Statin side effects all in the mind !

[Dollylolly]

Mine demanded me to take mine the last time I was in. I ask why she gave because of age and your diabetic. I said there is no heart disease in the family why do I need them? You could she says and I might not I say. I then went on to say about the muscles hurting and the heart is one too she grumbled something and typed something on the computer.

I have nursy this month and I await what she says once again should be interesting as she freaked the last time over my high fat diet when it not all high fats it's low carb high good fats with intermittent fasting that just means missing breakfast.

 

[RosieLKH]

When I told our diabolical, sorry diabetic nurse (she's OK in some ways) I wasn't taking my statins she got very shirty with me and said "Don't believe everything you read in the Daily Mail." I think I instantly slipped into Deputy Head mode, because I told her off for her insulting choice of words.

 

[zand]

Mine demanded me to take mine the last time I was in. I ask why she gave because of age and your diabetic. I said there is no heart disease in the family why do I need them? You could she says and I might not I say. I then went on to say about the muscles hurting and the heart is one too she grumbled something and typed something on the computer.

I have nursy this month and I await what she says once again should be interesting as she freaked the last time over my high fat diet when it not all high fats it's low carb high good fats with intermittent fasting that just means missing breakfast.

Well I think I read there's new NICE guidelines re diabetic cholesterol levels. The target is no longer TC <4, it's <5 , like the rest of the population. That should give you a bit more leeway. Or maybe I was dreaming?

I usually tell them I have read Dr Uffe Ravnskov 'The Cholesterol Myths' which debunks the theory that high cholesterol is bad. That shuts them up because they can't be bothered to read it themselves.

 

[dbr10]

"The trial was funded by Pfizer, which markets atorvastatin under the trade name Lipitor."

This was also covered by the BBC and Sky who both increasingly fail to question the stories they are given. I'm not suggesting there is any conflict of interest here, but why don't so-called journalists ever investigate what they are told, instead of just accepting it at face value?

 

[Bluetit1802]

Well I think I read there's new NICE guidelines re diabetic cholesterol levels. The target is no longer TC <4, it's <5 , like the rest of the population. That should give you a bit more leeway. Or maybe I was dreaming?

I usually tell them I have read Dr Uffe Ravnskov 'The Cholesterol Myths' which debunks the theory that high cholesterol is bad. That shuts them up because they can't be bothered to read it themselves.

https://www.nice.org.uk/guidance/cg...the-primary-and-secondary-prevention-of-cvd-2

It seems "the use of strict lipid cut-off values" is now removed from the recommendations

Lipid measurement and referral

1.3.3 Measure both total and high‑density lipoprotein (HDL) cholesterol to achieve the best estimate of CVD risk. [2008]

1.3.4 Before starting lipid modification therapy for the primary prevention of CVD, take at least 1 lipid sample to measure a full lipid profile. This should include measurement of total cholesterol, HDL cholesterol, non‑HDL cholesterol and triglyceride concentrations. A fasting sample is not needed. [new 2014]
For information about implementing this recommendation, see implementation: getting started.

1.3.5 Use the clinical findings, lipid profile and family history to judge the likelihood of a familial lipid disorder rather than the use of strict lipid cut‑off values alone. [new 2014]

1.3.6 Exclude possible common secondary causes of dyslipidaemia (such as excess alcohol, uncontrolled diabetes, hypothyroidism, liver disease and nephrotic syndrome) before referring for specialist review. [new 2014]

1.3.7 Consider the possibility of familial hypercholesterolaemia and investigate as described in familial hypercholesterolaemia (NICE guideline CG71) if they have:

• a total cholesterol concentration more than 7.5 mmol/litre and
  
  
• a family history of premature coronary heart disease. [new 2014]
  

1.3.8 Arrange for specialist assessment of people with a total cholesterol concentration of more than 9.0 mmol/litre or a non‑HDL cholesterol concentration of more than 7.5 mmol/litre even in the absence of a first‑degree family history of premature coronary heart disease. [new 2014]

1.3.9 Refer for urgent specialist review if a person has a triglyceride concentration of more than 20 mmol/litre that is not a result of excess alcohol or poor glycaemic control. [new 2014]

1.3.10 In people with a triglyceride concentration between 10 and 20 mmol/litre:

• repeat the triglyceride measurement with a fasting test (after an interval of 5 days, but within 2 weeks) and
  
  
• review for potential secondary causes of hyperlipidaemia and
  
  
• seek specialist advice if the triglyceride concentration remains above 10 mmol/litre. [new 2014]
  

1.3.11 In people with a triglyceride concentration between 4.5 and 9.9 mmol/litre:

• be aware that the CVD risk may be underestimated by risk assessment tools and
  
  
• optimise the management of other CVD risk factors present and
  
  
• seek specialist advice if non‑HDL cholesterol concentration is more than 7.5 mmol/litre. [new 2014]
  

https://www.nice.org.uk/guidance/cg181/chapter/2-Implementation-getting-started


2.1 Measuring non-high density lipoprotein cholesterol when lipid profiling for the primary prevention of cardiovascular disease
See recommendation 1.3.4.

