Statins?

[Daibell]

The Cholesterol level of 4 to be offered statins as a diabetic is the number provided by NICE and just plucked out of thin air. The algorithm used is also pretty silly as any older person automatically triggers the 'need'. When my diabetes GP a long time ago found that NICE had changed the previous 5 to 4 said before long we wouldn't have any fat left in our bodies!

 

[Guzzler]

Malcolm Kendrick on Data, sausages and statins.
Half an hour video but starts to speak about statins after about 15 mins.

Look out for the factoid of 15 days in 5 years, I was stunned.

 

[Vegman1441]

Statins crippled me, I can no longer stand or walk for more than 5 min.
After PPI Statins claims will be next.

 

[Vegman1441]

Statins crippled me, I can no longer stand or walk for more than 5 min.
After PPI Statins claims will be next.

 

[Guzzler]

Statins crippled me, I can no longer stand or walk for more than 5 min.
After PPI Statins claims will be next.

Kendrick mentions 'irreversible' symptoms. I am so sorry that you suffer with pain like this, it is so limiting.

 

[Daphne917]

A lesser known side effect is sleep issues. This happened to Mr. Blue when he took statins a few years ago. He didn't experience any muscle pains. He reported this to his GP who advised him to take them in the morning rather than bedtime. (Bedtime is the time advised on the package) He did this, but saw no improvement, so he just stopped taking them without informing anyone. The sleep issues improved. There must be thousands that do this - assuming they relate the problem to statins in the first place.

I had sleep issues as well as sudden dizzy spells and raised BS hence why I stopped taking them!

 

[mcdonagh47]

The Cholesterol level of 4 to be offered statins as a diabetic is the number provided by NICE and just plucked out of thin air.

No, the figure of 4 is not plucked out of thin air. It comes from the researches of Edwin Biermann in the mid 1990s. He found that at levels over 5 in the general population ( non-diabetics) the incidence of cardio/heart disease increased significantly. The same tipping point for cardio/heart disease for diabetics came at levels over 4. Consequently the recommendations were and are under 5 for non-diabetics and under 4 for diabetics. Of course more stringent ratios have been added to those general figures based on levels of HDL ( the scavengers/binmen who help to clean up the mess made by LDL).
The lower recommendations for cholesterol in diabetics arise because of the particular problem we have with LDL. These are the bad boys who get through the pores in the outer layer of the arteries into the Intima and fly-tip cholesterol onto the Endothelium ( inner layer of the artery). We have a problem with LDL because it is over-produced when bgs are raised. so diabetics are prone to raised levels of LDL depositing cholesterol in the linings of our arteries.
This is the basis of Diabetic Dyslipidemia ( raised Total Chol, raised LDL and depressed HDL) which is one of the commonest ( if not the commonest) complication of diabetes. Diabetic Dyslipidemia is the precursor of the cardio/heart disease that diabetics are heir to ( 80% of diabetics die of cardio/heart disease).
Of course raised Cholesterol ( hunter-gatherers have chols in the 2.25 to 2.75 range) is an integral part of the Metabolic Syndrome ( Reavons Syndrome or Syndrome X ) that affects Type 2 Diabetes. The Four Horsemen of the Apocalypse ride together and exacerbate each other - Weight/Obesity, Hyperglycemia, Hypercholesterolenemia and Hypertension. Type 2s have to juggle all four balls in the air at once ( weight, bgs, cholesterol, blood pressure) - good control is not just about bgs !
Control of cholesterol, meeting the targets and ratios, is not an optional extra for diabetics ( especially Type 2s) - it is an essential part of good diabetic control and Statins are an invaluable weapon in that battle. They are an insurance policy to keep good lipid panels acceptable and to improve unacceptable lipid panels. And as all the research with them says - they are well tolerated and cause few problems.

