Frequently Asked Questions About Statins
Here is an early draft FAQ that will be much expanded in the forth coming book "Statin Drugs - Side Effects" by Dr. Duane Graveline M.D which should help with so many questions that have been posed on the comments sections at:
Comments to: Bad News About Statin Drugs
Comments to: STATIN DRUGS Side Effects
Comments to: Lipitor - The Human Cost
Comments to: Lipitor: Side Effects And Natural Remedy
Comments to: Orthomolecular Solutions to Heart Disease
FAQ about Cholesterol & Heart Disease
FREQUENTLY ASKED QUESTIONS ABOUT STATINS
1. Can you give any general recommendation to readers who are already using statins, especially if they are experiencing muscle aches and pains, numbness and weakness, mental lapses or shortness of breath?
Answer - All statin users experiencing these symptoms or increased forgetfulness, confusion, disorientation and worsening senility should be aware that their statin drug could be the cause. Their family doctor may not know of this. Report such complaints promptly to UCSD's statin study and FDA's Medwatch program.
2. Do you believe statins are over-prescribed?
Answer - Statin drugs are being flagrantly over-prescribed, especially for so-called primary prevention, where the only justification is cholesterol elevation. Even children are becoming targets of the drug industry. Commercial airline pilots on statins bother me the most for amnesia attacks are completely unheralded. Imagine "waking up" at the controls of a jumbo jet, never having been there before! For high-risk patients and especially those genetically predisposed to elevated lipids with a positive family history for premature heart disease and stroke, statins will remain a valuable treatment resource.
3. Do you believe that the pharmaceutical industry/medical establishment is misguided in its "war on cholesterol"?
Answer - After 35 years of our "war on cholesterol, we now know that cholesterol is not our enemy, it is the most vital substance in our bodies. We also have learned that atherosclerosis, the basis of heart attacks and strokes, is an inflammatory process, with our "natural" cholesterol a passive bystander not a causal factor. Statins drugs lower CV risk not by their effect on cholesterol but by their newly recognized anti-inflammatory action. In this manner they do lower cardiovascular risk.
4. Can you recommend tips to readers who wish to lower their cardiovascular risk?
Answer - Treatment must be directed at inflammation. Such means include dietary supplements with omega 3, vitamins B6, 12 and folic acid, co-enzyme Q10 and buffered aspirin. All of these readily obtainable, safe, over the counter substances have proven anti-inflammatory benefit. For the "high risk' patient, consideration must be given to the addition of statin drugs for their established anti-inflammatory benefit but the dosage must be based on reduction of inflammation, not cholesterol. Although much more study is necessary to validate this concept, available information suggests that dosages required for effective inflammation reduction may be much less that required for cholesterol reduction.
5. When you stopped using Lipitor what did you do to help lower your cholesterol?
Answer - Since my research into this subject these past five years, including reading the remarkably informative books of Ravnskov and McCully, I no longer regard cholesterol as my enemy. I have reverted to daily use of the supplements mentioned above for their established anti-inflammatory effect and have replaced my low fat, low cholesterol diet of the past 35 years with McCullys Heart Revolution diet, a carbohydrate restrictive diet I find particularly appealing. Also have reverted to the whole milk, butter and unrestricted eggs of my care-free youth on a dairy farm. Last year after my NASA physical, their doctors called me, amazed at my blood lipid response.
6. Where are the case reports on statin side effects/cognitive disturbance that you cite generally reported?
Answer - case reports of statin associated adverse side effects are reported to the UCSD College of Medicine statin study (email@example.com) and to FDA's Medwatch program (www.fda.gov/medwatch). Those reported directed to me by contact with my website (www.spacedoc.net) are referred to these two repositories. We now have several hundred reports of episodic amnesia associated with statin use and tens of thousands of reports of lesser forms of memory impairment such as forgetfulness, confusion and disorientation. Amnesia is but the tip of a huge iceberg of cognitive impairment associated with statin drug use. And then, of course, we have the even larger numbers of case reports of the far more common side effects of muscle aches and pains, weakness, numbness and tingling, mood changes, shortness of breath and fatigue.