Potential impact of implementation

Non-high density lipoprotein (non-HDL) cholesterol is seen to be a better cardiovascular disease (CVD) risk indicator than low-density lipoprotein (LDL) cholesterol. It is more accurate, more practical and cost effective. A fasting blood sample is not needed. This is more convenient for patients and may reduce the need for additional blood samples. Those requesting lipid profiles for their patients – such as GPs, practice nurses and community pharmacists – may need to change their practice. Laboratories may also need to change their reporting procedures.

 

[librarising]

Well I think I read there's new NICE guidelines re diabetic cholesterol levels. The target is no longer TC <4, it's <5 , like the rest of the population. That should give you a bit more leeway. Or maybe I was dreaming?

"For people with diabetes NICE recommends [150]:

• Consider statin treatment for all adults with type 1 diabetes
• Offer statins to anyone with type 2 diabetes with a 10% or greater risk of developing heart disease in the next 10 years"

http://www.diabetes.co.uk/Diabetes-and-cholesterol.html

"1.1.9 Do not use a risk assessment tool to assess CVD risk in people with type 1 diabetes. See recommendations 1.3.23, 1.3.24 and 1.3.25 for advice on treatment with statins for people with type 1 diabetes. [new 2014]

1.1.10 Use the QRISK2 risk assessment tool to assess CVD risk in people with type 2 diabetes. [new 2014]"

https://www.nice.org.uk/guidance/cg181/chapter/1-recommendations

I tried looking for your 'new' guidelines, honest guv. Perhaps go for a lie-down ?
Geoff

 

[Dillinger]

It might be true that statins don't cause muscle pains directly.

Hi Zand!

They do cause myopathy (muscle pain) directly because they interfere with the production of co-enzyme q10. And the drug companies know this; Merck registered a patent for statins and co-enzyme q10 in 1989 but then never released the combo-pill. Who knows why? Possibly because it's not good pr to say your wonder drug that stops heart attacks causes myopathy in case anyone notices what the heart is made of?!

of http://weeksmd.com/2009/08/the-patent-for-statin-drugs-included-co-q-10/

If you are a woman and you take statins you will not live a day longer than if you didn't, if you are a man you live something like 3 months longer.

The best absolute risk reduction for statins ever demonstrated was a 1.8% reduction meaning if out of 100 unstatinated people you might expect 4 fatal heart attacks with 100 satinated people you would expect 2 fatal heart attacks. [Absolute mortality reduction in the Heart Protection Study (HPS), the most positive statin trial, was 1.8% over five years]

That's still a tiny impact if you think about it.

If you've had a heart attack it might be worth using them, if you haven't the evidence is very poor for their benefit. Low carb, drink red wine moderately, do exercise in the sun eat more potassium; all of those have no side effects and will make you live longer and better than statins.

 

[zand]

Hi Zand!

They do cause myopathy (muscle pain) directly because they interfere with the production of co-enzyme q10. And the drug companies know this; Merck registered a patent for statins and co-enzyme q10 in 1989 but then never released the combo-pill. Who knows why? Possibly because it's not good pr to say your wonder drug that stops heart attacks causes myopathy in case anyone notices what the heart is made of?!

of http://weeksmd.com/2009/08/the-patent-for-statin-drugs-included-co-q-10/

If you are a woman and you take statins you will not live a day longer than if you didn't, if you are a man you live something like 3 months longer.

The best absolute risk reduction for statins ever demonstrated was a 1.8% reduction meaning if out of 100 unstatinated people you might expect 4 fatal heart attacks with 100 satinated people you would expect 2 fatal heart attacks. [Absolute mortality reduction in the Heart Protection Study (HPS), the most positive statin trial, was 1.8% over five years]

That's still a tiny impact if you think about it.

If you've had a heart attack it might be worth using them, if you haven't the evidence is very poor for their benefit. Low carb, drink red wine moderately, do exercise in the sun eat more potassium; all of those have no side effects and will make you live longer and better than statins.