 

[Guzzler]

No, the figure of 4 is not plucked out of thin air. It comes from the researches of Edwin Biermann in the mid 1990s. He found that at levels over 5 in the general population ( non-diabetics) the incidence of cardio/heart disease increased significantly. The same tipping point for cardio/heart disease for diabetics came at levels over 4. Consequently the recommendations were and are under 5 for non-diabetics and under 4 for diabetics. Of course more stringent ratios have been added to those general figures based on levels of HDL ( the scavengers/binmen who help to clean up the mess made by LDL).
The lower recommendations for cholesterol in diabetics arise because of the particular problem we have with LDL. These are the bad boys who get through the pores in the outer layer of the arteries into the Intima and fly-tip cholesterol onto the Endothelium ( inner layer of the artery). We have a problem with LDL because it is over-produced when bgs are raised. so diabetics are prone to raised levels of LDL depositing cholesterol in the linings of our arteries.
This is the basis of Diabetic Dyslipidemia ( raised Total Chol, raised LDL and depressed HDL) which is one of the commonest ( if not the commonest) complication of diabetes. Diabetic Dyslipidemia is the precursor of the cardio/heart disease that diabetics are heir to ( 80% of diabetics die of cardio/heart disease).
Of course raised Cholesterol ( hunter-gatherers have chols in the 2.25 to 2.75 range) is an integral part of the Metabolic Syndrome ( Reavons Syndrome or Syndrome X ) that affects Type 2 Diabetes. The Four Horsemen of the Apocalypse ride together and exacerbate each other - Weight/Obesity, Hyperglycemia, Hypercholesterolenemia and Hypertension. Type 2s have to juggle all four balls in the air at once ( weight, bgs, cholesterol, blood pressure) - good control is not just about bgs !
Control of cholesterol, meeting the targets and ratios, is not an optional extra for diabetics ( especially Type 2s) - it is an essential part of good diabetic control and Statins are an invaluable weapon in that battle. They are an insurance policy to keep good lipid panels acceptable and to improve unacceptable lipid panels. And as all the research with them says - they are well tolerated and cause few problems.

How do you reconcile the fact that of the people who die of an MI more of them have low cholesterol than high? Also, it is sdLDL that 'can' do damage, the body's LDL is in itself a natural progression.
If someone were to take statins to artificially lower LDL and reach for the cholesterol lowering foods (another scam) what damage does that do to an otherwise healthy individual?

As for the data, see my earlier comment with a short interview with Malcolm Kendrick. Cardiovascular Surgeon Aseem Malhotra is another voice in the growing camp of boffins who say that statins/cholesterol has a history of poor research and underhand tactics by Big Pharma.

 

[maureen5752]

Disagree 100% A straw poll in one of the medical journals (BMJ or Lancet, can't remember but as they sit on either side of the fence, it's only one of them) found that 60% of GPs who answered the poll (skews results already I admit) would not prescribe statins for themselves or a family member.

It seems impossible to get proper empirical evidence because the bloke who has custody of most of the data in the UK (Prof Rory Collins, I think) won't let anyone look at it. I wonder why? Obviously nothing to do with his funding, or is it?

Anecdotally all I can say is that I had a lot of muscle pain which didn't disappear when I stopped taking them, in my view, that's harmful. My father, when 85 was prescribed statins and he could no longer walk round the block ever day because of muscle pain. Worried about cholesterol at 85? I think it was better he went for a walk, he got to 85 without any problems.

I think the prescribing of statins is down to NICE guidelines and a lot of GPs overlook the fact that it's not compulsory. I actually know somebody whose GP said "you can take them, or you could die". I would have reported any doctor try that old chestnut, we put a lot of faith in our GPs, we don't have too much choice, they need to be able to use their loaf a bit.

@DavidGrahamJones, I saw diabetic doctor few days ago, DN doubled my statins recently, after few days I had terrible pains in my hands & feet ect. I told doctor about the pain & said I wouldn't take high dose again In fact don't want to take statins, his reply was "you can have high cholestrol or low cholestrol". I was given prescription for 2 months on high dosage, Ive stopped taking high dosage & since pain has almost gone. I feel so much better. As you said we put our faith in the doctors,

 

[Guzzler]

This was my experience.

Locum GP at my old surgery, "Some people experience muscle pain".
DN at new surgery, "It's not true, only people in the trials that reported pain were in the control group".
New GP, "Some of the older statins caused pain, the newer ones don't".

I took them for one week and immediately experienced muscle pain (after just five days) so I stopped taking them.

Then came the silly qrisk and the mithering.

