symptoms to the normal aging process, denied their connection to statins or dismissed the symptoms altogether — missing opportunities to switch their patients’ prescriptions or otherwise mitigate the side effects, Golomb said.
Golomb speculated that doctors’ actions might reflect the relative dearth of information on the downsides of statins. “Ad campaigns that preserve statins’ miracle drug image are more powerful than education about side effects,” she said.
The findings raise important concerns about American drug safety monitoring, said Harvard Medical School professor Jerry Avorn, author of “Powerful Medicines: The Benefits, Risks and Costs of Prescription Drugs.”
“We already know that there is horrendous underreporting of side effects. Ninety to 99 percent of serious side effects are not reported by doctors,” he said.
Yet the FDA relies heavily on their reports. Tracking a drug’s safety once it hits pharmacies — so-called post-market surveillance — is a critical part of keeping patients safe, particularly since clinical trials with limited enrollees and a limited study period cannot catch every side effect.
Managed care deserves some of the blame, Avorn said. “Part of [the problem] is that doctors are granted so few minutes to deal with patient visits. It’s not as if doctors don’t care.”
Golomb and others worry that if even well-documented side effects aren’t being recognized by doctors, others will take much longer to surface. “A fifth of all drugs that fully pass FDA approval will ultimately have black box warnings or be withdrawn from market because of adverse effects,” Golomb said.
Some say that the FDA and drug companies should work harder to get feedback directly from patients. Getting drug surveillance reports from patients is common practice in New Zealand and other countries.
U.S. patients can report side effects to the FDA themselves — by logging onto the MedWatch Web site ( http://www.fda.gov/medwatch). But few know about this option, Avorn said.
The new study “points out that doctor reports on side effects is a very unreliable means of learning about the true extent of problems,” he said. “We ought to have a [better] mechanism for gathering information from patients. A lot of it will be noise, but there may be important signals there as well.”
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Atorvastatin Calcium; Lipitor; Statin. As the health care system fights hypercholesterolemia in America, statin drugs have become one of the most commonly prescribed drugs in medicine - sixteen million Americans take Lipitor to fight their diagnosed high cholesterol. Is the health care system doing the right thing with their patients?
Among countless suspicions against the negative side effects of Lipitor, we have something called TGA, temporary global amnesia. The connection between memory loss and statins is proven with biochemistry. Let me explain…
Cholesterol is one of the building blocks of the body. It aids in the rebuilding component of scar tissue; it is important in the digestion of fats; it is a leading antioxidant, protecting us against cancer and aging. Cholesterol is the precursor to ALL hormones produced in the adrenal cortex – meaning that if there is a low level of cholesterol, we are more apt to experience blood sugar problems, edema, mineral deficiencies, chronic inflammation, difficulty in healing, allergies, asthma, reduced libido, infertility and various reproductive problems. I say these things to draw importance to a balance of cholesterol in the body.
What does cholesterol have to do with memory? A lot. Glial cells, located in the brain between adjacent neurons, function mainly to provide support to the neurons (nerve cell bodies) and insulation for the transmission of messages through the nervous system. The brain cannot tap into the blood’s cholesterol supply – the molecules involved are too large to pass through the blood-brain barrier. So, the brain must depend upon its own cholesterol synthesis–which the glial cells provide. Statin drugs are able to cross the blood-brain barrier because they are fat soluble, so when these drugs are taken, they enter the brain environment and interact with the glial cell synthesis of cholesterol. Here we find a potential for memory loss to be caused by statin drugs. When cholesterol is limited, due to he consumption of statin drugs, the functions of the glial cells and therefore the transmission of messages throughout the nervous system is limited as well.
One person’s account states: “I have spent a lot of time with Doctors to determine what was wrong with me including an MRI that showed my brain has shrunk since starting Lipitor. I have had every battery of blood work to rule out other diseases. I just had a DNA test for the Apo gene, a test for early onset Alzheimer’s, if paired, and it was not positive. In four weeks I am having a memory evaluation test at a rehabilitation facility to measure the amount of damage to my short-term memory. I am only 54 years old and used to write software specifications and hold a patent in artificial intelligence.”
What I’m concerned with is why the pharmaceutical companies are choosing to keep this drug on the market with such a severe set of side effects including malfunction of neurotransmission. With a list of natural products like Policosanol, Guggulipid Extract, Green Tea Extract, and Tumeric Extract that do the same job with less of the problematic effects, why not look into these products a bit more before continuing to prescribe potentially harmful products to our citizens?
Have you had a bad experience with taking a statin drug? If so, please share. What we need is more people speaking up and being honest about the way these medications are affecting them.
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anon wrote:
MikeMD wrote:
emily4 wrote:
9. October 2008 at 2:52 am :
I returned from europe in april. after driving from LA x to the palm springs, ca area, i could hardly get out of the car to walk to the front door. i have never experience anything like that before. i had just turned 70. guess i thought it was age but it came on so quickly. well, it is now october. i became very worried as when i sat down, i was having difficulty getting up and couldn’t just take off walking. if was as if my brain wasn’t telling me to walk. once i started walking, i was fine. i had polio when i was 5 and i do wear a brace now as i have post polio symdrome. however, thiscondition came on me so quickly. i had been on lipitor, welchol and zetia. well, i immediately stopped lipitor thinking maybe that was it. then i stopped zetia and welchol. could those drugs have contributed to my problem and if so can it be reversed? i have had blood tests, nerve ending tests, mri of the and am taking pt for a month. since i had polio that complicates the situation. but i am frustrated to think that these statins might have caused my problem. thanks you i look forward to reading what you have to say.