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Statins and liver function

B

Beechnut

Active Member
Messages
28
Type of diabetes
Prediabetes
Treatment type
Diet only
OLast August at a routine GP appointment I was told that I was heading for metabolic syndrome with a high waist measurement, overweight BMI 28, high blood pressure 160/85, high cholesterol 6.5 and higher than normal blood glucose which I found out later was not in the diabetic range (39). I was advised to go on statins and blood pressure medication and lose weight by eating low fat diet which I did being somewhat alarmed by what I'd heard.

As advised I had repeat blood tests in February this year, my blood glucose was up to 42, I had not lost any weight despite going on the low fat diet as I was told to. Overall cholesterol was down to 4.3 but shockingly my liver function tests were all mega high, over three times what they should be! I must say I was stunned as they were all within the normal range in August last year.

The only thing that had changed was that I was on statins and blood pressure medication. The GP explained that statins directly affect the liver and can rarely affect liver enzymes. He had a medical student with him and he said to him " This is why it is vital to do liver function tests for people starting on statins. We would never have know that this lady had liver problems until it was too late if we hadn't done the tests". I was so stunned! He told me to stop taking the statins.

Since then having read around this forum and other things like Dr David Unwins's work I have gone against my GP's advice and started on a low carb diet and I feel great. I'm losing weight and have lost my cravings. Having been constantly hungry I'm now satisfied with my meals and can go hours without eating - totally unheard of for me. I'm hoping that my next blood tests in 3 weeks time show better liver function tests, the GP seems to think they will but this is so worrying. I wondered if anyone else had this experience with statins?
 
I had the same experience with statins, I was given Atorvastatin and my liver count went through the roof after 2 weeks, the GP himself actually called me to tell me to stop taking them immediately, he sent me for a liver scan but that was fine including no fatty liver, and my next blood test 6 weeks late my liver count was down a bit, the one after that was back to pre statin level so try not to worry, it’s now on my records as allergic to statins
 
Beechnut said:
... I wondered if anyone else had this experience with statins?
Click to expand...
I've been taking Atorvastatin 20mg as a maintenance dose
for about three years, with no negative effects on my liver
function.

​

 
Beechnut said:
Thanks lovinglife that's very reassuring. Yes ausGeoff I believe mine is a rare reaction to statins.
Click to expand...
Yes it’s rare to have the reaction we have to statins - save me having the “you need to be on statins” though every time I see any HCP, every cloud ;)
 
Haha yes but GP is threatening other meds instead of Atorvastatin to lower my cholesterol because he says that takes priority over my liver! I'm very wary of taking anything that messes with my liver but it's hard to know which is the most important experts do not always agree on this. I'm hoping new low carb diet will help with future results but again so many say all that fat is not going to lower your cholesterol. Hey ho
 
Beechnut said:
Haha yes but GP is threatening other meds instead of Atorvastatin to lower my cholesterol because he says that takes priority over my liver! I'm very wary of taking anything that messes with my liver but it's hard to know which is the most important experts do not always agree on this. I'm hoping new low carb diet will help with future results but again so many say all that fat is not going to lower your cholesterol. Hey ho
Click to expand...

I don’t get on with statins as the raise my BG, I have an alternative to statins that is both reducing my cholesterol and not affecting me in any other way
 
I'm on 10mg of Rosuvastatin I've been on them since last November. I had resisted them for several years as my Triglycerides were low at 0.53 mmol/Ls and my HDL was normal it was LDLs that were above normal (4.41) . I must say I am pleased with the results. Not a dramatic decrease in LDL's, but in the normal range. I see that my alanine aminotransferase (ALT) has risen from 13 U/L to 17 U/L. My Dr said that was nothing to worry about as it's still well within the normal range. Other than that, no other issues.
I have attached a study on Statins and Liver Injury for those interested.

https://pmc.ncbi.nlm.nih.gov/articles/PMC3983981/
 
There are alternatives to statins I take a low dose of Ezetimibe which dropped my cholesterol quite nicely and I have no side effects

www.bhf.org.uk

4 statin alternatives that lower cholesterol

Find out how well alternatives to statins like bempedoic acid work and who can be prescribed them under NHS rules.
www.bhf.org.uk www.bhf.org.uk
 
I’ve been on statins as long as I can remember I get total blood test every month due to dialysis treatment no problems recorded
 
That's interesting @Usethetaff - the clinical guidelines post 2013 actually call for not starting statins in the event of dialysis being necessary, however to continue if a patient is already taking statins. The actual phrase in use is "given the lack of clinical benefit for lipid reduction reported in large clinical trials." -

so I don't fall foul of the forum rules:
 
Beechnut said:
Haha yes but GP is threatening other meds instead of Atorvastatin to lower my cholesterol because he says that takes priority over my liver! I'm very wary of taking anything that messes with my liver but it's hard to know which is the most important experts do not always agree on this. I'm hoping new low carb diet will help with future results but again so many say all that fat is not going to lower your cholesterol. Hey ho
Click to expand...
I know exactly how yu feel about drugs messing with your liver. At the moment I’m fighting off the very determined surgery pharmacist who wants me to take statins. I took them many years ago before the side effects were known about. After a very short time I could barely walk - and I am someone who walks miles. I also felt really depressed which I eventually found was another side effect. I stopped taking the statins but I am also in the process of avoiding taking statins or ezitembe or any of the other drugs she is determined I take. I had a year of very, very bad eating before I had my last HbA1c and cholesterol tests done so I wasn’t surprised my results were awful. To be honest it was a miracle that I was still in the pre diabetic range.

