So, before we break down some of those myths, I guess the first question is why is there so much negativity about them? Well, you know, I think there's a lot of misinformation out there on the Internet. And people are really confused about what's true, what's a myth.
And then they don't necessarily speak to their doctors about these questions all the time. So, I think that it's really important to get the facts straight. Now, I do think there is, you know, generally a low desire to take medications long-term in most people. And also, I've heard, you know, because the medicine doesn't make you feel any differently, why should I take it?
Many people have that myth. And the other thing is that a lot of people think that once your cholesterol is better on a statin that you can stop taking the statin. Unfortunately, what happens is your cholesterol will go right back to where it was previously in many situations.
And perhaps the biggest myth of all is that they don't even work in the first place when it comes to preventing heart attacks. So, obviously, Doctor, you disagree. But what is the science behind that disagreement? We do know over decades of research that statins and other lipid lowering therapies are very effective in reducing the risk for major vascular events, such as death from cardiovascular causes, myocardial infarction, which is heart attack, stroke, or needing a coronary stent or bypass surgery.
We have data now from over 20 statin trials of over , patients that show that statins compared with placebo or no medication result in a 23 percent reduction in heart attacks, 17 percent reduction in fatal or non-fatal stroke, 19 percent reduction in death from cardiovascular causes and a 12 percent reduction in all-cause mortality.
So, they definitely work. They're definitely effective for heart disease and death. And those are data that have been around forever. And I think that myth should definitely be dispelled. So, it sounds like someone with higher cholesterol, for example, my cholesterol is around , That's considered high. So, you know, there's a lot of other stuff out there, right? Like statins cause dementia, or maybe people with a family history of dementia should avoid taking statins.
Are there people who shouldn't be, who have high cholesterol and then who shouldn't be taking statins? You know, certainly if you're allergic to the statin or the components of the statin medication, that will be a situation which you would want to choose an alternative medication. You mentioned about memory or dementia. Well, you know, the truth is that memory issues tend to occur in the same age group in people that take statins.
So, it's really difficult to know if it's the statin or it's other factors. The initial concerns about dementia came from self reports to the Food and Drug Administration, but it turned out that many reports where people who took the drug for really one day only. So, it's unlikely that drug had had any effect whatsoever. And we do know that we have more reliable data that come from other studies, including over 20, people taking statins. And the result of that is that there's really no effect of statins on thinking or memory issues.
And so, in general, although there are some potential side effects long-term for statins, in most cases, if your doctor has identified you as having high cholesterol and needing a statin, the risks greatly outweigh, or sorry, the benefits greatly outweigh the risks. It really amazes me how many people out there picking on statins based on what you're telling us right now. But the fact of the matter is they are.
I mean, we touched on this already. But I want to ask you again, Doctor, why is that? Why is there so much negative information out there? Well, I think, you know, a lot of people may have some questionable side effects that that come up when they start a statin, and they've heard, you know, negative reports or anecdotal information or stories from friends and family.
And a lot of times these are about muscle aches. So, you know, generally muscle aches are not dangerous and really there is only some discomfort. There are rare instances of severe muscle breakdown, could be dangerous for organs such as the kidneys, but these cases are extremely infrequent.
And I haven't even seen a case since medical school many years ago. Now, there's some fair evidence that repletion of vitamin D, thyroid regulation and perhaps the medicine Coenzyme Q may help decrease the muscle side effects of statins.
And it's certainly reasonable to try them, but we know that most of the supposed side effects of statins are actually not due to statins. So, in one recent study published in the New England Journal of Medicine just this past month showed that in patients who had discontinued statin therapy because of reported side effects, in truth, 90 percent of the symptom burden elicited by a statin challenge was also elicited by placebo.
So, most of the people who reported a symptom on statin of a side effect had the same side effect on placebo. And half of the trial patients were able to successfully restart their statins. So, these data really show that although there are side effects, they're very infrequent as being truly related to the statin, and most people can get through them and be on some dose of a statin for long-term benefit,.
Like many things in medicine, the benefits far outweigh the risk. And it sounds like that's true here as well. You mentioned a moment ago, you talked about potential long-term side effects of statins. What are those? Like what are the… You talk about a lot of the myths that are out there, but are there actual side effects that, whether they should be concerning or not, what are they?
You know, so, just like any medication, as I mentioned, you have to weigh the potential risk to the benefits. I had mentioned that the one side effect will be muscle aches.
Safety and efficacy of statin therapy. Nature Reviews — Cardiology. High blood cholesterol. National Heart, Lung, and Blood Institute. Listen to your heart: Learn about heart disease. Grundy SM, et al. Journal of the American College of Cardiology. Thanassoulis G, et al. A long-term benefit approach vs standard risk-based approaches for statin eligibility in primary prevention. JAMA Cardiology. Statin intolerance. Mayo Clinic; Lopez-Jimenez F expert opinion. Mayo Clinic. See also After a flood, are food and medicines safe to use?
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Hypothyroidism: Can calcium supplements interfere with treatment? Hypothyroidism diet Hypothyroidism and joint pain? Hypothyroidism: Should I take iodine supplements? Hypothyroidism symptoms: Can hypothyroidism cause eye problems? The guidelines are clear about which groups of people could benefit most from therapy — both medications like statins and lifestyle changes like eating better and exercising more — but in the fourth group, the guidelines leave room for doctors and patients decide together how best to lower cholesterol levels.
Of course, that is the very nature of guidelines, something that has been lost in the media shuffle over the past year. Another aspect of the guidelines that has created some confusion is the belief that, because there are no more LDL targets, doctors no longer need to do ongoing monitoring of LDL blood levels after a patient starts taking a statin. This is not the case. And the goal is to maintain the optimal intensity of proven therapy in order to keep LDL lower in groups that are shown to benefit.
Hitting the LDL target was just one reason for monitoring. Some patients may not respond well to statins or they may have bad side effects. Eating well and exercising have always been part of maintaining healthy cholesterol levels. However, because the new guidelines go into such depth about the use of statins to control cholesterol, some people feel that discussions about lifestyle have fallen by the wayside. The guidelines include therapies supported by many doctors.
In an attempt to address rising rates of heart disease, the new guideline identifies groups that would benefit most from cholesterol-lowering drugs…. Statins are a common treatment for high cholesterol. Learn about the latest FDA guidelines and recommendations about the use of statins for this….
Researchers say the benefits of cholesterol-lowering statins don't necessarily justify the side effects in some groups of people. As with any medication, a person should take it according to their prescription. They should also tell a doctor if they notice any side effects. Fasting before taking a cholesterol test used to be standard practice. Now, some doctors recommend that people do not fast before taking the test….
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