Statins - how long does one pill last?

[LittleGreyCat]

About to go for my bloods for my annual MOT.

One of the tests will be for cholesterol.

Now I am on a LCHF diet so I normally load up with protein and fats in the morning for breakfast which presumably loads up my bloodstream with digestive products, including cholesterol.

I read in the Symvastatin blurb

It is recommended that Simvastatin Tablets are taken in the evening, or at night, so that they will be working when the body is producing the most cholesterol.

Now I am on Pravasatin but the routine is the same - take with evening meal.

It is the "working when the body is producing most cholesterol" that interest me.
This implies two things
(1) It is expected that you will be producing most cholesterol in the evening/overnight.
(2) That the statin is not fully effective for the wholoe 24 hour period between doses.

Is this in effect saying that cholesterol production is not tied directly to your main meal, or is it based on the assumption that traditionally the evening meal is the main meal of the day followed generally by low activity and then sleep?

[Google and Wikipedia are not being my friends at the moment.
I think I will ask about cholesterol production and absorption in another post!]

So my main questions are:
(1) If you eat most of your high protein/high fat food in the morning, is this when you should take your statin?
(2) If the statin is not effective over the whole 24 hours then why not take a split dose, morning and evening?

Off now to spruce myself up for my pet vampire - have a wash, that sort of stuff

Cheers

LGC

 

[viviennem]

I can't help with cholesterol production, LGC, but I have heard it's lower in a fasting test anyway.

I tried to avoid fat for the 24 hours previous to my last one, having heard that some of the cholesterol in your blood is from your meals immediately before the test. Not easy on my diet! I've also heard 'don't drink alcohol' the night before because it increases your triglycerides.

My last one was certainly better than the one before Christmas, across the whole profile. But whether that was because of the previous 24 hours or because I'd been very good for the previous month :angel: I don't know!

Also before the last one I'd had a chest infection and a raging tooth abcess, so what with 3 courses of antibiotics ( of which 2 courses were with 2 different antibiotics), and had just the offending tooth out, so that review was all over the place!

Hope it all works out for you!

Viv 8)

 

[phoenix]

When is cholesterol made?
This paper was cited as evidence for the night time synthesis of cholesterol on GP notebook (won't link as you only get so many 'free looks' in a period.)
http://www.jlr.org/content/31/4/667.full.pdf+html
This is what I understand they did and found but the detail is beyond me.
6 subjects in a metabolic lab
self-select breakfast between 08:OO and 09:OO h,
lunch between 12:OO and 13:OO h, and
supper between 18:OO and 19:OO h.
no foods except water after 19:OO h
They used doubly labelled water ( Deuterium-labeled drinking water) for tracing food absorption/ cholesterol formation . There found a diurnal cycle with far less cholesterol being made during the day than at night.
Apparently other animals also have diurnal patterns in cholesterol formation. In those studied (I noticed rats and guinea pigs) The time of synthesis was directly affected by feeding times "maximum formation occurs during periods of food intake and activity "
This was not the case in these human subjects ; cholesterol synthesis took time, "peak production lagging almost almost 12 h after the last meal .'' (
The researchers say the study confirms the circadian periodicity in cholesterol synthesis previously reported in other studies.(so there is other evidence available)

When to take Statins
http://www.ncbi.nlm.nih.gov/pubmed/17200427
A review of seven studies comparing morning and evening dosing found:
Simvastatin: that there was good evidence to suggest that it was taken in the evening for best effect.
Lovastatin, Pravastatin, and Rosuvastatin. there was a trend to suggest it was better at night but this was non significant.
Atorvastatin demonstrated similar LDL-C reduction regardless of administration time
The authors of the review noted that except for SImvastatin some of the trials had
'several significant methodologic shortcomings'
So only for Simvastatin is their good evidence that it is best to take it at night.

How long do statins last in the body?
Half livesie the time that it takes for it to lose half it's pharmacological activity.)... again from the GP notebook site. don't jump to the conclusion a full life is double
http://en.wikipedia.org/wiki/Half-life
simvastatin < 5 hours
atorvastatin 14 hours
rosuvastatin 19 hours
pravastatin 22 hours
atorvastatin has active metabolites with half-lives ranging from 20 to 30 hours
As you can see the half life of simvastatin is much shorter which may be the reason it works better taken in the evening.

 

[noblehead]

or is it based on the assumption that traditionally the evening meal is the main meal of the day followed generally by low activity and then sleep?

I have no idea of the answer LGC but would assume the above may be applicable. My mother is on a fistful of pills....bp, angina, statin to name a few and she was advised to take these last thing at night.

Edit, just seen Phoenix excellent reply which gives a full explanation.

 

[LittleGreyCat]

Phoenix - wonderful reply.
Explains a great deal