 

[TipTop2]

Hmmmm there are very negative comments on statins here and the media is promoting this adverse reaction currently.
The facts are that if you have at least one CVD risk factor and/or ongoing raised cholesterol levels then there is a Ton of robust long-term evidence supporting the use of statins (20+ yrs). They are then indicated to be used by the major diabetic associations globally in the above situations. Quite honestly, if like me you are diabetic you’re already at higher risk of CVD which is why BS control is so important. So is cholesterol control. Read the evidence-based literature:
https://www.medscape.com/viewarticle/835238

Putting it simply they reduce CVD risk significantly. The evidence is overwhelming. If you’d rather take the risk and not use them that’s up to you. It’s your life. Me, I’ll go with the L-T well conducted evidence.

Like all drugs there are S/Es and those of statins are well known. If you can’t tolerate them that’s unfortunate. That’s doesn’t mean you shouldn’t try to take them. Personally I’ve been on atorvastatin since being diagnosed Type II age 50 and tolerated it without any problems whatsoever.

 

[TipTop2]

Hmmmm there are very negative comments on statins here and the media is promoting this adverse reaction currently.
The facts are that if you have at least one CVD risk factor and/or ongoing raised cholesterol levels then there is a Ton of robust long-term evidence supporting the use of statins (20+ yrs). They are then indicated to be used by the major diabetic associations globally in the above situations. Quite honestly, if like me you are diabetic you’re already at higher risk of CVD which is why BS control is so important. So is cholesterol control. Read the evidence-based literature:
https://www.medscape.com/viewarticle/835238

Putting it simply they reduce CVD risk significantly. The evidence is overwhelming. If you’d rather take the risk and not use them that’s up to you. It’s your life. Me, I’ll go with the L-T well conducted evidence.

Like all drugs there are S/Es and those of statins are well known. If you can’t tolerate them that’s unfortunate. That’s doesn’t mean you shouldn’t try to take them. Personally I’ve been on atorvastatin since being diagnosed Type II age 50 and tolerated it without any problems whatsoever.

Sorry - above Link didn’t work, try this for statin trial evidence:
https://www.wikijournalclub.org/wiki/WOSCOPS

 

[librarising]

Personally I’ve been on atorvastatin since being diagnosed Type II age 50 and tolerated it without any problems whatsoever.

Others have not been so fortunate as you. Statin-pushers seem to want to ignore such side-effects :
https://spacedoc.com/articles/lipitor-thief-of-memory
Geoff

 

[Jo_the_boat]

No, the figure of 4 is not plucked out of thin air. It comes from the researches of Edwin Biermann in the mid 1990s. He found that at levels over 5 in the general population ( non-diabetics) the incidence of cardio/heart disease increased significantly. The same tipping point for cardio/heart disease for diabetics came at levels over 4. Consequently the recommendations were and are under 5 for non-diabetics and under 4 for diabetics. Of course more stringent ratios have been added to those general figures based on levels of HDL ( the scavengers/binmen who help to clean up the mess made by LDL).
The lower recommendations for cholesterol in diabetics arise because of the particular problem we have with LDL. These are the bad boys who get through the pores in the outer layer of the arteries into the Intima and fly-tip cholesterol onto the Endothelium ( inner layer of the artery). We have a problem with LDL because it is over-produced when bgs are raised. so diabetics are prone to raised levels of LDL depositing cholesterol in the linings of our arteries.
This is the basis of Diabetic Dyslipidemia ( raised Total Chol, raised LDL and depressed HDL) which is one of the commonest ( if not the commonest) complication of diabetes. Diabetic Dyslipidemia is the precursor of the cardio/heart disease that diabetics are heir to ( 80% of diabetics die of cardio/heart disease).
Of course raised Cholesterol ( hunter-gatherers have chols in the 2.25 to 2.75 range) is an integral part of the Metabolic Syndrome ( Reavons Syndrome or Syndrome X ) that affects Type 2 Diabetes. The Four Horsemen of the Apocalypse ride together and exacerbate each other - Weight/Obesity, Hyperglycemia, Hypercholesterolenemia and Hypertension. Type 2s have to juggle all four balls in the air at once ( weight, bgs, cholesterol, blood pressure) - good control is not just about bgs !
Control of cholesterol, meeting the targets and ratios, is not an optional extra for diabetics ( especially Type 2s) - it is an essential part of good diabetic control and Statins are an invaluable weapon in that battle. They are an insurance policy to keep good lipid panels acceptable and to improve unacceptable lipid panels. And as all the research with them says - they are well tolerated and cause few problems.