Following my discussion with the pharmacist I got a call to go for a cholesterol retest a few weeks ago, then this morning I got a text to book for an HbA1c but as I was told to book for a fasting blood test I can only assume that is so that they can get a cholesterol test done as well because I don’t think an HbA1c needs to be fasting. I feel annoyed that when I had my last bloods taken they didn’t stipulate fasting knowing even though they knew I would be having a cholesterol test. I am 77 and I don’t want to take statins for lots of reasons and I certainly don’t want to take any sort of drug that could remotely spike my blood sugar levels where I could end up diabetic.

I hope you get on well with your low carb diet and manage to avoid statins.

Can I also add that my bio has me as T2D but I am not (and can’t figure out how to change it). I had steroid induced T2D for a few months but I discovered Dr David Cavan’s wonderful book on how to reverse T2 - basically a low carb diet so hopefully yours will work for you.
 
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I have never been advised to fast before the test, though I should have been. Nor have I had my liver function tested, though it should have been because I have to take a lot of meds. I also take a herbal supplement to support liver function. No doubt I would be told not to take that either, but I've never been asked. It would be good to be treated as a complete unit, not a series of illnesses.
 
@Lizzie2 I feel for you and also like you don't understand the push It's a bit of a minefield. I've just had my annual results back after reluctantly starting ezetimibe ( statin intolerant) and although I continue in remission from diabetes my liver ALT levels have gone up four fold - despite never ever been raised in the past! I'm due a telephone review on Thursday but have made my own decision to stop them meanwhile! I also have had gut issues since taking them. Ironically they haven't reduced my cholesterol that much ! We are all different in our reactions but side effects need to be in line with the benefits! I'm not looking forward to tomorrow........
 
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Thanks Lizzie2. I've never been told to fast before a test so not sure about that.

Shelley262 looking at the article link sent by Melgar only 3%of us get this reaction to statins but my GP certainly thought my high liver enzyme count was significant enough to warrant a liver scan which I'm pleased to say came back negative. My enzyme levels have come down all except ALT level but even that is now only slightly above normal.

Thanks for that article link Melgar some doctors seem to treat the alarmingly high liver enzymes as a temporary "adaptive" phase but obviously my GP was more cautious and took me off statins immediately. My LDL is still higher than it should be but GP seems happy to leave it without treatment.
 
@Beechnut
my two cents worth:
Statins are more controversial than medical establishment admits.
If I am not mistaken, GPs get credits for subscribing these, @KennyA can you confirm or otherwise please.
People with a history of Cardiovascular problems take them for good reasons.
All diabetics over 50 seem to be advised to take statins, independent of any other criteria,
Event without T2D, once you turn 65 (male) or 70 (female), GPs will tell you that your QRISK3 score is higher than 10%, which it will be as age is one of the major input in this; and wants to put you on statins.

Personally, after my T2D diagnosis, I was regularly advised to take them, but I refused.
Now that I managed to reduce my Hb1AC by changing diet and losing weight,
my cholesterol, HDL, LDL and TRIG numbers improved to such extent that I haven;t been asked anymore.

While HbA1c testing does not need you to fast, most other tests do.
I always go without eating or drinking for my blood tests,
as I want to compare measurements, e.g. Cholesterol, which are taken under the same conditions.
 
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Lupf said:
@Beechnut
my two cents worth:
Statins are more controversial than medical establishment admits.
If I am not mistaken, GPs get credits for subscribing these, @KennyA can you confirm or otherwise please.
People with a history of Cardiovascular problems take them for good reasons.
All diabetics over 50 seem to be advised to take statins, independent of any other criteria,
Event without T2D, once you turn 65 (male) or 70 (female), GPs will tell you that your QRISK3 score is higher than 10%, which it will be as age is one of the major input in this; and wants to put you on statins.

Personally, after my T2D diagnosis, I was regularly advised to take them, but I refused.
Now that I managed to reduce my Hb1AC by changing diet and losing weight,
my cholesterol, HDL, LDL and TRIG numbers improved to such extent that I haven;t been asked anymore.

While HbA1c testing does not need you to fast, most other tests do.
I always go without eating or drinking for my blood tests,
as I want to compare measurements, e.g. Cholesterol, which are taken under the same conditions.
Click to expand...
Here's a link to the Quality and Outcomes Framework guidance for 26/27.


As an example, there's a relevant section at 3.4 on page 28 of the document.

Percentage of patients on the QOF Coronary Heart Disease, Peripheral Arterial Disease, Stroke/TIA or Chronic KidneyDisease Register who are currently prescribed a statin, or where a statin is declined or clinically unsuitable, another lipid-lowering therapy.

Thresholds 70-95% (ie first points gained when 70% of the relevant patient cohort (people who already have a heart disease etc) is prescribed a statin (etc), maximum points when 95% of the cohort is prescribed. This is worth a maximum 20 points, and each point is worth £227.95 in 26/27. This is a reduction from the 38 points that were available last year. NHS England say that the reason for the reduction is to encourage a focus on continuing treatment, rather than just rewarding writing the original prescription.

It's not the only one. There are also (for example) two statin-related objectives in the diabetes section worth eight points each. I can't say for sure without combing through this year's guidance whether there are/ are not others.

Although this below is based on last years QOF, it's an interesting read from the point of view of practice managers.

www.mypracticemanager.co.uk

QOF Cardiovascular Disease Business Rules Guidance for 2025/26

2025/26 GP Contract invests big in CVD prevention—focusing on tight BP/lipid control, robust QOF performance, and streamlined practice strategies.
www.mypracticemanager.co.uk www.mypracticemanager.co.uk

My personal view is that the QOF rewards doctor activity - measuring, recording, and prescribing. It doesn't reward achieving good patient outcomes, but assumes that having all GPs following the NICE recommendations is enough.
 
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