7. What can you tell us about the statin study at UCSD?
Answer - The UCSD College of Medicine statin study has been funded by NIH these past four years, with Dr. Beatrice Golomb as principal investigator. This study is reaching conclusion and soon will be reported to the scientific community. Dr. Golombs final report is destined to have a profound impact on FDA, the drug industry and our entire health care delivery system. Wagstaff et al already have reported in Pharmacotherapy their 60 cases of statin associated transient global amnesia, gleaned from FDA's Medwatch files reflecting FDAs failure to review and react to the content of its burgeoning repository of case reports.
8. Why do you think that doctors generally fail to warn their patients about this lesser known side effect of statins?
Answer - Most prescribing physicians are completely unaware of the potential of cognitive side effects from statin drug use. Doctors are victims, in a sense, much like their patients, for they have never been informed of the cognitive problems of many statins, known for years by the drug industry. In a Pfizer paper, recently made available, Pfizer researchers reported seven cases of amnesia and four additional cases of severe memory loss in their 2502 study patients during the clinical evaluation phase of Lipitor development, over five years ago. Somehow this information never was effectively communicated to the doctors responsible to prescribe this drug, helping greatly to explain FAAs current practice of allowing statin drug use in commercial airline pilots. Their flight surgeons never were informed of this. And it is not as rare as one might think. This ratio of 11/2502 (5/1000) translates into 150,000 expected cases of severe memory impairment this year alone among our 30 million Lipitor users.
9. If I cant take statins, what about my cholesterol?
Answer See answer 4 and remember, cholesterol is not your problem. Inflammation is!
10. What is high cardiovascular risk?
Answer This is based on ones personal and family history. Regardless of your cholesterol level, if your ancestors and blood relatives experienced premature heart attacks and/or strokes, you are at high risk. If you have experienced symptoms of angina, transient ischemic attacks (TIAs) or have a history of definite or suspected myocardial infarction (MI, heart attack), you are high cardiovascular risk and should be thinking inflammation suppression. (See answer 4)
11. What is the best source of omega 3?
Answer Omega 3 is found in fish, especially the oil rich fish such as herring, mackerel and sardines. Small amounts are found in eggs. Certain vegetable oils such as flaxseed, canola and walnut contain a short chain type of omega less efficiently metabolized. Fish oils are now increasingly available for use directly in capsule form or as an additive in certain foods (eggs, spreads and juices).
12. What is better buffered baby aspirin or a regular 325 mg aspirin?
Answer The 81mg dose of buffered aspirin is nearly as effective as regular aspirin in platelet inhibition (the mechanism of action of aspirin in CV disease) and has much less likelihood for side effects in unusually sensitive individuals. Remember the buffer contains magnesium, having its own benefit in heart disease.
13. Your book recommends supplementing vitamins B6, B12 and folic acid. My pharmacy has many different brands of these vitamins, both single and combined. How big a dose should I be taking?
Answer The rules are somewhat arbitrary but 80-100mg of B6, 200-250mcg of B12 and 400-800mcg of folic acid would be considered in the desirable range to insure homocysteine control.
14. I have seen Co-enzyme Q10 recommended in doses varying from 100mg daily to 2000mg or more daily for certain diseases. Was this a typo or true and what is the best form of Q10 to take?
Answer True, the dose depends on the condition. If you are using it with your statin merely to prevent the onset of muscles aches and pains or nerve damage with its numbness, weakness and pain, a dosage or 100 to 200mg daily is reasonable. On the other hand, if you already have these symptoms and have stopped your statin drug and are trying to get back to normal, a daily dose of 500-1000mg might be reasonable, since Q10 is a very safe, natural substance. It is true also that in selected clinical trials of certain neurological diseases, doses up to 2400mg daily are being studied. As to the best form, try to find Gelcaps and look for economy.
posted by Chris Gupta on Monday March 28 2005
updated on Sunday October 24 2010
URL of this article:
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