From one of his obituaries...... . "In another seminal piece, he advocated a then-unconventional diet for diabetes that cut down on fat and cholesterol in favor of complex carbohydrates."
His research was over 20 years ago. May I suggest that things have moved on somewhat since then?

While reading a little about Type 2..
I may be mistaken but I have read that increased insulin produces arterial inflammation which in turn allows (one variant of) ldl to enter to the damaged arteries. So cutting back glucose reduces the need for insulin thus reducing inflammation.

For goodness sake someone put me right if I've messed up...

 

[Guzzler]

A couple of points. sdLDL is not measured by the NHS in any numbers here. The best, and by no means fully accurate, marker for measuring risk is the HDL to Triglyceride ratio. TC is a poor indicator as is LDL.
GPs mostly see TC and, because they are incentivised to do so, put those deemed at risk onto statins. Then, otherwise healthy people are put on statins simply because they have reached a prescribed age and even the very elderly are put on them which begs the question of why when someone has reached the age of eighty you would say they are at risk of dying? They reached 80! Of course there is a risk of dying.

That leads to the question of Data. Real world data says one thing but statistics can be made to say whatever one wants. Association is not causation and much of the data re statins relies on association. When even the top boffins cannot tell you the full role/s of cholesterol and admit openly that much more needs to be done in the way of research before making firm decisions about whether or not a 'treatment' should be devised then that speaks volumes in terms of the choices that real world people (that's you and me) can make about our own health.

Personally, there is a strong familial history of CVD/CHD in my family and I am a smoker and have Diabetes, I have not made the decision to avoid statins lightly.

 

[Guzzler]

From one of his obituaries...... . "In another seminal piece, he advocated a then-unconventional diet for diabetes that cut down on fat and cholesterol in favor of complex carbohydrates."
His research was over 20 years ago. May I suggest that things have moved on somewhat since then?

While reading a little about Type 2..
I may be mistaken but I have read that increased insulin produces arterial inflammation which in turn allows (one variant of) ldl to enter to the damaged arteries. So cutting back glucose reduces the need for insulin thus reducing inflammation.

For goodness sake someone put me right if I've messed up...

That is a theory that I have read. Ivor Cummins puts it in plain English in his lecture 'The Cholesterol Conundrum'.

 

[Mike d]

That’s doesn’t mean you shouldn’t try to take them.

In the face of evidence to the contrary, no way

 

[Squire Fulwood]

That’s doesn’t mean you shouldn’t try to take them.

I don't criticise them gratuitously. I took them as prescribed, four different makes in all. I spent months in a chair and a couple of weeks in the care of a physiotherapist. Finally, when it was proved beyond doubt what the trouble was I was regarded as "Intolerant of Statins" which was recorded on my medial record.

EDIT: I'm curious to know why you make the generalisation that opinions were formed by people who haven't tried to take them.

 

[bulkbiker]

They are then indicated to be used by the major diabetic associations globally in the above situations.

The ones that advocate carbs with every meal?
The evidence that statins are beneficial to those with risk factors is owned by the pharma companies that make and profit from them and has never been made available for independent scrutiny. Having read a lot about cholesterol and its being essential for life there is no way I'm going to mess with mine by taking a pill provided by a doctor who understands less than I do about the condition he is prescribing for.

 

[Guzzler]

The ones that advocate carbs with every meal?
The evidence that statins are beneficial to those with risk factors is owned by the pharma companies that make and profit from them and has never been made available for independent scrutiny. Having read a lot about cholesterol and its being essential for life there is no way I'm going to mess with mine by taking a pill provided by a doctor who understands less than I do about the condition he is prescribing for.

Aye, and the phrase 'Mass Medication' sends shivers of fear down my spine. There only one group of people benefitting from statins and that group is the one that pushes it.

That is unless you count the people who suffer from the extremely rare condition of hypercholesterolaemia.