Yeh ooops I forgot about CoQ10 ...which I shouldn't have done because I sometimes have a supplement of this myself.

 

[zand]

@librarising and @Bluetit1802 thanks for those links. Don't have the brain power to read them now, but I guess what on saw on TV weren't official guidelines then. So the bad news is that they are still trying to foist statins onto diabetics then...as if we don't have enough problems already huh?

 

[Bluetit1802]

@librarising and @Bluetit1802 thanks for those links. Don't have the brain power to read them now, but I guess what on saw on TV weren't official guidelines then. So the bad news is that they are still trying to foist statins onto diabetics then...as if we don't have enough problems already huh?

But not automatically for T2s. They have to do the overall risk thing and take account of all the factors, rather than blanket "we give statins to all diabetics" You weren't dreaming. I have seen it somewhere in writing that the <4 thing has gone. It seems to be more the Non-HDL level they look at now and I have a note this should be under 3.4 in UK units.

However, on the QRisk calculation it only takes account of T2 diabetes, not how well it is controlled. And ticking that box just about doubles the estimated risk on the formula, so very few of us have a chance of escaping, especially us oldies as age also increases the risk score quite considerably.

 

[librarising]

"For people with diabetes NICE recommends [150]:

• Consider statin treatment for all adults with type 1 diabetes
• Offer statins to anyone with type 2 diabetes with a 10% or greater risk of developing heart disease in the next 10 years"

http://www.diabetes.co.uk/Diabetes-and-cholesterol.html

"1.1.9 Do not use a risk assessment tool to assess CVD risk in people with type 1 diabetes. See recommendations 1.3.23, 1.3.24 and 1.3.25 for advice on treatment with statins for people with type 1 diabetes. [new 2014]

1.1.10 Use the QRISK2 risk assessment tool to assess CVD risk in people with type 2 diabetes. [new 2014]"

https://www.nice.org.uk/guidance/cg181/chapter/1-recommendations

I tried looking for your 'new' guidelines, honest guv. Perhaps go for a lie-down ?
Geoff

Found this, regarding a rejigging of the QRISK2 criteria from 2015 to 2016 :
"Total cholesterol (TC) will be categorised into three bands (<5.0, 5.0–6.9 and ≥7.0 mmol/L), and high-density lipoprotein (HDL) cholesterol into four bands (≤1.2, 1.3–1.4, 1.5–1.7 and ≥1.8 mmol/L) as these cut-offs have been used previously in the literature."
and from the same source :
"In 2014, guidelines for England and Wales on lipid modification reduced the predicted risk threshold at which patients should be offered statins from a 20% 10-year risk to 10%.5 ,7 This recommendation was met with considerable concern from the medical community that it would lead to widespread overprescribing of statins with little clinical benefit but considerable potential for harm.36 ,37 This widely publicised criticism may have increased concerns that risk scoring leads to oversimplification of clinical decisions and overprescribing and may have, perversely, decreased the use of risk scoring and reinforced the use of lipid levels to guide decision-making. There is some evidence to suggest there was a decrease in statin initiations around this time due to the negative media attention."
http://bmjopen.bmj.com/content/6/11/e013120.full

Without knowing what the previous Total Cholesterol bands were, I notice that the lower group is Under 5.0. If it was previously Under 4.0, when they lowered the threshold for prescribing statins, it seems to have been raised again due to external pressure.
N.B. Under 4.0 and Under 5.0 are not necessarily a GP's target figure for a T2D. They are figures used in an algorithm to determine risk.
Hope that's clear.
**goes for a lie-down**
Geoff

 

[daisyduck]

If I was reporting false side effects then I did it four times on four different statins over a period of two years or so. My DN does not give up easily. Now, even she admits I can't tolerate them.

Snap ! I was tried on 4 different statins and they all had the same effect of severe muscle and joint pain after a couple of weeks which got worse the longer I took them. I couldn't tolerate it any more after trying 3/4 weeks on each type, so now refuse to consider them..

 

[JeanCL]

A study in the Lancet has concluded that patients suffer side effects from statins due to a 'nocebo' effect. They experience them because they expect them.

They are calling for the side effects NOT to be listed due to this.

The study compared a dosage of 10mg of Atorvastatin vs a placebo where the rate of muscle aches and pains reported was the same for both arms of the trial.

My first thought was that 10mg of Atorvastatin was only a very small dosage.

http://www.express.co.uk/life-style...-side-effects-life-saving-statins-cholesterol

The Express doesn't give much info on the background of the trial but via the Hindustan Times there is this info ...

"The trial was funded by Pfizer, which markets atorvastatin under the trade name Lipitor."

It sounds very suspicious and of questionable integrity not to list side effects, not least as people may continue taking the drugs even if they are causing them distress and harm, and be unaware that they are to blame. I had a lot of muscle pain when I'd been on them a while and came off them. I've taken take a Soya Lecithin supplement from the Healthfood shop ever since and have just learnt that, though my overall cholesterol reading is a bit high, it is because my 'good' cholesterol is high - which is great news. I've also reduced stress levels and carbohydrates, reducing my Blood Glucose below prediabetes levels, and halving my Blood Pressure medication.

 

[Squire Fulwood]

It sounds very suspicious and of questionable integrity not to list side effects, not least as people may continue taking the drugs even if they are causing them distress and harm, and be unaware that they are to blame.

The situation is a little worse than that since the professor in charge of testing the statins said that he never tested them for side effects at all but would be willing to do so if someone would fund it.

http://www.express.co.uk/news/uk/558249/statins-expert-heart-drug-rory-collins

 

[Bluetit1802]

The situation is a little worse than that since the professor in charge of testing the statins said that he never tested them for side effects at all but would be willing to do so if someone would fund it.

http://www.express.co.uk/news/uk/558249/statins-expert-heart-drug-rory-collins

and of course, Big Pharma won't cough up.

 

[Nicksu]

Either way, at my appointment at the diabetic clinic on Monday, if they mention it, I am going to say declined. Taking a drug which could potentially cause muscle weakness, when I already have a condition which can cause this when active (Myasthenia Gravis) is a no no as far as I'm concerned. Oh, this nanny state we live in!

 

[Enclave]

"For people with diabetes NICE recommends [150]:

• Consider statin treatment for all adults with type 1 diabetes
• Offer statins to anyone with type 2 diabetes with a 10% or greater risk of developing heart disease in the next 10 years"

The problem I have is personal with any nice recommendations ... If they are still recommending the eat well plate for T2 diabetes then how can we have faith in any of their advice ..

 

[Squire Fulwood]

The problem I have is personal with any nice recommendations ... If they are still recommending the eat well plate for T2 diabetes then how can we have faith in any of their advice ..

I think it's Public Health England who push the Eatwell Guide.

NICE just say that Type 2's should be encouraged to eat the same as the rest of the population. I think they modified their statement a couple of months ago but it it less clear than before. Anyway it's section 1.3.3. of the guidelines on diabetes.

1.3.3Emphasise advice on healthy balanced eating that is applicable to the general population when providing advice to adults with type 2 diabetes. Encourage high‑fibre, low‑glycaemic‑index sources of carbohydrate in the diet, such as fruit, vegetables, wholegrains and pulses; include low‑fat dairy products and oily fish; and control the intake of foods containing saturated and trans fatty acids. [2009]

 

[Enclave]

I think it's Public Health England who push the Eatwell Guide.

NICE just say that Type 2's should be encouraged to eat the same as the rest of the population. I think they modified their statement a couple of months ago but it it less clear than before. Anyway it's section 1.3.3. of the guidelines on diabetes.

1.3.3Emphasise advice on healthy balanced eating that is applicable to the general population when providing advice to adults with type 2 diabetes. Encourage high‑fibre, low‑glycaemic‑index sources of carbohydrate in the diet, such as fruit, vegetables, wholegrains and pulses; include low‑fat dairy products and oily fish; and control the intake of foods containing saturated and trans fatty acids. [2009]

Its also my bit of Scotland .. I am labelled no confirming because I refuse to up my carbs and lower my fats to almost zero !!! Ordered to eat to the eat well nice plate

 

[zand]

I've been mulling over the issue - Statin side effects all in the mind ! What makes these people so arrogant that they think we are all stupid ? What I always say about placebos is 'does it matter if my brain is clever enough to heal me with some harmless placebo?' Healed is healed. I don't care why, I just want to feel better. So the reverse of that is much the same. I don't believe for one minute that the statin issue is down to the nocebo effect, and even if it is, muscle pains are horrid. Why take statins to get them?

It's the same mentality as doctors who put you on a diet and when you come back fatter than before won't believe it's their diet at fault but assume you have been cheating. Honestly! Why would I cheat if I want to lose weight/ control my BGs/etc?

Grrrrr 'They' are arrogant, complacent and money grabbing - which in themselves are pretty bad qualities... and then in addition to all of that these people will happily cause harm to others to satisfy their own pride/ambition and to increase their wealth? Criminal doesn't begin to cover it.